Seeing blood in the semen can make a man anxious. Fortunately, it doesn't always signal a major medical problem. For men younger than 40 with no related symptoms and no risk factors for underlying medical conditions, blood in semen often disappears on its own. But for men 40 and over, chances are higher that blood in the semen needs evaluation and treatment. This is especially true for men who:
- Have repeated episodes of blood in the semen
- Have related symptoms while urinating or ejaculating
- Are at risk for cancer, a bleeding disorder, or other conditions
Blood in the semen is called hematospermia or hemospermia. When men ejaculate, they typically don't examine their semen looking for blood. So it’s not known how common the condition is.
Causes
Blood in the semen can come from several different sources:
- Infection and inflammation. This is the most common cause of blood in the semen. Blood can come from an infection or inflammation, in any of the glands, tubes, or ducts that produce and move semen from the body. These include:
- Prostate (the gland that produces the fluid part of semen)
- Urethra (the tube that carries urine and semen from the penis)
- Epididymis and vas deferens (tiny tube-like structures where sperm mature before ejaculation)
- Seminal vesicles (which add more fluid to the semen)
- It can also come from an STI (sexually transmitted infection) such as gonorrhea or chlamydia, or from another viral or bacterial infection. Infection and inflammation are the culprits behind nearly four out of every ten cases of blood in the semen.
- Trauma or a medical procedure. Blood in the semen is common after medical procedures. For instance, as many as four out of five men may temporarily have blood in their semen following a prostate biopsy.
Procedures done as treatment for urinary problems can also cause mild trauma that leads to temporary bleeding. This usually disappears within several weeks after the procedure. Radiation therapy, vasectomy, and injections for hemorrhoids can also cause blood. Physical trauma to the sex organs after pelvic fracture, injury to the testicles, excessively rigorous sexual activity or masturbation, or other injury can cause blood in the semen.
Symptoms
When looking for an underlying cause of blood in the semen, the doctor will ask about any related symptoms, including:
- Blood in the urine (called hematuria)
- Hot, burning urination or other symptoms of painful urination
- Difficulty emptying your bladder completely
- A painful bladder that feels distended
- Painful ejaculation
- Swollen or painful areas on the sex organs or obvious scrapes from injury
- Penis discharge or other signs of an STD
- Fever, racing pulse, and higher-than-normal blood pressure
Treatment
In younger men, blood in the semen that happens just once or twice without any additional symptoms or history of certain medical conditions can disappear on its own without treatment. If you have repeated episodes of blood in the semen along with painful urinary or ejaculatory symptoms, the doctor may refer you to a urologist.
If the doctor suspects prostate cancer, or another form of cancer, the doctor may ask for a prostate biopsy to evaluate the tissue for cancer. The incidence of prostate cancer is low in younger men -- only 0.6% to 0.5% of cases occur in men younger than 45. But for men of any age with risk factors for cancer, testing that rules out prostate cancer may be the most reassuring part of treatment for blood in semen.
