What is hematospermia (blood in the semen)?
Hematospermia (also called hemospermia) is the presence of blood in the semen. Hematospermia may naturally cause concern for men who experience it. However, it is not likely to be a sign of a major health problem.
Is hematospermia a common condition in men?
It is unclear how common hematospermia is because men usually do not examine their semen after ejaculation.
Hematospermia can affect men of any age, but it is more common in men aged 30 to 40.
Symptoms and Causes
What are the causes of hematospermia?
The most likely cause of hematospermia is a seminal tract infection or inflammation. Less likely causes may include:
- Sexually transmitted infections (STI), such as gonorrhea, chlamydia, or a viral or bacterial infection
- Blood disorders, such as clotting disorders or sickle cell disease
- Recent medical procedures, such as vasectomy, prostate biopsy, or cystoscopy
- Tumors (cancerous) and polyps (non-cancerous or benign growths)
- Testicular or prostate cancer (rare)
- Other medical problems, such as high blood pressure, human immunodeficiency virus (HIV), liver diseases, and leukemia (blood cancer)
What are the symptoms that can be associated with hematospermia?
- Blood in urine (hematuria)
- Burning sensation when urinating
- Trouble emptying a bloated bladder completely
- Pain in the bladder
- Painful ejaculation
- Discharge from the penis or signs of a sexually transmitted disease (STD)
- Fever, higher-than-normal blood pressure, and rapid heart rate
Diagnosis and Tests
How is hematospermia diagnosed?
Your doctor will do the following:
- Take a full history, including questions about your current symptoms, recent sexual activities, and any medicine you take
- Physical exam to check for lumps or swelling in the genitals
- Rectal exam to check the prostate for swelling, tenderness, etc.
- Check your blood pressure
- Blood test to measure kidney function, prostate-specific antigen (PSA), etc.
- Urine culture (urinalysis) to check for infections or abnormalities
- STD test to detect any sexually-transmitted disease
- PSA test to check for prostate cancer
The evaluation and tests above may not show the cause of hematospermia. Your doctor may refer you to a urologist (a doctor who specializes in the urinary tract and male reproductive organs) to do some or all of the following tests:
- Cystoscopy (a thin tube with a camera is inserted through the urethra into the bladder to see the inside of the bladder)
- Computed tomography (CT-scan)
- Magnetic resonance imaging (MRI)
Management and Treatment
How is hematospermia treated?
If you are under the age of 40, have no urinary tract symptoms, and no risk factors for other medical conditions, the blood in your semen will disappear on its own.
However, your doctor will treat your condition if you:
- Are over the age of 45
- Repeatedly have blood in the semen
- Have other urinary/ejaculation related symptoms
- Have a bleeding disorder or other medical condition
Although treatment depends on determining the cause(s) of hematospermia, it may include taking:
- Antibiotics if you have an infection
- Anti-inflammatory drugs
- Medicines to treat other medical conditions, such as high blood pressure, liver disease, or sexually transmitted disease/infection
In general, hematospermia in healthy young men goes away by itself.