Doctors call “hematospermia” blood in the body. Injuries, infections, prostate problems, and several other factors and conditions can cause blood to appear in the semen.
Although it may be disturbing, blood in the semen generally does not endanger life and does not necessarily mean that something is seriously wrong. In addition, there is no clear cause at all in many cases.
Continue reading to learn more about the semen’s blood causes and symptoms and how to treat the problem.
When blood is in the semen, the blood usually comes either from the prostate or from the seminal vesicles, which make up the majority of the semen.
However, a doctor is unable to identify the exact cause in at least 70 per cent of cases. If the bleeding occurs only once, the probability that there will be a serious underlying problem is very low.
The most frequent causes for such bleeding include:
Ruptured blood vessel
A prostate blood vessel or seminal vesicles may break in the course of sex or ejaculation. This is similar in that the nose bleeds after a sneeze. This may be more likely if the person is taking medicines that thin the blood.
A sudden gush of blood or bleeding may occur that lasts for several minutes, and then stops.
A ruptured blood vessel has some symptoms including:
- blood in the ejaculate
- red bleeding
- bleeding that appears
A ruptured blood vessel is generally not a major health concern. However, a blockage such as a cyst can sometimes put pressure on the blood vessels, causing them to rupture.
Having sex after long periods without it
Long periods of sexual abstinence can result in blood appearing in the semen.
A person may also note when this happens:
- bleeding during or after sex
- blood in the ejaculate
- a single episode of bleeding
- light bleeding for a day or two
In males under 40, the most common cause in blood to surface for the semen is an infection or associated inflammation.
The infection occurs in the urinary tract in many cases but it may also affect other regions, such as the prostate. This may occur due to infections typical of the urinary tract (UTIs) and sexually transmitted infections (STIs).
Individuals with an infection can note other symptoms including:
- pain or pressure when urinating
- painful sex or ejaculation
- swelling in the genital area
- a fever, or generally feeling sick
- frequent urination or difficulty emptying the bladder
Holding an urinary tract or genital injury may cause blood to appear in the semen.
Sometimes a minor injury— such as from vigorous sex — in the prostate or seminal vesicles breaks a blood vessel. When this happens a person may notice a sudden blood gush that will eventually go away on its own.
More serious injuries can lead to swelling, chronic bleeding and significant genital damage. When this happens, a person may notice bloody semen that either lasts a long time or follows an impact on the genitals, genital surgery, or falling.
Bloody semen can cause prostate problems. Prostatitis is one of the commonest problems.
A 2015 study of 37 males with bloody semen found that two-thirds had prostatitis of some form.
Prostatitis can be a chronic problem caused by inflammation or by an infection as a sudden problem. The person may, in either case, notice symptoms other than hematospermia including:
- blood in the urine
- painful urination
- painful sex
- a feeling of fullness or swelling in the rectum or genital area
Inflammation leads to pain and the swelling. This can sometimes happen alongside an infection, but it may also appear alone.
Prostatitis is one form of inflammation, but irritation can also cause blood to appear in the semen elsewhere in the genitals or urinary tract.
Inflammation in the epidididymis, which is the sperm-holding channel, can also cause blood to appear in the semen.
An person may also develop other symptoms, such as:
- pain when urinating
- pain in the penis or groin
- swelling and tenderness
A tumor can be causing blood in the semen on rare occasions. Prostate cancer would be the most likely tumor to do this.
A person can sometimes experience frequent bouts of hematospermia when this happens. We may also present with other symptoms, such as excessive urination or groin pain.
If blood appears in the semen only once or happens after an accident or a change in lifestyle, the cause is not likely to be a tumor.
Although less common, some other problems may be causing blood in the semen. Including:
- taking drugs that cause bleeding, such as warfarin
- high blood pressure
- liver disease
- an enlarged prostate
- ejaculatory duct obstruction
Anybody in the semen may produce blood, and doctors are often unable to determine a cause.
There are however certain risk factors that increase the probability of hematospermia. Including:
- having vigorous sex, especially after a long period of abstinence
- being over the age of 40
- having a history of prostate issues, including prostatitis
- having a family history of prostate disease
- having a urinary or genital infection
Assessment may usually include a doctor taking a medical history, such as inquiring about the sexual history of the person, doing a physical examination, and doing specified laboratory testing and imaging.
Tests may include:
- a digital rectal and prostate examination
- urinalysis and urine culture
- prostate-specific antigen blood test, to evaluate for prostate cancer
- semen analysis
- direct urethral visualization with cystoscopy
- prostate ultrasound imaging
- prostate MRI imaging
Bloody semen often does not require any treatment whatsoever.
When the male is under 40 and has few or no risk factors for cancer or other serious health problems, they may not need treatment for a single hematospermia instance.
However, if there is an infection or a blockage they may need treatment. Some treatment options possibly include:
- antibiotics, for bacterial prostatitis and UTIs
- anti-inflammatory medications, to treat inflammation
- surgery, to remove blockages or treat problems with blood vessels
- treatments for underlying conditions, such as STIs or chronic liver disease
- medication, chemotherapy, or surgery, for tumors and other forms of cancer
Some doctors can suggest antibiotics even in cases where they can not find an infection. Indeed, one 2014 study found that in 96 per cent of cases, a combination of antibiotics and an anti-inflammatory drug relieved symptoms.
When to see a doctor
A single blood incident in the semen isn’t an emergency. Nevertheless, it is perhaps better to see a doctor to rule out more serious causes.
Doing so takes prompt treatment of any underlying issues and can provide substantial reassurance when nothing is wrong.
You should also see a doctor for:
- recurring blood in the semen
- blood in the semen that gets worse with time
- pelvic pain
- urinary difficulties
- possible infertility
- swelling in the groin
- signs of prostatitis, such as frequently using the bathroom or trouble urinating
Noticing blood in the semen can be disturbing, but there’s nothing to think about for most males who experience this.
Even if there is a more serious problem, the search for and receipt of timely treatment will keep it from getting worse. Someone worried about blood in the semen should therefore talk to their doctor.