Blood in semen

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at December 9, 2015
StartSymptomsBlood in semen

Any man would be worried to see blood in their semen; it's not the place one would expect to see blood. However, for most men, it does not signal any sort of major medical problem or issue. In fact, most incidents of blood appearing in the semen usually resolve without any medical attention. However, in some cases, especially in men over the age of 40, it could be a sign of a serious underlying condition, especially if there are other symptoms present.


Definition & Facts

Semen is a mixture of sperm and fluid that is released by the prostate and other glands during ejaculation. The fluids, or ejaculate, mixes with the sperm while passing through series of tubes leading to the urethra.

The actual term for blood in semen is called hematospermia or hemospermia. It's thought to be relatively common, but since men don't typically spend time examining their ejaculate, it's not known how common this actually is.


Blood in the semen occurs when any number of things breaks blood vessels in any of the ducts, glands, or tubes that produce and move the semen out of the body. This includes the prostate, urethra, epididymis and the seminal vesicles. There are many things that can cause blood vessels to burst. Of course, any trauma to the sex organs can cause blood in semen.

This includes pelvic fracture, testicle injuries, or even excessive, vigorous sexual activity or masturbation. Certain medical procedures can also cause blood in semen; in fact, four out of five men may experience blood in their semen after a prostate biopsy. Other procedures that can cause this include vasectomy, hemorrhoid injections, and radiation therapy for cancer treatment, specifically external beam radiation for prostate cancer.

Blood can also be caused by a sexually transmitted infection, such as gonorrhea or chlamydia. Other bacterial infections may also cause blood. These infections can trigger inflammation, which causes bleeding. There could also be some sort of obstruction causing the bleeding; obstructions are commonly caused by enlarged prostate, which pinches and blocks some of these tubes or ducts.

Bleeding can also be caused by tumors or polyps, or medical conditions such as HIV, liver disease, high blood pressure, genital herpes, prostatitis, hemophilia or leukemia. In very rare cases, blood in the semen can be caused by amyloidosis, tuberculosis, and testicular cancer. Some medications such as Warfarin may even cause blood in semen. However, there are times when blood appears in the semen without any noticeable cause.

When to see a doctor

If a man is under the age of 40 and notices blood in his semen, there is most likely nothing to worry about, especially if there are no other symptoms. If there has been a recent medical procedure or injury, or if there is not much blood and the occurrence is rare, there is no need to see a doctor.

For some men, blood may appear in the semen for a few weeks after a procedure such a a prostate biopsy. However, in some cases, it is a good idea to see a doctor, especially for men over the age of 40. If the blood is present for more then 3-4 weeks, or occurs frequently, it's a good idea to make an appointment.

Other symptoms to look out for include blood in the urine, painful urination, painful ejaculation, fever, or other discharge from the penis, among other symptoms. If there are risk factors, such as bleeding disorders or a history of cancer, or if there has been recent possible exposure to sexually transmitted disease, than making an appointment with a doctor would be wise.

Treatment & Therapy

Treatment for blood in semen will depend on what is causing it. Most cases will resolve on their own. Diagnosing the reason for blood in semen will involve a complete medical exam and discussing any recent sexual activity. There will also be a physical exam, in which the doctor will examine the genitals for any injury, lumps, swelling or tenderness, and may perform a rectal examination.

There may also be a urinalysis or testing for sexually transmitted disease or prostate cancer. If necessary, there may also be ultrasounds or other urological tests to determine the cause of bleeding. Treating the cause of the bleeding will help stop the symptoms. If the blood is a result of a reaction from medications, those may be stopped.

Antibiotics will be given for any infections, and anti-inflammatory medication given to reduce inflammation, if present. If there is an STD or any other medical condition that is causing the bleeding, the doctor will treat those issues.

Prevention & Prophylaxis

When it comes to preventing the occurrence of blood in semen, the only ways are to try and prevent anything that can cause it. Of course, in the random cases where cause can't be determined, and it goes away on it's own, there is not much that can be done to prevent this. However, since blood in semen could result from things like infection or sexually transmitted diseases, then it's logical to do whatever it takes to avoid these things.

Always urinate when the urge comes; holding in urine can cause bacteria to build up in the urine, which can cause infection. Practice safe sex; choose partners wisely and always use a condom. If there is any signal that something may be wrong, seek out a doctor immediately. For most things, including things such as prostate cancer, the earlier the detection, the better the chances of healing and overcoming the issue. Be careful when engaging in sexual activities, avoiding any vigorous methods that may lead to injury which could cause bleeding.

If participating in sports or any other physical activity, always make sure to wear a cup to avoid any injury to the genitals, which could lead to blood in semen. Of course, if there is any medical condition that is causing blood to appear in the semen, follow all orders given by doctors and take all medication to maintain or avoid symptoms. Again, most cases of blood in the semen will resolve on it's own.

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