Blood in Semen - Hemospermia - Causes & Treatments

Blood in Semen


It is terrifying for a man of childbearing age to see blood in his semen after ejaculation!

The blood can be of a pink, red or brown color.

Many men who are very concerned by this phenomenon believe they have testicular cancer or something very serious. Fortunately, this is rarely the case. This is what we will discover in this article.

In medical terms, the presence of blood in the semen (red sperm) is called a hemospermia or hematospermia (Greek hemo- or hemato- meaning ‘blood’ and spermie meaning ‘seed’).

What Are The Causes Of Blood In Semen ?


The presence of blood in the semen is a condition that can be caused by small hemorrhages that occur in the male genito-urinary system. The areas affected may be : the bladder, urethra, testis, seminal vesicles, epididymis and prostate (or prostate gland).


Hematospermia is relatively frequent in the aftermath of a biopsy of the prostate gland. Over 80 % of men who undergo a prostate biopsy (to detect a possible cancer) find blood in semen for a period of three to four weeks after surgery.


In the same way, a vasectomy (sterilization of the vas deferens by surgical ligation) can lead to the appearance of red sperm or bloody semen for about a week after the procedure.


What about men who have not recently undergone a biopsy of the prostate gland or vasectomy and have a hemospermia ? The cause may be related to a benign or malignant tumor (in 5-10 % of cases) of the male genital system.

Be aware that in many cases, no cause is identified. Bleeding in the genito-urinary system may be caused by an injury so insignificant (a rupture of small blood vessels) that no review can highlight it. In this case, we are speaking of idiopathic hemospermia, a troublesome symptom which may disappear spontaneously or persist for months in some people.


Here is a list (which is not exhaustive) of diseases associated with hematospermia :


• An accident which has affected the groin(e.g. falling on the bar of the bicycle)

• Inflammation of the prostate (prostatitis), epididymis (epididymitis) or urethra (urethritis)

• infections (chlamydia, herpes, cytomegalovirus, trichomoniasis , etc.).

• Stones (similar to kidney stones) in the seminal vesicles and prostate

• Polyps in the urethra

• Obstruction of the ejaculatory ducts or channels

• benign tumors (e.g. adenoma or benign prostatic hypertrophy) or malignant prostate, bladder, testicular or the seminal vesicles

• Metastatic cancer that has spread to an organ of the human body in the genito-urinary system

• Cysts, benign bleeding or other abnormalities in the seminal vesicles.

Warning! If after having unprotected sex, you observe blood mixed with sperm in the glands or penis, check properly where the blood comes from! It may very well come from your partner!


What Are The Symptoms Of Hemospermia ?


The symptoms that accompany the presence of blood in the semen may be one or more of the following according to the etiological origin:

• Pain with urination

• Painful ejaculation

• Blood in the urine (spermaturia)

• Pain in the lower back

• Fever

• Sensitivity in the testes and/or the scrotum

• Swelling of the testicles and/or the scrotum

• Swelling or tenderness in the groin area

Blood In Semen – Tests and Diagnosis


A number of tests can be performed after a medical consultation. The most common tests include urinalysis: a urinalysis (Urine culture) to possibly diagnose acute prostatitis, identify a sexually transmitted infection or another type of infection.


When indicated, and when the patient is more than 45/50 years old, more research is needed. An endorectal ultrasound or MRI can reveal tumors or other abnormalities. In some cases, a semen analysis may be recommended (semen culture).


How Is Hemospermia Treated ? – Semen In Blood Treatment


The treatment of hemospermia is directly related to the underlying cause, if it has been identified of course. Sometimes the doctor prescribes antibiotics for a presumptive diagnosis of prostatitis (inflammation of the prostate gland). In fact, we now know that one man in four with a hemospermia suffers from prostatitis. However, the therapeutic benefits of such treatment (antibiotics) have not been clearly established.


In many cases, if the presence of blood in the semen is not associated with a known abnormality or worrying symptoms, no treatment is given, because the symptoms often disappear without a specific remedy. Most cases of hematospermia are benign and disappear without treatment. When symptoms persist, abstinence for several weeks is generally recommended.

Cancer is fortunately a rare cause of the presence of blood in the semen. The majority of cases are not associated with cancer, particularly among young men.


In this section, we cannot discuss further specific treatments (antibiotics, minor or major surgery, radiation or chemotherapy) for hemospermia, since they depend on the precise etiology or cause of symptoms.


When Should One See A Doctor ?


In the case of a young man in good health, the presence of blood in the semen is usually not a serious thing. This is something that happens to many men. It is important to consult a doctor if you notice blood in the semen and if you have pain in the anal area or penis.


Helpful Hint: Before consulting a doctor or a urologist, it is well to consider the following questions which you will likely ask yourself :

1) How much blood do I find in the ejaculation (discharge) ? Only traces, a little, or a lot ?

2) What color was the semen ? Rather pink, bright red or brownish ?

3) Is this the first time I see red sperm ? If not, how many times this has happened to me in the past ?

4) Do you have any idea of why hemospermia occurs ?

5) Have I noticed other symptoms or signs that could be associated with the presence of blood in the semen ?


Author : Alexis ROGER

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