Blood in Semen

image: blood in semen no other symptoms

image: blood in semen no other symptoms

What is it?

Blood in semen (hematospermia) can be frightening, however the cause of this unusual condition is generally benign. Typically, blood in semen goes away on its own.

Blood in Semen: Causes

Semen consists of sperm and fluids launched by the prostate and other glands. The fluids, likewise called ejaculate, join the sperm as they travel through a series of tubes to the urethra for ejaculation. A variety of things can break capillary along this path or along the urinary path to the urethra. Broken vessels then leak blood into the semen, urine or both.

Your doctor will ask if you’ve had prostate surgery or a prostate biopsy recently, since these treatments can cause blood in semen for a number of weeks later.

Frequently, no cause can be found for blood in semen. In some cases, especially among men under age 40, infection is a possible cause. Infection is normally associateded with by other symptoms and signs, such as painful urination.

For men age 40 and older, or if the blood in semen is severe or reoccurring, in rare cases this might be a warning sign for conditions such as cancer. As a result, a more-careful examination might be required. However the risk is low. In a follow-up study of 200 men, primarily over 40, who typically had numerous episodes of blood in their semen, prostate cancer established in just 4 percent.

Possible causes of blood in semen:

  • Brachytherapy
  • Chlamydia
  • Epididymitis
  • Extreme sex or masturbation
  • External beam radiation for prostate cancer
  • Genital herpes
  • Forgotten (retained) tampon
  • Hemophilia
  • Interrupted sex
  • Orchitis
  • Extended sexual abstaining
  • Prostate biopsy
  • Prostate cancer
  • Prostatitis
  • Testicular injury
  • Vasectomy

Uncommon causes of blood in semen:

  • Amyloidosis
  • Benign developments (cysts, polyps) in the bladder, urethra or prostate
  • Schistosomiasis
  • Testicular cancer
  • Tuberculosis
  • Warfarin side effects

Causes shown here are commonly associated with this symptom. Work with your doctor or other healthcare specialist for an accurate diagnosis.

The male reproductive system is made up of the testes, a system of ducts (tubes) and other glands that open into the ducts. Sperm are made in the testes. At orgasm, waves of contraction transfer the sperm, with a small amount of fluid, from the testes through to the vas deferens. The influential blisters and prostate contribute additional fluid to protect the sperm. This mix of sperm and fluid (semen) travels along the urethra to the tip of the penis where it is ejaculated (released). Bleeding can occur anywhere along the way.

Blood in semen may be brought on by swelling, infection, clog, or injury anywhere along the male reproductive system. As the seminal vesicles (a pair of pouch-like glands located on either side of the bladder) and the prostate are the main organs that contribute the fluid to the sperm, an infection, inflammation or injury in either of these organs can cause blood in the semen.

Blood can be found in semen as a symptom on its own (primary haematospermia) or connected to other symptoms (secondary haematospermia).

Can blood in semen be brought on by injuries or rough sex?

Blood in the semen can be discovered during/after sex, but rough sex is not the cause of the bleeding. Severe injury to the genital/urinary tract can cause blood from the urethra but this is different to haematospermia.

Can blood in semen be brought on by sexually transferred infections?

Blood in semen is extremely not likely to be triggered by any sexually transmitted infection (STI). Some STIs can be sent through blood and semen, but they do not normally cause blood to appear in semen.

What is primary haematospermia?

Primary haematospermia is when blood in the semen is the only symptom. No blood is discovered in the urine, and a physical examination does not discover other problems. If there is blood in semen however no other symptoms, it is common for no cause to be found.

What is secondary haemotaspermia?

Secondary haematospermia is when there is a thought or understood cause for the bleeding, such as after a prostate biopsy or a urinary or prostate infection or, in unusual cases, if cancer exists. Blood in semen can also occur in men over 50 years of age with benign prostate augmentation (BPH) with calcifications (deposits of calcium) that can be seen on ultrasound.

In extremely uncommon cases, secondary haematospermia can be caused by tuberculosis, parasitic infections, or any illness that affect blood clot such as haemophilia and chronic liver disease, and some medications that thin the blood.

An ultrasound-guided biopsy of the prostate can cause blood in semen in about one third of men. It is very unusual for cancer of the testes to be linked with blood in semen.

Prostate cancer can cause blood in semen; nevertheless, most men with prostate cancer do not have this symptom unless they have had a prostate biopsy that has actually triggered the blood.

When to see a doctor

If you’re under age 40 and see blood in semen, you most likely don’t need to see the doctor as long as:

  • You have no other symptoms
  • You’ve had a current prostate exam or birth control, which could discuss short-term bleeding
  • There isn’t really a lot of blood in the semen and it takes place infrequently, then goes away

Make a visit with your doctor if:

  • You’re 40 or older
  • Blood in semen persists longer than three to 4 weeks
  • The blood consistently repeats
  • You have other symptoms and signs, such as painful urination
  • You have other risk factors, such as a history of cancer, bleeding disorders or genital or urinary system malformation, or you’ve recently participated in habits that put you at risk of sexually transmitted infections


Last modified: August 12, 2016


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