Blood in the semen, also called hermatospermia or hemospermia, is enough to make a man nervous, however, it doesn’t always signify a serious medical problem. Blood in semen often disappears on its own for men younger than 40 with no related symptoms.
But for men above 40, blood in the semen needs treatment, especially for men who have a bleeding disorder, cancer, or other related symptoms while urinating or ejaculating.
Causes of Blood in the Semen
Blood in the semen can come from several different sources:
1. Infection and inflammation
This is the most common cause of blood in the semen. Blood can come from an infection or inflammation in any of the tubes, glands, or ducts that produce and move semen from the body. These include:
- Prostate(the gland that produces the fluid part of semen)
- Seminal vesicles (responsible for adding more fluid to the semen)
- Urethra (the tube that carries urine and semen from the penis)
- Epididymis and vas deferens (tiny tube-like structures where sperm mature before ejaculation)
It can also come from an STI (sexually transmitted infection) such as gonorrhea or chlamydia, or from another viral or bacterial infection.
Blood vessels can break and release small amounts of blood in sperm when any of the tiny tubes or ducts in the reproductive tract is obstructed. The condition called BPH, which causes the prostate to become enlarged.
3. Trauma or a medical procedure
Blood in the semen is common after medical procedures such as prostrate biopsy, radiation therapy, hemorrhoid injections, and vasectomy. Procedures done as treatment for urinary problems can cause mild or temporary bleeding which usually disappears several weeks after the procedure. Other conditions that can cause blood to appear in urine include; physical trauma to the sex organs after pelvic fracture, injury to the testicles, rigorous sexual activity or masturbation.
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4. Tumors and Polyps
Benign growths in the reproductive tract called polyps, which causes no any medical problem, can cause blood in semen. Older men with risk factors for cancer should be evaluated if they have blood in their semen.
5. Blood vessel problems
The delicate blood vessels involved in ejaculation can become damaged resulting in blood in the semen.
Other medical conditions like HIV, leukemia, liver disease, high blood pressure, can also cause blood to appear in semen.
Related symptoms include:
- Hot, burning urination
- Blood in urine (hematuria)
- Difficulty emptying bladder completely
- A painful bladder that feels enlarged
- Painful ejaculation
- Racing pulse
- Swollen or painful areas on sex organs
- Penis discharge or other signs of an STD
Tests and Evaluation for Blood in Semen
The doctor may take a complete medical history to diagnose blood in the semen. A physical exam will be conducted on the male organ, including examining the genitals for lumps or swelling and a digital rectal exam to examine the prostate for swelling, tenderness, and other symptoms. The doctor may also ask for the following tests:
- Urine culture or urinalysis to identify infection or other abnormalities.
- STD testing if a sexually transmitted disease is suspected is suspected.
- PSA (prostrate-specific antigen) test, to check for prostate cancer in the blood.
- Cystoscopy, CT, MRI, or ultrasound may be conducted to assess the patient further.
- Condom test may be conducted where the man will wear a condom and the protected semen will be checked for blood to examine if the blood is actually coming from the partner’s menstrual cycle or from the semen.
Treatment for Blood in Semen
- Antibiotics may be administered for the infections.
- An anti-inflammatory drugs may be prescribed for some types of inflammation.
- When blood in semen comes from a recent urology procedure, it usually disappears by itself in a matter of weeks.
Blood in the semen that occurs in younger men, just once or twice without any additional symptoms can disappear on its own without treatment. Men with recurrent episodes of blood in the semen along with painful urination or ejaculation, may need to see a urologist.