Alternative names
hematospermia, hemospermia
Definition
Blood in the semen is uncommon. Seeing it can make people
quite anxious, but it is rarely serious.
What is going on in the body?
Most cases of blood in the semen are from unknown causes. It
usually goes away on its own.
What are the signs and symptoms
of the condition?
Seeing blood in the semen can be quite frightening. Men with
this symptom are often asked several questions by the healthcare provider, including: how
many times blood has been seen in the semen when the bleeding started if there is blood in
the urine or bleeding in other areas of the body if the man has any pain how often the man
has had sex recently if the man has ever had a sexually transmitted disease what kind of
sexual practices the man engages in
Other questions may be asked as well.
What are the causes and risks of
the condition?
Most cases are from an unknown cause. Known causes include:
- infections of the prostate gland, called prostatitis.
Prostatitis may be acute, chronic, or non-bacterial .
- infections of the seminal vesicles, which are two structures
that secrete some of the fluid found in semen
- infections of the urethra, known as urethritis. The urethra is
the tube that carries urine and semen to the outside of the body.
- urethral strictures, or narrowing in an area of the urethra.
This may be caused by trauma or a previous infection.
- certain sexual habits, such as prolonged abstinence or lack of
sex, or unusually frequent sex
- bleeding or blood clotting problems, such as hemophilia A or
hemophilia B. Clotting problems can also occur in men who are taking too much of the
blood-thinning drug warfarin.
- tumors or cancer, a rare cause. The cancer may be in the
prostate, seminal vesicles, or urethra.
What can be done to prevent the
condition?
Most cases cannot be prevented because the cause is unknown.
Urethral stricture and infection of the urethra are often due to sexually transmitted
diseases. So practicing safer sex could prevent some cases of blood in the semen.
How is this condition diagnosed?
Diagnosis begins with a history and physical. This may be all
that is needed in some cases. In other cases, further testing may be done. Urine tests,
including a urinalysis and urine culture, are commonly used to look for infection or
bleeding. Imaging studies or x-ray tests may be used to look for a urethral stricture.
What are the long-term effects?
There are usually no long-term effects. Many affected men
have repeated episodes of blood in the semen with no other symptoms or problems. Urethral
strictures are usually permanent unless they are treated. Cancer is quite rare, but could
possibly result in death.
What are the risks to others?
Blood in the semen itself is not contagious. If the cause is
an infection, such as a sexually transmitted disease, the infection may be contagious.
What are the treatments?
Treatment is directed at the cause, if one can be found. A
man may be given antibiotics for a short time in case there is an infection. A man with
cancer or urethral strictures may need surgery.
What are the side effects
of the treatments?
Antibiotics may cause allergic reactions, stomach upset, or
headaches. All surgery carries a risk of bleeding, infection, and other complications.
What happens after
treatment?
Many men continue to have occasional episodes of blood in
their semen. Others may only have it once. Treatment doesn't seem to affect this.
A man with a known cause for the blood usually gets better
with treatment. After treatment, most men have no limitations on activities.
How is the condition monitored?
The man can monitor his semen at home for further episodes of
bleeding. Changes or response to treatment can be reported to the healthcare provider.
Other monitoring is related to the cause. For example, a man who takes a blood thinner
such as warfarin usually has regular prothrombin time, or PT, blood tests.
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