Semen - bloody; Blood in ejaculation; Hematospermia Blood in the semen is called hematospermia. It may be in amounts too small to be seen except with a microscope, or it may be visible in the ejaculation fluid. The presence of blood in semen (the fluid discharged upon ejaculation) may be caused by inflammation, infection, obstruction or trauma. Most of the time, the cause for blood in the semen is not known. It can be caused by
swelling or infection of the prostate or seminal vesicles. The problem may occur after a prostate biopsy. Blood in the semen may also be caused by: Often, the cause of the problem cannot be found. Sometimes, the visible blood will last several days to weeks, depending on the cause of the blood and if any clots formed in the seminal vesicles. Depending on the cause, other symptoms that may occur include: Home CareThe following steps may help ease discomfort from a prostate infection or urinary infection:
When to Contact a Medical ProfessionalAlways contact your health care provider if you notice any blood in your semen. What to Expect at Your Office VisitThe provider will perform a physical exam and look for signs of:
You may need the following tests:
ReferencesElsamra SE. Evaluation of the urologic patient: history and physical examination. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 1. Kaplan SA. Benign prostatic hyperplasia and prostatitis. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 120. O'Connell TX. Hematospermia. In: O'Connell TX, ed. Instant Work-ups: A Clinical Guide to Medicine. 2nd ed. Philadelphia, PA: Elsevier; 2017:chap 30. Small EJ. Prostate cancer. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier Saunders; 2020:chap 191. Version InfoLast reviewed on: 7/26/2021 Reviewed by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.  Doctors call blood in the semen “hematospermia.” Injuries, infections, prostate issues, and several other factors and conditions can cause blood to appear in the semen. Although it may be alarming, blood in the semen is not usually life threatening and does not necessarily mean that something is seriously wrong. In fact, in many cases, there is no clear cause at all. Keep reading to learn more about the causes and symptoms of blood in the semen, as well as how to treat the issue. When there is blood in the semen, the blood usually comes from either the prostate or the seminal vesicles, which make the majority of the semen. In at least 70% of cases, however, a doctor is not able to identify the exact cause. If the bleeding happens only once, the likelihood of there being a serious underlying problem is very low. The most common reasons for this type of bleeding include: Ruptured blood vesselA blood vessel in the prostate or seminal vesicles can rupture during sex or ejaculation. This is similar to when the nose bleeds following a sneeze. This may be more likely if the person is taking blood-thinning medications. There may be a sudden gush of blood or bleeding that lasts for several minutes and then stops. Some symptoms of a ruptured blood vessel include:
A ruptured blood vessel is not usually a serious health concern. Sometimes, however, an obstruction such as a cyst can put pressure on the blood vessels, causing them to rupture. Having sex after long periods without itLong periods of abstinence from sexual intercourse may cause blood to appear in the semen. When this happens, a person may also notice:
InfectionIn males under 40, an infection or related inflammation is the most common reason for blood to appear in the semen. In many cases, the infection occurs in the urinary tract, but it can also affect other areas, such as the prostate. This can develop due to typical urinary tract infections (UTIs) and sexually transmitted infections (STIs). People with an infection may notice other symptoms, including:
InjurySustaining an injury to the urinary tract or genitals may cause blood to appear in the semen. Sometimes, a minor injury — such as from vigorous sex — ruptures a blood vessel in the prostate or seminal vesicles. When this happens, a person may notice a sudden gush of blood that eventually goes away on its own. More serious injuries can cause swelling, chronic bleeding, and serious damage to the genitals. When this happens, a person may notice bloody semen that either lasts for a long time or comes and goes following an impact to the genitals, genital surgery, or a fall. Prostate issuesProblems with the prostate may give rise to bloody semen. One of the most common issues is prostatitis. A 2015 study of 37 males with bloody semen found that two-thirds had some form of prostatitis. Prostatitis can be a chronic issue due to inflammation or a sudden problem due to an infection. In either case, the person may notice symptoms other than hematospermia, including:
InflammationInflammation refers to swelling and irritation. Sometimes, this can occur alongside an infection, but it can also appear on its own. Prostatitis is one form of inflammation, but irritation elsewhere in the genitals or urinary tract may also cause blood to appear in the semen. Inflammation in the epididymis, which is the tube that holds the sperm, may also cause blood to appear in the semen. A person may also experience other symptoms, such as:
A tumorOn rare occasions, a tumor may be the cause of blood in the semen. The most common tumor to cause this would be prostate cancer. When this happens, a person may sometimes notice repeated bouts of hematospermia. They may also have other symptoms, such as painful urination or pain in the groin. When blood in the semen occurs just once or happens following an injury or a lifestyle change, a tumor is not likely to be the cause. Other factorsThough less common, there are some other issues that may cause blood in the semen. These include:
Anyone can develop blood in the semen, and doctors are often unable to identify a cause. However, there are certain risk factors that increase the likelihood of experiencing hematospermia. These include:
Evaluation will generally include a doctor taking a medical history, such as by asking about the person’s sexual history, conducting a physical examination, and running selected laboratory testing and imaging. Tests may include:
In many cases, bloody semen does not require any treatment at all. When the male is under the age of 40 and has few or no risk factors for cancer or other serious health issues, they may not need treatment for a single instance of hematospermia. However, they may need treatment if there is an infection or a blockage. Some potential treatment options include:
Some doctors may recommend antibiotics even when they are unable to find an infection. In fact, one 2014 study found that a combination of antibiotics and an anti-inflammatory drug relieved symptoms in 96% of cases. A single episode of blood in the semen is not an emergency. Nevertheless, it may be best to see a doctor to rule out more serious causes. Doing so enables prompt treatment of any underlying issues and can offer significant reassurance if nothing is wrong. It is also important to see a doctor for:
Noticing blood in the semen can be alarming, but for most males who experience this, there is nothing to worry about. Even when there is a more serious problem, seeking and receiving prompt treatment can prevent it from worsening. For this reason, anyone concerned about blood in the semen should speak to their doctor. Is it normal for blood to come out with sperm?Is blood in the semen normal? Blood in the semen is not normal, but it is reasonably common. Most men who have it, have repeated episodes. It can affect men at any age after puberty but is most common in men aged 30 to 40 years and in men over 50 years who have an enlarged prostate gland not caused by cancer.
What causes blood in a man's sperm?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 glands, tubes, or ducts that produce and move semen from the body. These include: Prostate (the gland that produces the fluid part of semen)
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Blood in sperm but not urine no pain
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