Blood in Semen (Hematospermia)

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

View the Impotence Slideshow Pictures

Blood in semen facts

  • Blood in the semen is known as hematospermia.
  • Prostate biopsy is the most common cause of blood in the semen.
  • Blood in the semen can be caused by tumors, infections, anatomical abnormalities, stones, or inflammation in many sites throughout the genitourinary system.
  • Usually blood in the semen is benign and resolves on its own.
  • Treatment, if indicated, depends upon the underlying cause.
  • In most cases, hematospermia has no underlying cause, is benign, self-limited, and no treatment is required.

What is blood in the semen?

The presence of blood in the semen (ejaculate) is also called hematospermia. Hematospermia is not always noticed; therefore, it is difficult to make estimates of its incidence.

What are the causes of blood in the semen?

Blood in semen can be caused by many conditions affecting the male genitourinary system. Areas affected may include the bladder, urethra, the testicles, the tubes that distribute semen from the testicles (known as the seminal vesicles), the epididymis (a segment of the spermatic ducts that serves to store, mature, and transport sperm), and the prostate gland.

Blood in the semen is most commonly a result of a prostate gland biopsy. A majority of men who undergo a prostate biopsy may have some blood in their semen that persists for three to four weeks. Likewise, vasectomy can lead to bloody semen for about one week after the procedure.

In men with hematospermia who have not had a recent prostate biopsy or vasectomy, a number of benign and malignant conditions of the male genital system may be the cause. In many situations, no definitive cause is found.

The following conditions have been reported in association with hematospermia:

  • Benign or malignant tumors of the prostate, bladder, testes, or seminal vesicles
  • Infections including, but not limited to, chlamydia, herpes, cytomegalovirus, and trichomoniasis
  • Inflammation of the prostate (prostatitis), epididymis (epididymitis), or urethra (urethritis)
  • Calculi (stones similar to kidney stones) in the seminal vesicles or prostate
  • Polyps in the urethra
  • Ejaculation duct obstructions
  • Metastatic cancers (that have spread from other sites in the body) located in the genitourinary system
  • Cysts, hemorrhage, or other abnormalities in the seminal vesicles

Causes of Blood in Semen

Blood in semen (ejaculate) is also called hematospermia. Blood in semen can be caused by many conditions affecting the tubes that distribute semen from the testicles (seminal vesicles) or the prostate gland.

What are the symptoms of blood in the semen?

The symptoms that can occasionally accompany blood in the semen may be any of the following, depending upon the cause (these are not all inclusive):

How is blood in the semen evaluated?

A number of diagnostic tests may be performed after the clinical history is evaluated and a physical examination is performed. Some of the most commonly performed diagnostic tests are a urinalysis and cultures to identify any sexually transmitted or other infections. When indicated, imaging studies such as ultrasound or MRI may reveal tumors or other abnormalities. In some situations, a semen analysis, in which the semen is analyzed under a microscope, may be recommended.

What is the treatment for blood in the semen?

Treatment of blood in the semen is directed toward the underlying cause if a cause has been found. Sometimes, treatment with antibiotics for a presumptive diagnosis of prostatitis (inflammation of the prostate gland) is given, since some studies have shown that up to about one-fourth of men with hematospermia have prostatitis. However, the benefit of such treatment has not been definitively established.

In most cases, if blood in the semen is not associated with any known abnormality of other troubling symptoms, no treatment is given, and the condition usually resolves on its own with time in these situations. Persistent hematospermia (for a month or more) even in the absence of other symptoms warrants further or follow-up evaluation.

What is the prognosis (outlook) for patients with blood in the semen?

The prognosis relates to the underlying cause of blood in the semen if a cause can be identified. However, most cases of hematospermia are benign and resolve without treatment. While cancer is a rare cause of blood in the semen, the majority of cases are not related to cancer, especially in younger men.

REFERENCE:

Schiff, Jonathan D. "Hematospermia." Medscape. July 24, 2016. <http://emedicine.medscape.com/article/457632-overview>.

Last Editorial Review: 8/7/2017

Subscribe to MedicineNet's Men's Health Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

Reviewed on 8/7/2017
References
REFERENCE:

Schiff, Jonathan D. "Hematospermia." Medscape. July 24, 2016. <http://emedicine.medscape.com/article/457632-overview>.

Health Solutions From Our Sponsors