Blood in Semen
(Hematospermia)

Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

• What is blood in the semen?
• What are the causes of blood in the semen?
• What are the symptoms of blood in the semen?
• How is blood in the semen evaluated?
• How is blood in the semen treated?
• What is the prognosis (outlook) for patients with blood in the semen?
• Blood in Semen At A Glance

What is blood in the semen?

The presence of blood in the semen (ejaculate) is also called hematospermia. Hematospermia is an uncommon condition.

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 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. More than 80% 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, and



• cysts, hemorrhage, or other abnormalities in the seminal vesicles.

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