Blood in Semen
(Hematospermia)

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Medical Author:

Melissa Conrad Stöppler, MD

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.

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Medical Editor:

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.

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• 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.

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.

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