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.

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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):

  • Painful urination
  • Pain with ejaculation
  • Blood in urine
  • Lower back pain
  • Fever
  • Tenderness in the testes and/or scrotum
  • Swelling in the testes and/or scrotum
  • Swelling or tenderness in the groin area

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.

How is blood in the semen treated?

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.

Medically Reviewed by a Doctor on 10/30/2015

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