What Causes Blood in Semen? And When You Should Seek Treatment
Key takeaways:
Blood in semen can be scary. Fortunately, it’s usually not a cause for alarm.
Infection, inflammation, surgery, and trauma are the most common causes for blood in semen.
Treatment for blood in the semen depends on its cause. Your treatment plan could include just watching it over time — or antibiotics or surgery.
Semen is the fluid that comes out with ejaculation. It’s made up of sperm and liquid secretions from the reproductive tract. Semen is normally pearly-white and translucent. But there are rare times when you might notice something else, like blood.
Seeing blood in your semen is also known as hematospermia — and it can be pretty scary. But it’s not always a cause for alarm. There are many reasons for blood to appear in your semen. And most of them go away on their own. Let’s take a look at what might be going on if you do see blood in your semen.
What causes blood in semen?
Blood in semen usually comes from the urinary or reproductive (genitourinary) tract. In most cases, a single episode of hematospermia is nothing to worry about. In fact, non-serious reasons blood can appear in ejaculate include:
Periods of prolonged abstinence (not having sex)
Frequent masturbation
Intense sexual experiences
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Some of the other genitourinary causes of blood in the semen include:
Prostatitis (inflammation of the prostate)
Urinary tract infection (UTI)
Sexually transmitted infections (STIs) or prostate infections
Tumors of the urethra (non-cancerous)
Surgical procedures (like vasectomy or a prostate biopsy)
Trauma (like from an accident or injury)
Hemangioma (a mass of abnormal blood vessels)
Other times, blood in semen can be from cancer, such as:
Some of the less common causes of hematospermia that don’t involve the reproductive or urinary system include:
Bleeding disorders (like hemophilia or leukemia)
Liver disease (like cirrhosis)
Hypertensive emergency (severe cases of high blood pressure)
How long does blood in semen usually last?
It’s hard to say exactly how long a person might experience blood in the semen. It may happen one time and then never again. But if there’s a known cause (like recovery from surgery), you could have blood in semen for many ejaculations. It could take up to 4 weeks for blood to be completely cleared after surgery.
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When you see blood in your semen repeatedly, it’s important to discover the underlying cause. And to make sure you get proper treatment. Infections, benign tumors, and cancer can have long-term consequences if not treated promptly.
How do you treat blood in semen?
How you treat blood in semen depends on what’s causing it to happen. Most cases resolve on their own and don’t need evaluation or treatment. A good history and physical exam will guide your healthcare professional in deciding which treatment option is best.
Depending on your symptoms, some of the possible treatments for blood in semen could be:
Waiting and watching: This may be a good option if you don’t have any other symptoms and only one or two episodes.
Antibiotics: STIs, UTIs, and prostate infections are treated with antibiotics. If infection is the cause of blood in your semen, antibiotics can help it to go away.
Surgery: Endoscopic surgery is a minimally invasive way to treat abnormal growths in the urethra, bladder, prostate, or ureters. Traditional surgery may be needed depending on the size, location, or type of growth.
Treating underlying conditions: Blood in your semen can also go away by treating medical conditions like a bleeding disorder, malignant hypertension (sudden spike in blood pressure), or liver problem.
Do you need to stop ejaculating if you see blood in your semen?
Whether you should stop ejaculating when you have blood in your semen also depends on the cause. In general, you can have sex or masturbate as you normally would. Two exceptions include:
After surgery: Wait until your surgeon tells you it’s OK to resume normal activities, including ejaculation.
After trauma: You should wait until any trauma has healed so that you don’t cause further trauma to damaged tissues.
What other symptoms should you watch for if you have blood in semen?
Having other symptoms along with blood in your semen can be a clue that something more serious is going on. Some of the things you should watch out for and seek medical attention for are:
Fever
Rash
Joint pain
Discharge from the penis
Abdominal pain
Weight loss
Bone pain
Trouble urinating
Bleeding or bruising easily
If you’re under age 35 and don’t have any other symptoms, you can schedule an appointment to see your primary care provider at your convenience. Schedule an appointment right away if you have you have any other symptoms listed above, or if:
You see blood in semen frequently or over a few weeks.
You’ve had recent international travel and may be at risk for parasite infection.
You have a lump in your testicle.
You’re over 35 years old.
You’re worried.
The bottom line
Seeing blood in your semen can be a frightening experience. Trauma, prolonged abstinence, and recent surgery are the most common reasons for having blood in your semen. Fortunately, it usually goes away on its own.
Fever, testicular lumps, discharge from the penis, and weight loss can point to serious medical conditions as the cause of the blood in your semen. If you have symptoms of an underlying medical condition, you should see your primary care provider to find the cause. Prompt diagnosis and treatment gives you the best chance for a swift recovery.
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References
Abdelkhalek, M., et al. (2013). Hemosepermia after transrectal ultrasound-guided prostatic biopsy: A prospective study. Urology Annals.
Akhter, W., et al. (2013). Should every patient with hematospermia be investigated? A critical review. Central European Journal of Urology.
Kujovich, J. L. (2015). Coagulopathy in liver disease: A balancing act. Hematology.
Fuse, H., et al. (2011). Hematospermia: Etiology, diagnosis, and treatment. Reproductive Medicine and Biology.
Oh, T. H., et al. (2016). Endoscopic treatment for persistent hematospermia: A novel technique using a holmium laser. Scandinavian Journal of Surgery.
Ramamurthy, R., et al. (2011). Primary malignancy of seminal vesicle: A rare entity. Indian Journal of Urology.
Stefanovic, K. B., et al. (2009). Evaluation and treatment of hematospermia. American Family Physician.
