Hematospermia
- The presence of blood in your semen is known medically as hematospermia (also called hemospermia).
- Hematospermia may naturally cause concern for men who experience it. However, it is not likely to be a sign of a major health problem.
What are the causes of blood in semen?
The most likely cause of blood in semen are:-
- Trauma from a prostate biopsy. You may see blood for up to four weeks after the procedure.
- Trauma from a vasectomy. You may see blood for over a week.
- Treatment of prostate cancer with external beam radiation or brachytherapy.
- A seminal tract infection or inflammation.
- Leaking of blood from a small blood vessel that bursts during ejaculation — the same way that a person gets a nose bleed after blowing their nose.
Other potential causes or associated conditions may include:-
- Sexually transmitted infections (STI): Including gonorrhea, chlamydia, or other viral or bacterial infection.
- Prostate conditions: Including benign prostatic hyperplasia, acute bacterial prostatitis, cysts and polyps.
- Testicular and epididymis conditions: Including orchitis, epididymitis.
- Seminal vesicle disorders: Including stones (calculi) and cysts.
- Blood disorders: Including clotting disorders or sickle cell disease.
- Chronic infections: Including tuberculosis or schistosomiasis.
- Cancers: Including testicular/epididymal cancer, prostate cancer, bladder cancer, seminal vessel cancer, urethral tumor. It’s rare for such cancers to present with their first symptom of blood in semen.
- Other medical problems: Including severe, uncontrolled high blood pressure; human immunodeficiency virus (HIV), liver diseases, and leukemia (blood cancer).
Investigation/Diagnosis:-
Initial evaluation:-
Your healthcare provider will:-
- Take a full medical history, including asking questions about your current symptoms, when you first noticed the blood, how often you’ve seen blood in your semen, and your sexual activities/practices.
- You will also be asked about medications you take, if you’ve had any recent medical procedures, have any bleeding disorders, or have any symptoms of a urinary tract infection.
- Conduct a physical exam to check for lumps, swelling, redness or discharge from your genitals.
- Perform a rectal exam to check the prostate for swelling, tenderness or a lump.
Diagnostic tests:-
- Urine culture to check for infections or abnormalities.
- STD test to detect any sexually-transmitted disease.
- Prostate Specific Antigen (PSA) test to check for prostate cancer.
- Transrectal ultrasound to diagnosis prostate problems including cysts, calculi, varices, inflammatory changes.
- Computed tomography (CT-scan) or magnetic resonance imaging (MRI).
Treatment:-
- Treatment is based on extent and duration of the presence of blood in your semen, your age and presence of other symptoms.
- If you are under the age of 40, have no urinary tract symptoms, have no risk factors for other medical conditions, and there’s been only a single episode of blood in your semen, you’ll likely not need any treatment. The symptom will resolve on its own.
- If a cause for blood in your semen is identified, your provider will prescribe appropriate treatments, including:-
- Antibiotics if you have an infection.
- Anti-inflammatory drugs.
- Finasteride, a medication used to shrink an enlarged prostate can often stop hematospermia if due to fragile/friable blood vessels on the prostate.
- Medicines to treat other medical conditions
