I have blood in Semen


  • 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).


    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 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
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