Dear Alice,

For the past couple of days, I have had what felt like a pressure on my left testicle. This started after the day after some pretty intense petting with my girlfriend. I notice blood in my underwear and now found that blood comes out with my semen when I ejaculate. How serious is this.

Signed,
"in a painful way"

Dear "in a painful way,"

While it may be startling to experience pressure after pleasure and notice blood unexpectedly, blood in semen (aka hematospermia) does not always indicate a serious health problem.

Sometimes, a small (less than half an inch) fluid-filled cyst called a spermatocele grows in the epididymis, which is located in the testicle and stores sperm. When this cyst grows larger, it may be uncomfortable, painful, and may potentially contribute to a feeling of pressure. Although their causes are unknown, it is believed that spermatoceles result from trauma and inflammation in the area. You mentioned that you noticed the blood and pressure following "some pretty intense petting," so it may be possible that the timing of the petting is related to these symptoms. You may want to take this opportunity to start performing regular testicular self-exams (if you don't already) to get to know yourself a bit more and help detect any changes that concern you. Separate from your testicles, prostate cancer can cause bloody semen and pelvic discomfort, along with additional symptoms. Routine exams by your provider can also help you stay on top of your prostate health.

It may be a good idea for you to discuss any lingering concerns with a health care provider, who can determine a possible cause. You may find it helpful to read the responses in Testicle hurts in the Go Ask Alice! sexual health archives for additional information.

Here's hoping that you find yourself in a less "pressured" situation after reading this.

Alice!
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