Blood in semen

Dear Alice,

My wife and I had sex the other day, and when I ejaculated, my semen had blood in it. I have no blood in my urine. What could be wrong?

Dear Reader,

Blood in the semen is known as hematospermia. This condition is actually fairly common, and in younger men, it's very rarely a sign of a serious problem. Hematospermia has many potential causes, the most common of which is inflammation of the seminal vesicles (the small glands that produce most of the fluid in semen). Other possible explanations may include inflammation or lesions in other parts of the reproductive system (e.g., the prostate, urethra, testicles, and epididymis), trauma to the genitals, or certain infections.

Hematospermia will usually clear up on its own, but it's a good idea to check in with your health care provider just to be sure. It's especially key to meet with your provider if you keep noticing blood for more than ten ejaculations or two months, or if you're over 40 years of age. These factors might indicate a rarer, more serious cause like a systemic infection or, for older men, cancer.

When you visit a health care provider for hematospermia, they may do any of a variety of tests to pinpoint the cause. These may include semen analysis and culture, blood work, urinalysis and culture, a digital rectal exam (to check the prostate), or imaging studies (like ultrasound). Once there's a diagnosis, you and your health care provider can discuss any treatment options that might be necessary.

Last updated Jun 15, 2015
Originally published Nov 15, 1996

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