Hematospermia (Blood in the Semen)

If you suddenly spot blood in your ejaculated semen, don’t be frightened. You might be experiencing a condition called Hematospermia. While initially it might seem relatively frightening or distressing, it so happens that this condition is commonly experienced by a majority of men, but not openly discussed.

This may be a one-time occurrence or a recurring episode. Whether the blood condition is old or fresh, Hematospermia is most often caused by infectious or inflammatory disorders and follows a self‐limiting, benign course. 

Although major dysfunctions are not readily associated with this condition, in males over the age of 40, a more serious pathology may be present, necessitating further testing. Irrespective of the persistence of the condition, one must always seek medical advice to rule out any chances of prostate cancer. Before you visit your doctor for an examination or any necessary tests, let us understand the condition better, in order to voice your worries and receive reassurance.

What is Hematospermia?

Semen is your organic bodily fluid which contains spermatozoa. It is secreted by a male’s sexual glands (gonads) and organs and can fertilise the female’s ovum. 

Hematospermia (or Hemospermia) is the presence of blood in your semen. It may naturally worry men who encounter it, but it does not mean that it is a likely indication of a serious health issue.

It is not clear how common the symptom of blood in semen is because men typically do not examine their semen after ejaculation. Men of any age can have blood in their semen, although men in their 30s and 40s seem to have it more frequently.

Although it is frightening to see blood in your semen, it is rarely a symptom of a major health problem. A single episode of blood in your semen is normally not a sign of cancer. However, you might still want to see your healthcare provider to be reassured, to fully discuss this symptom and get an exam and perhaps other tests if your provider thinks they are needed.

What are the Symptoms of Hematospermia?

Your semen may include as little as a single drop of blood or as much as is necessary to give it the appearance of blood. The reason for your bleeding will determine how much blood is in your semen. You may also experience:

• Blood in your urine

• Pain in your lower back

• Tenderness in the groin area

• Swelling or tenderness in your scrotum 

• Pain when urinating

• Pain when ejaculating

You Can Also Read: Factors that affect male infertility

What are the Causes of Hematospermia?

On its route to the urethra for ejaculation, the semen travels via many channels. Blood vessels along this tract might rupture for any variety of reasons, causing blood to spill into the semen. 

In many instances, the precise reason for blood in the semen remains unknown. If you’re under 40, most incidences of blood in the semen are not dangerous. Some of the possible causes of bloody semen that your doctor may investigate are below:

Inflammation

Bloody semen frequently results from inflammation of the seminal vesicles. Inflammation of any organ, tube, duct or gland involved in the male genitals can cause blood in your semen. This includes:

• Prostatitis (inflammation of the prostate gland), can cause sexual dysfunction, urination problems and pain.
• Epididymitis (inflammation of the epididymis, or the coiled tube in the back of the testicle where sperm is stored), is most often caused by a bacterial infection, including STIs (sexually transmitted infections) like chlamydia, gonorrhoea or herpes. Symptoms include painful urination, discharge, testicle pain and tenderness on one side and a red or swollen scrotum. 
• Urethritis (inflammation of the urethra), which can cause penile discharge, itching or burning near the opening of the penis or pain while urinating. 

Additionally, irritation from calculi (stones) in the prostate, urethra, bladder, or seminal vesicles can result in inflammation. 

Infections

Just as with inflammation, infections in any organ, tube, duct or gland involved in the male genitals can cause blood in the semen. 

Sexually transmitted infections (STIs), like herpes, gonorrhoea or chlamydia can also cause blood in semen. Infections caused by fungi, bacteria and viruses can also lead to this condition. 

Obstruction

Blockages in ducts like the ejaculatory duct might cause the blood vessels in the area to enlarge and rupture. When your urethra is under strain from an enlarged prostate, bloody semen may result.

Tumours

Malignant tumours or benign polyps in the seminal vesicles, epididymis, testicles or prostate could lead to blood in your semen. 

Vascular Abnormalities

The blood you’ve noticed in your semen may be due to vascular anomalies in the male genitals, such as vascular cysts.

Other Factors

Semen blood might result from illnesses that impact your entire body. These include haemophilia (a disorder that leads to easy and excessive bleeding) and hypertension (high blood pressure). Other possibilities include chronic liver disease and leukaemia. 

Medical Procedures/Trauma 

Blood in your semen might result from physical damage, such as getting struck in the testicles while participating in sports. Trauma can cause blood vessels to leak, and that blood might leave your body in semen.  A medical procedure such as a vasectomy, biopsy or prostate exam can cause blood in your semen. 

You Can Also Read: Premature ejaculation-causes, symptoms and treatment

How is Hematospermia Diagnosed?

Initial Evaluation

Your healthcare provider will:

• Check your blood pressure.
• Perform a rectal exam to check the prostate for lump, tenderness or swelling.
• Conduct a physical exam to check for discharge, redness, swelling or lumps from your genitals.
• Take a full medical history, including asking questions about your sexual activities/practices, how often you have seen blood in your semen when you first noticed the blood and your current symptoms.

Diagnostic Tests

Your healthcare provider might order one or more of these tests: 

• PSA (Prostate Specific Antigen) test to check for prostate cancer.
• A test for sexually transmitted infections (STIs).
• Urine culture to check for abnormalities or infections.

Specialised Tests

The results of your tests and exam might not show the cause of blood in your semen. Your provider might refer you to a urologist (a doctor who specialises in the male reproductive organs and urinary tract) if your urinalysis and initial evaluation are not normal or if the blood in your semen is present for longer than a month. Your urologist might order some or all of the following tests:

• Computed tomography (CT) 
• Magnetic resonance imaging (MRI)
• Transrectal ultrasound to diagnose prostate problems including inflammatory changes, Varices, calculi and cysts

What is the Treatment for Hematospermia? 

You may be able to treat yourself at home depending on the cause of the blood in your semen. 

Treatment at Home

If you have blood in your semen as a result of a trauma, simply resting and allowing your body to heal might help. If your groin is also swollen, you should apply ice to it for no more than 10 to 20 minutes at a time. 

Most cases of Hematospermia are cured on their own. Keep an eye on your symptoms and alert your doctor if they persist for longer than one month or get worse. 

Medical Treatment

Your doctor will recommend antibiotics if an infection is the reason for the blood in your semen. If the only problem is swelling, anti-inflammatory drugs are readily available.

If the blood in your semen is caused by a blockage in your genitourinary tract, surgery might be necessary. Potential surgeries include the removal of a bladder stone that’s obstructing the urinary tract or the removal of tumours.

Your doctor will likely recommend an oncologist to you if cancer is the cause of the blood in your semen, who will then decide on the most effective course of action.

Conclusion

Blood in your semen might look scary, but it is a common symptom for many men.  You can treat this issue at home, but if it continues for a long duration or gets worse, then it is always advisable to seek medical help from an experienced urologist. Timely care and help can ensure an appropriate diagnosis and treatment of your condition.

At the CK Birla Hospital, we ensure patients get holistic medical support which includes treatment in a compassionate and judgement-free environment. This patient-centric approach not only helps patients heal better but also ensures they are aware of the preventive measures in place to make an informed decision about their health. In case you need to consult a urologist, reach out to us, or Book a direct appointment with Dr. Kumar Saurav at the CK Birla Hospital.

FAQs

Is Hematospermia Serious?

Although it is worrisome to see blood in your semen, it is typically not a symptom of a serious health problem. See your healthcare provider to get reassurance, discuss your concerns and get any needed tests or exams. 

How Long Does Hematospermia Last?

The majority of patients experience several episodes spread out over weeks or months. Blood in the ejaculate that lasts for more than 10 ejaculations necessitates additional assessment, although there is no universally agreed-upon definition of chronic Hematospermia.