Hematospermia – Blood in Semen

What is Hematospermia?

Blood in semen is relatively uncommon. Seeing it can cause significant concern, but in most cases, the causes are rarely so serious as to endanger one’s life.

What are the causes and risks of blood in semen?

Known causes include:

• Infections of the prostate gland, called prostatitis, intraprostatic calcifications, and vascular problems within the gland, such as telangiectasia or varicose veins. Prostatitis can be acute, chronic bacterial, or non-bacterial.
• Infections, calcifications, and dilation of the seminal vesicles, which are two structures that secrete the majority of the fluids found in semen.
• Urethral infections, known as urethritis, as well as warts or polyps in the posterior urethra. The urethra is the tube that carries urine and semen out of the body.
• Urethral strictures, which are narrowings in a portion of the urethra. This may be due to trauma or a previous infection.
• Certain sexual practices, such as prolonged sexual abstinence, lack of sexual activity, or unusually frequent and extended sexual intercourse.
• Bleeding disorders or blood clotting issues, such as hemophilia A and hemophilia B. Blood clotting problems can also occur in men who take many anticoagulants, such as warfarin.
• Problems in the scrotal area, such as epididymitis, varicocele, trauma, or even testicular cancer.
• Benign or malignant tumors, which are less common causes. Cancer may affect the prostate, seminal vesicles, or urethra.

What are the symptoms of hematospermia?

The presence of blood in semen is the only symptom, typically appearing as dark brown with a thread-like texture, though in many cases, it may be red. Men with this symptom are often asked a series of questions by their doctor, including:

• How often they have seen blood in their semen.
• When the bleeding first appeared.
• Whether there is blood in the urine or bleeding in other parts of the body.
• If they are experiencing any pain.
• How frequently they have engaged in sexual activity recently.
• Whether they have had a sexually transmitted disease in the past.
• What kind of sexual practices they engage in.

How is hematospermia diagnosed?

Diagnosis begins with a medical history and physical examination. Urinalysis, including a general and culture test, may be used in some cases to check for infection or bleeding. Tests that include detailed and specialized ultrasound examinations of the genitourinary system, such as kidney-bladder ultrasounds, transrectal ultrasound, uroflowmetry, and urethrocystoscopy, are essential for evaluating the problem and identifying the cause.

What are the effects of hematospermia?

Usually, there are no long-term effects. Many men experience repeated episodes of blood in semen without developing any other significant symptoms or problems. The effects arise from the underlying causes of the symptom, and failure to identify them can lead to other complications that are often difficult and time-consuming to manage, such as prostate inflammation with urethral strictures. While cancer is a relatively rare cause, it could potentially lead to death.

What are the risks to sexual partners?

Blood in semen is not dangerous to others. However, if the cause is an infection, such as a sexually transmitted disease or inflammation of the prostate or seminal vesicles, it is understood that the infection could be contagious.

What are the treatments for hematospermia?

Treatment targets the cause and depends on how long the underlying condition has been present. For someone with an infection, antibiotics or anti-inflammatory medications may be prescribed, while urethral strictures may require surgical opening and subsequent dilation. A person with urethral cancer will need immediate surgery.

What happens after hematospermia treatment?

Treating the underlying cause with appropriate therapy usually resolves the issue, though in some cases, certain causes may not entirely prevent the recurrence of hematospermia. After treatment, most men do not face restrictions on their activities.

How is the condition monitored?

A person can check their semen at home for further episodes of bleeding. Changes or responses to treatment can be reported to the doctor. Other forms of medical monitoring depend on the underlying cause.