Blood in the semen

This is not always serious

If a man sees blood in the semen, it can put him in an anxious frame of mind. Fortunately, it does not always mean that there is a major medical problem. If you are under 40 and have no symptoms or risk factors for an underlying medical condition, blood in the semen often goes away on its own.

However, if you are over 40 and have continuous episodes of blood in your semen, have related symptoms when urinating or ejaculating, or have a bleeding disorder, and are at risk for cancer – then medical intervention may be necessary.

The medical name for blood in the semen is called hemospermia.

The causes of this condition

Blood in the semen can come from various sources, with the most common being inflammation and infection. This can come from any of the tubes, glands or ducts that remove semen from the body.

The inflammatory and infection issues can include the following:

  • The prostate gland, which produces the fluid component of the semen.
  • The urethra, the tube that carries urine and semen from the penis.
  • Inflammation of the tiny tubes situated behind the testicles where sperm mature before ejaculation.
  • The seminal vesicles, located within the pelvis, secrete fluid which is also a component of semen.
  • A bacterial infection as a result of a sexually transmitted infection (STI) can cause in blood in the semen.

Other traumatic issues

Some medical procedures can cause mild trauma and temporary blood in the semen. These may include:

  • A prostate biopsy. This is known to happen to as many as four out of five men after a biopsy.
  • Procedures for urinary tract problems can also cause mild trauma and temporary bleeding.
  • Radiation therapy and a vasectomy may also lead to some bleeding.
  • Physical trauma after a pelvic injury or fracture, can bruise the testicles, and may cause blood in the semen for a protracted length of time.
  • If there is an obstruction in the tiny tubes of the reproduction tract, small blood vessels make break and release small amounts of blood. This condition is usually caused by an enlarged prostate which squeezes the urethra, causing pressure on the blood vessels.
  • Blood in the semen can also be linked to cancer of the testicles, bladder and the prostate.

In many cases, if there is no underlying medical condition, the blood will go away without any medical treatment.

Here are some symptoms a doctor might ask you about if you have blood in the semen:

These symptoms may indicate an undiagnosed medical condition:

  • Persistent blood in the urine.
  • Burning or painful urination, and difficulty completely emptying the bladder.
  • Painful ejaculation.
  • Swollen or painful areas on the sex organs.
  • A discharge from the penis which can indicate a sexually transmitted disease.
  • Signs of fever, or a higher than normal blood pressure reading.

If any of these symptoms are present the doctor will most likely order tests which can include a physical examination of the genitals, as well as a rectal exam of the prostate to check for swelling and tenderness, and also a blood test to check antigen levels.

Other urological tests may be ordered such as an ultrasound or a CT scan for further diagnostic evaluation. Treatment is usually targeted according to the diagnosis.

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    October 15, 2019 — Colin Katz