Blood in semen can have many causes. What does this symptom mean?

The presence of blood in the semen, called hematospermia, is most often seen as red or brownish streaks or lumps in the semen and is usually caused by inflammation or infection of the prostate or seminal vesicles. This is one of the urological symptoms that scares men the most, because we usually associate the presence of blood with something serious, although in this case it does not have to be. Sometimes it is simply the result of damage to the tiny blood vessel through which semen passes before ejaculation occurs. It is important that the presence of blood in the semen is accompanied by other symptoms, because on their basis the doctor can better assess the cause of the problem.

Well-known Spanish urologist Dr. Fernando Gómez Sancha, of the Cemtro urology clinic in Madrid, explains that hematospermia is in a sense “like a nosebleed.” In this way, he wants to convey to men affected by this condition that in most cases it is not a cause for concern, as it may be a single episode that will not recur, especially in the case of men under 40 years of age. However, it can turn into a chronic symptom, especially in older men.

Possible causes of blood in semen:

• A high frequency of ejaculation can often cause bleeding, so it affects more sexually active patients, but sexual abstinence can also contribute to this.

• This is common in patients born with only one kidney who are prone to blood in the semen.

• Blood in semen may be caused by trauma or a bacterial infection.

• Inflammation of the prostate or testicles is another cause of blood in the semen.

• Benign prostatic hyperplasia is a very common problem in men over 50, accompanied by difficulty and pain when urinating or a sudden increase in the frequency of urination, and is one of the causes of blood in the semen.

• Semen with traces of blood can also indicate various diseases. These include: hypertension, genitourinary tuberculosis or prostate, testicular or urethral cancer.

• The use of certain medications, especially anticoagulants, increases the risk of bleeding from the small blood vessels that are in the path through which semen passes.

• A prostate biopsy can also lead to blood in the semen. This is an invasive test that uses a needle to take tissue and can cause a wound and rupture of a blood vessel.

• The presence of sexually transmitted diseases is another reason for the presence of blood in semen. This is the case with genital herpes, chlamydia or gonorrhea.

Symptoms of hematospermia

Depending on the cause, hematospermia may be accompanied by the following symptoms:

• blood in the urine

• fever or chills

• pain in the lumbar spine,

• pain with bowel movements,

• painful ejaculation,

• painful urination,

• scrotal swelling,

• swelling or tenderness in the groin area.

In the event of blood in the semen, especially if it is accompanied by any of the above symptoms, you should contact your general practitioner or urologist who will order appropriate tests depending on the diagnosis, including prostate examination, lymph node examination, urinalysis, semen culture or Ultrasound of the prostate and scrotum and, if necessary, the PSA (Prostate Specific Antigen) test, which allows to diagnose prostate cancer.