Blood in semen (hematospermia or hemospermia)

The blood in the semen can be a reason for anxiety. Fortunately, the most frequent causes for it are benign diseases like infection of the epididymis, prostate, or urethra. Moreover, for men younger than 40 without symptoms and other diseases, blood in semen often disappears on its own.

However, in older people who have repeated episodes of hemospermia, having related urinary and ejaculatory symptoms (mainly pain), or are at risk for cancer, bleeding disorders, or other conditions, a correct diagnosis should be done.

Semen passes along a series of tubes on the way to the urethra for ejaculation. Any number of things can cause blood vessels along this path to break and leak blood into the semen.

In many cases, the exact cause for blood in the semen is never determined. Most cases of blood in the semen are not serious, especially if you're 40 or younger. Below are some of the possible causes of bloody semen that your doctor might investigate.


As already told before, infection/inflammation is the leading cause of blood in semen. Any point in the genital tract can be the source of bleeding:

  • Prostatitis (inflammation of the prostate gland), which can cause painful urination, frequent urination, and urethral discharge (associated symptoms);
  • Epididymitis (inflammation of the epididymis, or the tube carrying the sperms from the testicle to the seminal vesicles where are stored in the liquid part of the semen). Usually, the scrotum is swollen and the testicle is painful. Discharge and painful urination are common symptoms associated;
  • Urethritis (inflammation of the urethra), which can cause pain while urinating, itching or burning near the opening of the penis, or penile discharge;
  • Obstruction (stones and calcifications). If the ejaculatory ducts are blocked, surrounding blood vessels can dilate and break. Prostate enlargement is another obstructing situation where ejaculatory ducts are compressed and blocked;
  • Benign polyps or malignant tumours in the prostate, testicles, epididymis, or seminal vesicles could lead to hematospermia;
  • Vascular abnormalities in the male genitals, such as vascular cysts, could explain the blood;
  • Other conditions that affect your whole body can cause blood in your semen. These include hypertension (high blood pressure) and haemophilia (a disorder that leads to easy and excessive bleeding). Other possibilities include leukaemia and chronic liver disease;
  • Scrotal trauma while playing sports can lead to blood in your semen. Trauma can cause blood vessels to leak;
  • A medical procedure like a prostate biopsy or a vasectomy can cause blood in your semen.

When is better to see your doctor

Men ages 40 and over have a higher risk of developing illnesses like prostate cancer. Because of this, you should tell your doctor any time you see blood in your semen. Your doctor will want to check for the cause of the blood as soon as possible.

Young people without any symptoms other than bloody semen, wait, and see could be reasonable. If the semen continues to be bloody or there are additional symptoms like pain or a fever, it is better to book an appointment with the physician. In older men, after 50, some frequent malignancies should be ruled out, like prostate or bladder cancer.

Treatment of blood in semen

Depending on the cause of the blood in the semen. The urologist will diagnose the underlying disease and will plan a treatment or he will follow it up.

In most of the cases, the treatment is conservative and ranges from "wait and see" to antibiotic and anti-inflammatory treatment.

If the blood is caused by a blockage in the genitourinary tract, surgery may be necessary.