Blood in the Semen: Causes & Treatments

Blood in the Semen
Medically reviewed by Richard Honaker M.D.

Overview

Finding blood in your semen can be a distressing situation. It may not be painful, but frequent episodes of bloody semen are a cause of concern, especially for men in their 30s. Blood in semen can be caused by various underlying health conditions, such as infections, enlarged glands, and certain medications, or can be an initial symptom of cancer. It is treatable, and treatment is provided depending on the cause, such as prescription medication for infections. This article discusses the causes and available treatments for blood in semen.

What does blood in semen mean?

Blood in semen, also known as hematospermia, is a condition where semen can appear discolored due to mixing with blood. The blood can give semen a red, pink, brown, or reddish-brown appearance. It is uncommon in younger males as a symptom of a health condition, but after 30, it could indicate something serious. It is better to consult with a healthcare professional if you notice blood or discolored semen. 

What causes blood in the semen?

Underlying medical conditions and poor reproductive health can cause men to ejaculate blood. Some of the underlying causes can include:

Popped blood vessel

Blood vessels lining the prostate or seminal vesicles can rupture or pop during sexual conduct. This causes blood to mix with semen, giving it a colored appearance. Fresh blood will make it red or pink, and the sperm will darken, such as brown sperm, depending on how long the blood remains in the tube.  

A ruptured vessel can heal on its own in a few days. If bleeding continues, seek immediate medical attention

Blood in ejaculation is often not reported because either men don’t examine their ejaculate or feel ashamed of talking about it with their healthcare provider. It can signify a more serious medical problem for which immediate treatment is needed”, says Dr. Richard Honakar

Inflammation and infection

Inflammation and infection in the genitals, urinary tract, or any other reproductive gland and organ can cause blood in the ejaculatory fluid. Inflammation can occur due to infectious or non-infectious causes.

Infectious causes include bacteria, fungi, viruses, and sexually transmitted diseases (STDs) like chlamydia, herpes, and gonorrhea. A few symptoms of infections include:

  • Swelling in the genital area
  • Painful ejaculation
  • Experiencing pain while urinating or discharging
  • Fever 

Inflammation can cause a gland to swell or become enlarged. The following medical conditions can lead to blood in the ejaculate due to inflammation.

  • Prostatitis: Inflammation of the prostate gland causes pain, irritation, and blood to appear in the semen.
  • Epididymitis: Inflammation of the epididymis, the tube where the sperm is stored, causes pain while ejaculating, redness, and swelling in the scrotum.
  • Orchitis: Inflammation of both testicles.
  • Urethritis: Inflammation of the urethra leads to itching and burning around the opening of the penis, pain while urinating, and bloody semen. 
Infections like STDs can cause blood in ejaculatory fluid.

Trauma and injury

Blood in semen is common after experiencing physical trauma from an injury or medical procedure. Medical procedures such as prostate biopsy, vasectomy, radiation therapy, brachytherapy, and hemorrhoid injections can all lead to bleeding. 

A 2016 study involving 5000 male patients in a urology clinic found that 50-80% of patients experienced blood in semen (hematospermia) after prostate biopsy.  

Sexual activity

Having vigorous sex or abstaining from sexual intercourse for prolonged periods can be the source of blood in seminal fluid. You may also notice blood during or after sex, a bleeding episode after ejaculating, and light bleeding for a couple of days. 

Tumors

Tumors, though rarely, can also cause bloody ejaculations. Most common cancerous conditions include tumors in the prostate, testicles, polyps in the urethra, prostate cancer, and melanoma. You may also experience pain while urinating or ejaculating and in the groin. Men over 40 years of age have an increased risk of getting bloody sperm due to tumors. 

Other causes

Other potential causes, although rare, of blood in your semen include:

  • Diseases related to blood clots/blood disorders, like hemophilia
  • Anticoagulants and blood thinner medication
  • Tuberculosis
  • Parasitic infections 

How to treat blood in semen?

Bloody semen is mostly treatable, and treatment options are provided depending on the underlying condition. Some potential options include:

  • Antibiotics are prescribed to treat blood in sperm if the underlying cause is infection. Azithromycin, Amoxicillin, and Minocycline antibiotics are given for treating STDs like gonorrhea, chlamydia, and prostate infections.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) are prescribed to treat inflammation, especially in the cases of prostatitis, epididymitis, and orchitis.
  • Rest is advised if you experience bloody ejaculation after procedures such as prostate biopsy and vasectomy. Talk to your medical professional if blood in semen lasts over four weeks.
  • Prostate cancer, tumors, and polyps in the urethra are treated with surgery, radiation, and hormonal therapy.
  • Practice good hygiene and wear loose, comfortable clothes to avoid irritating the groin area. 
  • Communicate with your partner if the underlying cause is an STD so they can get tested and treated as well.
Most prostate infections are caused by bacteria. Get them treated with antibiotics now!

When should I see a doctor?

Blood in semen can resolve on its own after a few weeks. If you are experiencing recurring episodes of bloody semen, pain while urinating or ejaculating, swelling, or discomfort in the pelvis, suffered from a recent injury, or had a recent medical procedure done, then you should see a doctor. 

FAQs about blood in the semen

Can blood in sperm affect a woman?

Typically blood in the semen does not affect a woman. However, you can pass a contagious condition, such as STD, through sexual contact or contact with blood and other bodily fluids. If you risk spreading a disease, inform your partner and seek immediate help to stop the spread of infection.

How long can hematospermia last?

Hematospermia can last a few days to months, depending on the underlying cause. If the cause is a ruptured blood vessel, it can resolve itself in a few days. After a medical procedure like a vasectomy or an infection, if blood appears, it can take four to six weeks for semen to return to normal.

Can blood in semen affect fertility?

Bood in semen has no effect on fertility and sexual activity except in the case of testicular or prostate cancer. Even during cancer, the main cause of infertility is related to the cancer treatment rather than the disease itself. 

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Wallach, Edward E., and Hans Wolff. “The biologic significance of white blood cells in semen.” Fertility and sterility 63.6 (1995): 1143-1157.
  • Wilson, Leo. “Sperm agglutinins in human semen and blood.” Proceedings of the Society for Experimental Biology and Medicine 85.4 (1954): 652-655.
  • Vennemann, Marielle, et al. “Sensitivity and specificity of presumptive tests for blood, saliva and semen.” Forensic science, medicine, and pathology 10.1 (2014): 69-75.
  • Havrylyuk, Anna, et al. “Cytokines in the blood and semen of infertile patients.” Central European Journal of Immunology 40.3 (2015): 337-344.

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