Blood in Semen (Haematospermia)

What is blood in your semen?

Haematospermia is the medical term used to refer to the presence of blood in your semen. It’s usually painless, but the sight of blood in your semen can be scary. A single occurrence of haematospermia is usually nothing to worry about.

It’s difficult to know how common haematospermia is because people don’t always look at their semen after they ejaculate. People who do notice it might not talk to their doctor about it because they’re embarrassed or scared.

Among more than 26,000 American men screened for prostate cancer (aged 40 years or older), only 0.5% had haematospermia¹. It might be more common in men under 40 years², but available data isn’t reliable.

Symptoms of blood in your semen

Blood in your semen may appear as a spot of bright red blood, or your entire ejaculate may be coloured.

Bright red blood is fresh and due to recent bleeding, whereas brown or black blood is older and suggests some time has passed since the bleeding occurred.

If you’re over 40 and haematospermia is observed over a prolonged period of time, it may be a symptom of a problem that needs treatment, especially if you have other symptoms such as pain or lower urinary tract symptoms (LUTS).

Causes of blood in your semen

Infections, inflammation or small stones within the reproductive system are the most likely causes of haematospermia. Injury and trauma are other common causes of haematospermia, sometimes resulting from procedures used to diagnose or treat other conditions. Cancer is a rare cause of haematospermia.

People who have blood clotting problems, or who are taking blood-thinning medication, may get blood in their semen more often than those who don’t. Severely high blood pressure may also cause haematospermia. In most cases, haematospermia is not caused by anything life-threatening. In lots of cases, the cause of haematospermia is not known, and it goes away on its own.

Diagnosis of blood in your semen

When you see your doctor about blood in your semen, they will perform a physical examination and ask questions to rule out the possibility that the blood is from somewhere else, like your urine.

Your doctor may take your blood pressure and ask for samples of urine. They may refer you to a urologist if they think further investigations are needed.

Other initial investigations may include blood tests or imaging using ultrasound.

Treatment of blood in your semen

Treatment for haematospermia depends on the underlying cause. If it’s due to infection, the right antibiotics or other treatment should fix it. If your haematospermia might be due to something more serious, the priority will be to identify and treat that.

Injury or trauma should heal itself with time.

Health effects of blood in your semen

Haematospermia might alert you and your doctor to some underlying problem that may impact your health, but usually, there are no implications for your health and wellbeing.

What to do about blood in your semen

If you notice blood in your semen, you should go and see your doctor about it.

This information has been produced in consultation with and approved by: Healthy Male

References

[1] Han, M., Brannigan, R.E., Antenor, J.A.V., Roehl, K.A., and Catalona, W.J., 2004. Association of hemospermia with prostate cancer. Journal of Urology.

[2] Mulhall, J.E. and Albertsen, P.C., 1995. Hemospermia: diagnosis and management. Urology.

Where to get more information and support

• Sexual Health Victoria
• Healthy Male (formerly Andrology Australia)
  
• A doctor or nurse
• Your local community health service
• A dermatologist
• Melbourne Sexual Health Centre – a specialist sexual health clinic
• Better Health Channel - Is my body normal?
• Equinox – for transgender services
• The Centre Clinic – a safe and friendly general practice, providing care for LGBTI community members as well as specialist medical care for people living with HIV, and expert sexual health screening and treatment.

If you are using the internet for information, only use reliable and reputable websites, such as the ones provided above.