Blood in Your Semen Should Be a Red Flag

If there's one element you're not expecting in semen, it's blood. To be honest, there's probably not a whole lot you would expect to see in semen other than, well, semen.

Fortunately, if you do happen to notice blood in your semen—a condition called hematospermia—it's usually harmless and nothing to worry about. However, in some rare cases, blood in the semen could be a sign of a deeper medical problem. Here's what you need to know if you notice hematospermia.

What causes hematospermia?

Multiple outside factors, such as trauma, could lead to having blood in your semen, or it could originate from something more serious, like cancer.

Most of the time, however, blood in the semen is nothing to worry about, explained Mohit Khera, M.D., MPH, a professor of urology at Baylor College of Medicine who specializes in male and female sexual dysfunction and male infertility.

"Typically, blood in the semen is not dangerous," he said. "The majority of the time, it's benign."

Finding blood in your semen can be a sticky situation because not everyone is in the habit of examining their semen after ejaculation, so doctors can't say with certainty how often it occurs. But it does happen, and when it does, a few different culprits may be responsible.

Prostate inflammation

The number-one cause of blood in the semen is inflammation in the prostate gland, also known as prostatitis, said S. Adam Ramin, M.D., a urologist and the medical director of Urology Cancer Specialists in Los Angeles.

He explained that prostatitis can occur on its own or secondary to an infection in the prostate. Blood in the semen could be the result of more serious prostate inflammation resulting from prostate cancer, though it's usually only a very late symptom of very advanced prostate cancer and is seen only in rare cases.

"The most common finding is usually some type of inflammation having to do with the prostate," Ramin said.

Khera added that, thanks to screening, most prostate cancers are detected early. He stressed that it's very rare to see blood in semen because of prostate cancer, but said the possibility should definitely be evaluated.

Infection

Blood in the semen can also result from an infection elsewhere in the reproductive system. For instance, an infection in the seminal vesicles—the glands responsible for producing a large portion of the ingredients in semen—could lead to blood showing up in semen. Sexually transmitted infections (STIs) could also lead to hematospermia.

Khera added that if you have pain when you ejaculate, along with blood, it's another point on the side of an infection being the ringleader.

"Do you have pain? That's important," he said. "Because if [you] have pain with the ejaculate and there's blood, sometimes it leads more to an infectious process."

A tumor

A tumor in the pelvic area or the seminal vesicles is among the lesser known and uncommon causes of blood in the semen, Ramin said.

Trauma

If you recently had a procedure done near the prostate, such as a biopsy or vasectomy, or suffered an injury near your reproductive system, the blood could be a result of that trauma.

"We know that many men who have a prostate biopsy will have and see blood in the semen, sometimes even several months after having the prostate biopsy," Khera said.

A broken blood vessel

The cause of hematospermia could be as simple as a blood vessel breaking during ejaculation, according to the Mayo Clinic, much like when you sometimes see blood while blowing your nose.

When to worry about blood in your semen

Anytime you notice blood in your semen, it warrants a checkup with your doctor, Ramin said. He added that even if the blood is a one-time occurrence or goes away on its own, it's still a good idea to get checked out and rule out the possibility of an infection or something more serious.

"It's important to understand that the sources of infection sometimes can be sexually transmitted sources," Ramin explained. "And that's why it is important for that person to seek help. If they have an STD, it's important for them to get treated. And even if it's a run-of-the-mill type of infection, it's still important to get treated."

You should also be on the lookout for any additional symptoms that could signal a problem. For instance, if you experience any of the following symptoms, be sure to bring them up to your doctor:

• Burning with urination
• Increased urinary frequency
• Pelvic pain
• Pain in the perineum, the area between the genitals and anus

Ramin encourages a trip to your family doctor, and if they conclude further investigation is needed, to see a urologist. You can expect a physical examination as well as potentially a prostate ultrasound. If an infection is found, your doctor will most likely prescribe antibiotics and a follow-up visit to ensure the infection has cleared.

On a final note, if you aren't experiencing other symptoms and aren't having pain when you ejaculate, Khera offered the reassurance that there's typically no harm to your sexual partner if you do notice blood in your semen. If you want to continue sexual activity while you wait for your doctor's appointment, you can wear a condom.