Urology of Greater Atlanta

Hematospermia: Should You Be Concerned?

A man worried about hematospermia.

Hematospermia is a type of urological disorder that affects a large number of men. While it is not normally a reason for concern, it is important to learn about this condition. In this article, we will talk about how common hematospermia is, its possible causes, symptoms you should watch out for, as well as potential treatments for this condition.

When faced with chronic hematospermia, seeking prompt medical evaluation is crucial to uncover the underlying causes and explore effective treatment options. Contact the board-certified urologists at Urology of Greater Atlanta for further help with this condition. You can find us in multiple locations throughout Georgia.

What is Hematospermia?

Hematospermia is the medical term for the presence of blood in your semen. It is also called hemospermia. In many cases, the presence of blood in your semen is not usually a sign of a significant health problem.

Who Does Hematospermia Affect?

Hematospermia can affect men of any age. However, it is more likely to occur in men aged between 30 and 40 years old.

The Causes of Hematospermia

Until recently, the exact cause of hematospermia was not known and attributed to prolonged sexual abstinence or vigorous sexual experiences. Advances in medicine have now found that there could be several causes of blood in the semen. They may include the following:

Infection and Inflammation

Infection or inflammation is often the leading culprit behind blood in the semen. This can stem from issues within various reproductive structures, including:

  • Prostate: The gland responsible for semen’s fluid component.
  • Urethra: The tube that conveys both urine and semen from the penis.
  • Epididymis and Vas Deferens: These tiny tube-like structures are where sperm mature before ejaculation.
  • Seminal Vesicles: These contribute additional fluid to semen.

Sexually transmitted infections (STIs) like gonorrhea and chlamydia, as well as other viral or bacterial infections, can also lead to blood in semen. Remarkably, infection and inflammation are responsible for nearly 40% of such cases.

Trauma or Medical Procedures

Following medical procedures, blood in the semen is not uncommon. For example, after a prostate biopsy, up to 80% of men may temporarily experience this condition.

Procedures intended to treat urinary issues can also cause minor trauma, leading to temporary bleeding, which typically subsides within several weeks.

Radiation therapy, vasectomy, and hemorrhoid injections can also be sources of blood in semen. Physical trauma to the genitalia, as a result of pelvic fractures, testicular injuries, or overly strenuous sexual activity, can trigger this phenomenon.


Blockages within the reproductive tract can cause tiny blood vessels to rupture, releasing small amounts of blood. Benign prostatic hyperplasia (BPH), an enlargement of the prostate that can constrict the urethra, is linked to blood in semen.

Tumors and Polyps

While tumors are a less common cause, accounting for only 3.5% of cases involving blood in semen, they are a serious concern. Most often, these tumors are found in the prostate. However, blood in semen can also be associated with cancer in the testicles, bladder cancer, and other reproductive or urinary tract organs.

Individuals with risk factors for cancer, particularly older men, should seek medical evaluation if they experience blood in their semen. Untreated cancer can pose a grave threat to one’s health. Benign growths known as polyps in the reproductive tract, though harmless in most cases, can also lead to blood in semen.

Blood Vessel Problems

Blood vessels are present throughout the delicate structures involved in ejaculation, ranging from the prostate to the sperm-carrying tubes. Damage to these blood vessels can result in the presence of blood in semen.

Other Medical Conditions

Several medical conditions can be linked to hematospermia, including severe hypertension, HIV, liver disease, leukemia, bleeding disorders, and others.

Unexplained Cases

It’s worth noting that up to 15% of hematospermia cases lack a clear cause. Many of these instances are self-limiting, meaning that the blood in the semen resolves itself without the need for medical intervention.

Related Symptoms of Hematospermia

When looking for an underlying cause of blood in the semen, the doctor will ask about any related symptoms, including the following:

  1. Hematuria (Blood in the Urine)
  2. Painful Urination Symptoms:
    • Intense burning sensation during urination
    • Difficulty fully emptying the bladder
  3. Bladder Discomfort:
    • A sense of distension and pain in the bladder
  4. Painful Ejaculation
  5. Genital Issues:
    • Swollen or painful areas on the genitals
    • Noticeable abrasions or injuries
    • Presence of penile discharge or other potential STD indicators
  6. Systemic Symptoms:
    • Fever
    • Elevated pulse rate
    • High blood pressure, exceeding the normal range
A man experiencing blood in his semen.

Diagnostic Tests and Evaluation

When addressing the concern of blood in semen, diagnostic tests and a comprehensive evaluation are crucial in determining the underlying causes. The diagnostic process typically unfolds as follows:

  1. Medical History and Sexual Activity: The initial step involves the doctor considering your medical history and recent sexual activity. This provides valuable context for the evaluation.
  2. Physical Examination:
    • Genital Examination: A physical examination includes an assessment of the genital area to detect any lumps, swelling, or abnormalities.
    • Digital Rectal Examination: To assess the prostate, the doctor may conduct a digital rectal exam, checking for swelling, tenderness, and other indicative symptoms.
  3. Laboratory Tests:
    • Urinalysis or Urine Culture: These tests help identify potential infections or abnormalities in the urinary system.
    • STD Testing: If there is suspicion of a sexually transmitted disease, relevant testing will be performed to rule out or confirm this possibility.
    • Condom Test: In cases where it’s conceivable that the blood in semen originates from a partner’s menstrual cycle, a unique “condom test” may be conducted. The man is advised to wear a condom during intercourse, and the subsequent examination of the collected semen helps determine the source of the bleeding.
  4. Prostate-Specific Antigen (PSA) Testing: PSA testing involves measuring prostate-specific antigen levels in the blood. This test is essential for evaluating the potential presence of prostate cancer.
  5. Additional Urological Assessments: In some instances, further tests may be necessary to delve deeper into the patient’s condition. These may include:
    • Cystoscopy: A procedure using a thin, flexible tube with a camera to examine the bladder and urethra.
    • Transrectal Ultrasound: Utilizing ultrasound imaging to visualize the prostate and surrounding structures.
    • CT (Computed Tomography) and MRI (Magnetic Resonance Imaging): These imaging techniques provide a comprehensive view of the urological and reproductive systems, aiding in a more precise diagnosis.

By following this structured diagnostic approach, healthcare professionals can effectively determine the cause of blood in semen and tailor appropriate treatment strategies accordingly.

A couple happy about there being no more blood in his semen.

How is Hematospermia Treated?

When experiencing persistent hematospermia, it’s vital to consult a healthcare professional for a comprehensive evaluation and tailored treatment. The approach to treating hematospermia is customized to address the specific underlying cause:

  • Infection-Related Hematospermia: Antibiotics are administered to combat infections causing blood in semen.
  • Inflammatory Hematospermia: In cases of inflammation, an anti-inflammatory medication may be recommended to alleviate symptoms.
  • Sexually Transmitted Diseases (STDs): If an STD is determined to be the source of the issue, the doctor will initiate treatment for the specific STD in question.
  • Post-Urological Procedure Hematospermia: In instances where blood in semen follows a recent urological procedure, such as a prostate biopsy, it often resolves naturally over several weeks, requiring no additional treatment.

Book Your Appointment Today

If you need further assistance with hematospermia, consider booking an appointment with the board-certified urologists at Urology of Greater Atlanta, which has multiple locations across Georgia. We can discretely help you get the peace of mind you are looking for. Contact us today!

Stockbridge, Country Club Drive

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Atlanta, GA 30342

Griffin, West College Street

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