Medically reviewed by
Dr Gideon Blecher
What does blood in your semen mean?
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 blood in your ejaculate 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 haematospermia. It might be more common in men under 40 years, 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 you’ve noticed blood in your semen for 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
In most cases, blood in your semen is not caused by anything life-threatening. In lots of cases, the cause is not known and it goes away on its own. However, here are some of the most common causes of blood in your semen.
Infection
Infection can cause of blood in your semen. When bacteria, viruses or other pathogens enter the male reproductive tract, they can trigger inflammation in the prostate, urethra, seminal vesicles or epididymis. This inflammation can damage small blood vessels in the area, allowing blood to mix with semen. Prostatitis (inflammation of the prostate), sexually transmitted infections (like chlamydia or gonorrhoea) and urinary tract infections can cause blood in your semen.
Injury and trauma
Injury or trauma can cause blood to appear in semen, typically when small blood vessels in the prostate, urethra or seminal vesicles are ruptured. This may happen after a blow to the groin, vigorous sexual activity or activities like cycling. Medical procedures like a prostate biopsy or vasectomy can have a similar effect. In most cases, blood in semen from trauma is short-lived and clears once the affected tissues heal.
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Cancer
Cancer is a rare cause of blood in semen. Growths in areas like the prostate, bladder or testes can disrupt or damage nearby blood vessels, allowing blood to leak into the reproductive tract. While non-cancerous conditions are more common causes of blood in your semen, it’s important to see a doctor to rule out serious causes if the bleeding is persistent or unexplained.
Blood clotting problems
Blood clotting problems can make it easier for bleeding to occur within the reproductive tract, leading to blood in the semen. Conditions that affect how the blood clots, or the use of medications such as blood thinners, may cause even minor irritation or vessel damage in the prostate, seminal vesicles or urethra to result in visible bleeding. In these cases, blood in semen may persist until the underlying clotting issue is managed.
High blood pressure
Severely high blood pressure may also cause blood in your semen, because it can cause a blood vessel to rupture in your reproductive system.
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 or from your sexual partner.
Your doctor may take your blood pressure and ask for samples of urine or semen. They may refer you to a urologist if they think further investigations are needed. Other investigations may include blood tests, imaging using ultrasound or MRI, and cystoscopy.
How is blood in your semen treated?
Treatment for haematospermia depends on the underlying cause. If it’s due to infection, the right antibiotics or other treatment should fix it.
If the blood in your semen 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.
