Blood in Semen: Causes and Concerns for Men

Experiencing blood in the semen for several consecutive months?

Hello, doctor! Over two years ago, I experienced blood and blood clots in my urine after watching adult films, after sexual intercourse, and upon waking up in the morning.
After consulting a doctor, I underwent X-rays, ultrasounds, and contrast imaging, all of which showed no abnormalities.
Eventually, a cystoscopy revealed microvascular rupture.
The doctor prescribed anticoagulants, and I did not have any recurrences for nearly two years.
However, at the end of December last year, I noticed blood (pure blood) during sexual activity, and after finishing, I saw blood again.
I thought it was another microvascular rupture, and I refrained from sexual activity for two to three weeks, including abstaining from masturbation.
When I attempted to engage in sexual activity again, I experienced blood in my urine before even starting, which led me to see a doctor again.
This time, I was told I had seminal vesiculitis.
I underwent contrast imaging again and was prescribed anti-inflammatory medication.
About a month later, during sexual activity, I experienced bleeding (pure blood) again.
After stopping for another month, I had no sexual activity or masturbation, and on April 23, I tried to masturbate and ejaculated normally.
However, on April 27, during sexual intercourse, I ejaculated blood (pure blood) again.
What could be the cause of this? My sexual activity is not frequent or very vigorous.
Is this related to the prostate? Please help me understand! Thank you.

zenme ban, 30~39 year old female. Ask Date: 2016/05/01

Dr. Li Xinyi reply Urology

Hematospermia is mostly benign, but it can sometimes be associated with prostatic calculi.
However, it is important to remain cautious of other potential causes.
It is advisable to continue monitoring and follow-up with a urologist.

Reply Date: 2016/05/01

More Info

Understanding blood in semen, or hematospermia, can be concerning for many men, especially when it occurs repeatedly or is accompanied by other symptoms. Based on your detailed history, it seems you have experienced episodes of blood in your urine and semen over the past two years, with various investigations revealing microvascular rupture and inflammation of the seminal vesicles.
Hematospemia can arise from several causes, including infections, inflammation, trauma, or even benign conditions. In your case, the previous findings of microvascular rupture and the recent diagnosis of seminal vesicle inflammation suggest that these may be contributing factors to your symptoms. The seminal vesicles are glands that produce a significant portion of the fluid that makes up semen, and inflammation in this area can lead to bleeding.

The fact that you have had episodes of blood in your urine (hematuria) and semen (hematospermia) raises the possibility of a systemic issue or localized pathology. While your imaging studies (X-ray, ultrasound, and contrast studies) did not reveal any significant abnormalities, it is essential to consider that some conditions may not be easily detectable through these methods. For example, conditions like prostatitis (inflammation of the prostate gland) or benign prostatic hyperplasia (BPH) can sometimes lead to bleeding, although they may not always be visible on imaging.

Your recent experience of blood during ejaculation could be linked to the inflammation of the seminal vesicles, which may cause irritation and bleeding during sexual activity. It is also worth noting that sexual activity itself can sometimes exacerbate underlying conditions, leading to bleeding.
Given your history, it would be prudent to follow up with a urologist, especially since you have had recurrent episodes of hematospermia. They may recommend further evaluation, such as a repeat cystoscopy or additional imaging studies, to rule out any other potential causes. It may also be beneficial to discuss your sexual activity patterns and any other symptoms you may be experiencing, as this can provide valuable context for your healthcare provider.

In the meantime, here are some general recommendations:
1. Avoid Irritants: If you notice that certain activities (like vigorous sexual activity or certain positions) seem to trigger bleeding, it may be wise to avoid them until you have further clarity on your condition.

2. Stay Hydrated: Adequate hydration can help maintain urinary tract health and may reduce irritation.

3. Monitor Symptoms: Keep a log of any occurrences of blood in your urine or semen, including the timing, associated activities, and any other symptoms. This information can be helpful for your healthcare provider.

4. Follow Up: Since you have a history of this issue, regular follow-ups with your healthcare provider are essential to monitor your condition and adjust treatment as necessary.

5. Consider Lifestyle Factors: Factors such as stress, diet, and overall health can impact inflammation and bleeding. A balanced diet, regular exercise, and stress management techniques may help improve your overall health.

In conclusion, while hematospermia can be alarming, many cases are benign and related to inflammation or minor trauma. However, given your history and the recurrence of symptoms, it is crucial to work closely with a healthcare provider to ensure proper diagnosis and management.

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