Blood in Semen: Causes and When to Seek Help

The issue of hematospermia?

Hello Doctor: Recently, during DIY (not frequently) or sexual activity, I noticed that the color of my semen is dark brown with a slight blood tinge.
After researching, I found that this could possibly be due to holding in urine or trauma during exercise, which may have caused bleeding.
In this situation, will it return to normal after a few ejaculations? Thank you, Doctor.

JC, 20~29 year old female. Ask Date: 2017/06/19

Dr. Xu Wencang reply Urology

It can be observed, and after a few visits, a follow-up appointment should be scheduled.

Reply Date: 2017/06/19

More Info

The presence of blood in semen, known as hematospermia, can be concerning and may arise from various causes. It is essential to understand the potential reasons behind this symptom and when it is necessary to seek medical attention.

Common Causes of Blood in Semen
1. Infection or Inflammation: One of the most common causes of blood in semen is an infection or inflammation in the reproductive system. Conditions such as prostatitis (inflammation of the prostate gland), epididymitis (inflammation of the epididymis), or sexually transmitted infections (STIs) can lead to hematospermia.

2. Trauma or Injury: Physical trauma to the genital area, whether from vigorous sexual activity, sports, or accidents, can cause bleeding. If you have experienced any recent impact or injury, this could explain the presence of blood.

3. Vascular Issues: Abnormalities in blood vessels, such as varicoceles or other vascular malformations, can lead to bleeding in the semen.
4. Benign Prostatic Hyperplasia (BPH): In older men, an enlarged prostate can lead to various urinary and sexual symptoms, including hematospermia.

5. Tumors: Although less common, tumors in the prostate, seminal vesicles, or other parts of the reproductive system can cause blood to appear in semen.

6. Systemic Conditions: Certain systemic conditions, such as hypertension or blood clotting disorders, can also contribute to hematospermia.

When to Seek Medical Help
While occasional blood in semen may not always indicate a serious problem, it is crucial to monitor the situation. Here are some guidelines on when to seek medical attention:
- Persistent Symptoms: If the blood in your semen persists over several ejaculation events, it is advisable to consult a healthcare provider.

- Associated Symptoms: If you experience additional symptoms such as pain during ejaculation, swelling in the genital area, fever, or any unusual discharge, you should seek medical attention promptly.

- Recent Trauma: If you have experienced any trauma to the genital area, and you notice blood in your semen, it is wise to consult a healthcare professional to rule out any serious injury.

- Age Considerations: Men over the age of 40 should be particularly vigilant, as hematospermia can sometimes be associated with prostate issues that require evaluation.

Conclusion
In summary, while blood in semen can sometimes resolve on its own, especially if it is related to minor trauma or temporary inflammation, it is essential to remain vigilant. If you notice persistent blood, experience additional symptoms, or have concerns about your health, do not hesitate to seek medical advice. A healthcare provider can perform a thorough evaluation, including a physical examination and possibly imaging or laboratory tests, to determine the underlying cause and recommend appropriate treatment. Remember, early intervention can often lead to better outcomes and peace of mind.

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