Changes in Semen Color: Causes and When to Seek Help

Q: Changes in Semen Color: Causes and When to Seek Help

Hello： Unless it is an acute infection, there is generally no urgency, and most conditions will resolve on their own. <br>It is important to pay attention to lifestyle, such as staying hydrated, avoiding spicy and irritating foods, and refraining from intense exercise. <br>Immedi

After taking the medication for a week, it became very, very dark?

Hello, I used to have my girlfriend help me with ejaculation (masturbation) once a week.
On April 20, everything was normal with a light whitish color.
On April 26, I noticed a slight light brown color, and after researching online, I found it could be hematospermia (blood in semen).
On the morning of April 27, I sought help from my girlfriend again, but since I had ejaculated the night before, there was less semen, and it appeared slightly pink.
I then mentioned this to a nurse I know at a clinic and even sent her a photo.
With her 20 years of experience, she conducted a brief consultation and suggested that it probably wasn't prostatitis or urethritis and advised me to refrain from seeking help from my girlfriend for now.
On Sunday, April 28, with my family out of the house, I visited a nearby clinic.
The doctor asked about my discomfort, and I explained that there was no pain or itching, just a change in color after ejaculation.
After reviewing the photo, he confirmed it was hematospermia, indicating inflammation as a possible cause.
He prescribed a course of medication (3 doses over 2 days) and asked if I wanted an anti-inflammatory injection, to which I agreed.
On April 28, I received my first dose of medication and the injection.
On April 30, I had my first follow-up appointment with the same medication and injection.
On May 3, I had my second follow-up with the same treatment.
On May 4, thinking that a week had passed, I hoped for improvement and sought help from my girlfriend again.
However, after ejaculation, I noticed the color had darkened significantly, possibly to a dark brown or chocolate-like color, not fully mixed but with varying shades.
I'm uncertain whether this indicates a worsening condition or if it is a sign of improvement.
The doctor prescribed the following three medications: paracetamol, pyridium, and Levoxin.
I found information stating that "old blood typically clears after 10-15 ejaculations." However, the nurse I know mentioned that it seemed to have worsened and advised me to see a doctor immediately.
I promptly visited my family doctor, who provided me with a referral to a urologist, but I have to wait until Monday for an appointment.

Xianggang ren, 30~39 year old female. Ask Date: 2019/05/04

Dr. Du Shixi reply Urology

Hello: Unless it is an acute infection, there is generally no urgency, and most conditions will resolve on their own.
It is important to pay attention to lifestyle, such as staying hydrated, avoiding spicy and irritating foods, and refraining from intense exercise.
Immediate medical attention is necessary only if there is fever, cloudy urine, or perineal pain.
However, this phenomenon (red or dark-colored semen) may recur, so it is important to be mentally prepared.
Wishing you good health.

Reply Date: 2019/05/04

More Info

Understanding changes in semen color can be concerning, and it's important to approach this issue with a clear understanding of potential causes and when to seek medical help. Based on your description, it seems you have experienced a transition from normal semen color to shades of brown and pink, which can indicate the presence of blood (hematospermia).

Causes of Changes in Semen Color:
1. Infection or Inflammation: Conditions such as prostatitis (inflammation of the prostate gland) or urethritis (inflammation of the urethra) can lead to changes in semen color. These infections can cause bleeding, resulting in a reddish or brownish tint.

2. Trauma: Any recent trauma to the genital area, whether from vigorous sexual activity or injury, can lead to blood in the semen.

3. Vascular Issues: Conditions affecting blood vessels, such as varicocele (enlargement of veins within the scrotum), can also lead to hematospermia.

4. Benign Prostatic Hyperplasia (BPH): An enlarged prostate can sometimes cause bleeding, which may manifest as discoloration in semen.

5. Malignancy: Although less common, tumors in the prostate or seminal vesicles can lead to blood in the semen. This is why persistent changes in semen color should be evaluated by a healthcare professional.

When to Seek Help:
You have already taken a significant step by consulting with healthcare professionals. It is crucial to follow up with a urologist, especially since you have experienced a change in color that has persisted despite treatment. Here are some guidelines on when to seek help:
- If the discoloration persists beyond a few weeks.

- If you experience additional symptoms such as pain during ejaculation, difficulty urinating, or any other unusual symptoms.

- If you notice any other changes in your health, such as fever, chills, or weight loss.

Treatment and Follow-Up:
The medications you were prescribed (paracetamol, pyridium, and Levoxin) suggest that your doctor is addressing potential infection and inflammation. Levoxin, an antibiotic, is particularly important if an infection is suspected. It's essential to complete the full course of antibiotics as prescribed, even if symptoms improve.

Regarding your concern about whether the change in color indicates worsening or improvement, it can be challenging to determine without further medical evaluation. The presence of darker shades may suggest ongoing bleeding or a more significant issue that needs to be addressed.
The advice you received about "old blood" being cleared after several ejaculations is generally accurate; however, it is essential to monitor the situation closely. If the discoloration continues or worsens, it is advisable to seek immediate medical attention.

In conclusion, while changes in semen color can be alarming, they are often treatable. Your proactive approach in seeking medical advice is commendable. Continue to follow up with your healthcare provider, and do not hesitate to express any concerns you have during your visits. Early intervention can lead to better outcomes, so staying vigilant about your symptoms is key.

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