Blood in Ejaculation: Causes and Concerns

Hematospermia

Hello doctor, I have a question.
In the past two weeks, I have experienced blood in my ejaculation during sexual intercourse twice.
Additionally, I have a slight burning sensation in the anterior urethra.
Sometimes, when I don't drink enough water, I feel some discomfort in the urethra when urinating.
What could be the issue? Thank you.

Hsu, 20~29 year old female. Ask Date: 2020/12/21

Dr. Xu Wencang reply Urology

Return to outpatient examination for treatment.

Reply Date: 2020/12/21

More Info

Experiencing blood in ejaculation, known as hematospermia, can be concerning and may indicate an underlying health issue. There are several potential causes for this condition, and it is essential to consider various factors, including your medical history, recent activities, and any accompanying symptoms.

Causes of Hematospermia:
1. Infection or Inflammation: One of the most common causes of blood in semen is an infection or inflammation in the reproductive or urinary tract. Conditions such as prostatitis (inflammation of the prostate gland), urethritis (inflammation of the urethra), or sexually transmitted infections (STIs) can lead to hematospermia. The accompanying symptom of urethral pain you described may suggest an infection.

2. Trauma or Injury: Any trauma to the genital area, whether from vigorous sexual activity or injury, can cause bleeding. If you have engaged in any activities that could have caused trauma, this might be a contributing factor.

3. Prostate Issues: Conditions affecting the prostate, such as benign prostatic hyperplasia (BPH) or prostate cancer, can also lead to blood in the semen. While these conditions are more common in older men, they should not be overlooked, especially if there are other concerning symptoms.

4. Vascular Issues: Abnormal blood vessels in the reproductive system can sometimes rupture, leading to bleeding. This is less common but can occur.

5. Systemic Conditions: Certain systemic conditions, such as hypertension or blood clotting disorders, can also contribute to hematospermia. If you have a history of bleeding disorders or are on anticoagulant medications, this may be relevant.

Concerns and Recommendations:
Given that you have experienced this symptom twice in the past two weeks, it is advisable to seek medical attention. A healthcare provider will likely perform a thorough evaluation, which may include:
- A detailed medical history and physical examination.

- Urinalysis to check for signs of infection or blood.

- Semen analysis to assess for abnormalities.

- Imaging studies, such as an ultrasound, to evaluate the prostate and surrounding structures.

It is crucial to address any potential infections promptly, as untreated infections can lead to more severe complications. Additionally, if there are any signs of systemic issues or if the bleeding persists, further investigation will be necessary.

Hydration and Urinary Health:
You mentioned experiencing discomfort when urinating, especially when dehydrated. Staying well-hydrated is essential for urinary health, as concentrated urine can irritate the bladder and urethra, potentially exacerbating discomfort. Aim to drink plenty of fluids throughout the day, and consider reducing irritants such as caffeine and alcohol, which can worsen urinary symptoms.

In conclusion, while hematospermia can be caused by various factors, it is essential to consult a healthcare professional for an accurate diagnosis and appropriate treatment. Early intervention can help address any underlying issues and prevent potential complications.

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