Definition Blood in the semen is uncommon. Seeing it can make people quite anxious, but it is rarely serious.
What is going on in the body? Most cases of blood in the semen are from unknown causes. It usually goes away on its own.
What are the signs and symptoms of the condition? Seeing blood in the semen can be quite frightening. Men with this symptom are often asked several questions by the doctor, including:
how many times blood has been seen in the semen
when the bleeding started
if there is blood in the urine or bleeding in other areas of the body
if the man has any pain
how often the man has had sex recently
if the man has ever had a sexually transmitted disease
what kind of sexual practices the man engages in
Other questions may be asked as well.
What are the causes and risks of the condition? Most cases are from an unknown cause. Known causes include:
infections of the prostate gland, called prostatitis. Prostatitis may be acute, chronic, or non-bacterial.
infections of the seminal vesicles, which are two structures that secrete some of the fluid found in semen
infections of the urethra, known as urethritis. The urethra is the tube that carries urine and semen to the outside of the body.
urethral strictures, or narrowing in an area of the urethra. This may be caused by trauma or a previous infection.
certain sexual habits, such as prolonged abstinence or lack of sex, or unusually frequent sex
bleeding or blood clotting problems, such as haemophilia A or haemophilia B. Clotting problems can also occur in men who are taking too much of the blood-thinning drug warfarin.
tumours or cancer, a rare cause. The cancer may be in the prostate, seminal vesicles, or urethra.
What can be done to prevent the condition? Most cases cannot be prevented because the cause is unknown. Urethral stricture and infection of the urethra are often due to sexually transmitted diseases. So practicing safer sex could prevent some cases of blood in the semen.
How is the condition diagnosed? Diagnosis begins with a history and physical. This may be all that is needed in some cases. In other cases, further testing may be done. Urine tests, including a urinalysis and urine culture, are commonly used to look for infection or bleeding. Imaging studies or x-ray tests may be used to look for a urethral stricture.
What are the long-term effects of the condition? There are usually no long-term effects. Many affected men have repeated episodes of blood in the semen with no other symptoms or problems. Urethral strictures are usually permanent unless they are treated. Cancer is quite rare, but could possibly result in death.
What are the risks to others? Blood in the semen itself is not contagious. If the cause is an infection, such as a sexually transmitted disease, the infection may be contagious.
What are the treatments for the condition? Treatment is directed at the cause, if one can be found. A man may be given antibiotics for a short time in case there is an infection. A man with cancer or urethral strictures may need surgery.
What are the side effects of the treatments? Antibiotics may cause allergic reactions, stomach upset, or headaches. All surgery carries a risk of bleeding, infection, and other complications.
What happens after treatment for the condition? Many men continue to have occasional episodes of blood in their semen. Others may only have it once. Treatment doesn't seem to affect this.
A man with a known cause for the blood usually gets better with treatment. After treatment, most men have no limitations on activities.
How is the condition monitored? The man can monitor his semen at home for further episodes of bleeding. Changes or response to treatment can be reported to the doctor. Other monitoring is related to the cause. For example, a man who takes a blood thinner such as warfarin usually has regular prothrombin time, or PT, blood tests.
Author: Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
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