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Blood in the Semen

What is blood in the semen?

For any man, seeing blood in his semen can be startling. It is a rare disorder, but fortunately, it rarely signals a serious problem, especially in men under the age of 40. Blood in the semen (hematospermia) usually does not last long, as it is usually a self-resolving problem.

What should I look for?

The amount of blood in your semen can vary from a small drop to enough to give your semen the look of blood. The amount of blood in your semen will depend on the cause of your bleeding. In addition to having blood in your semen, you might also experience:

  • pain when ejaculating
  • pain when urinating
  • tenderness or swelling in your scrotum
  • tenderness in the groin area
  • pain in your lower back
  • blood in your urine

Potential causes of blood in the semen

Semen passes along a series of tubes on the way to the urethra for ejaculation. Any number of things can cause blood vessels along this path to break and leak blood into the semen.

In many cases, the exact cause for blood in the semen is never determined. According to Harvard Medical School, most cases of blood in the semen are not serious and can be attributed to six causes: inflammation/infection, obstruction, tumors, vascular abnormalities, systemic factors, or trauma/medical procedures. The most common cause is prostate biopsy.


Inflammation of the seminal vesicles is a common cause of bloody semen. Inflammation of any gland, duct, tube, or organ involved in the male genitals can cause blood in your semen. This includes:

  • prostatitis (inflammation of the prostate gland), which can cause pain, urination problems, and sexual dysfunction.
  • epididymitis (inflammation of the epididymis, or the coiled tube in the back of the testicle where sperm is stored), most often caused by a bacterial infection, including sexually transmitted infections (STI’s) gonorrhea or chlamydia. Symptoms include red or swollen scrotum, testicle pain and tenderness on one side, discharge, and painful urination.
  • urethritis (inflammation of the urethra), which can cause pain while urinating, itching or burning near the opening of the penis, or penile discharge.

Inflammation can also be caused by irritation from calculi (stones) in the prostate, seminal vesicles, bladder, or urethra.


Just as with inflammation, infections in any gland, duct, tube, or organ involved in the male genitals can cause blood in the semen.

Sexually transmitted infections like chlamydia, gonorrhea, or herpes can also cause blood in semen. Infections caused by viruses, bacteria, or fungi can also lead to this condition.


If ducts like the ejaculatory duct are blocked, surrounding blood vessels can dilate and break. If your prostate is enlarged, it can put pressure on your urethra, which can cause hematospermia.


Benign polyps or malignant tumors in the prostate, testicles, epididymis, or seminal vesicles could lead to blood in your semen.

Vascular abnormalities

Vascular abnormalities in the male genitals such as vascular cysts could explain the blood you’ve seen in your semen.

Systemic factors

Conditions that affect your whole body can cause blood in your semen. These include hypertension (high blood pressure), hemophilia (disorder that leads to easy and excessive bleeding), leukemia, and chronic liver disease.

Trauma/medical procedures

Physical trauma like being hit in your testicles while playing sports can lead to blood in your semen. Trauma can cause blood vessels to leak, and that blood may leave your body in semen. A medical procedure like a prostate exam or biopsy or a vasectomy can cause blood in your semen.

Knowing when to see your doctor

If you are over 40

Men age 40 or over have a higher risk of developing illnesses like prostate cancer. Because of this, you should tell your doctor any time you see blood in your semen. Your doctor will want to check for the cause of the blood as soon as possible.

If you are under 40

If you are under the age of 40 and don’t have any symptoms other than bloody semen, wait and see if the blood goes away on its own. If your semen continues to be bloody or if you start experiencing additional symptoms like pain or a fever, make an appointment with your doctor. He or she might perform a prostate exam or analysis of your semen and urine to determine the source of the blood.

Diagnosing the problem

When you visit your doctor, they’ll first need to determine the cause of the blood in the semen. Things they may do include:

  • Physical examinations. Your doctor may examine you for other symptoms, including swollen testicles, redness, or other visible signs of infection or inflammation.
  • STI tests. Through tests including blood work, your doctor will check to make sure you don’t have STI’s that could be causing the bleeding.
  • Urinalysis. This can help detect bacterial infections or other abnormalities in your urine.
  • PSA testing, which tests for prostate-created antigens and evaluates the health of the prostate.
  • Screening tests like ultrasounds, CTs, and MRIs, which can help locate obstructions.

If hematospermia lasts longer than 1 month, a transrectal ultrasound may be indicated.

Men older than age 50 may be referred to a urologist for further evaluation

Treatment: resolving your symptoms

Depending on the cause of the blood in your semen, you might be able to treat yourself at home. If the underlying cause requires medical treatment, your doctor will decide the course that is right for you.

Treatment at home

If you have blood in your semen as a result of a trauma, simply resting and allowing your body to heal may help. If you also have swelling in your groin, you can apply ice to the area for 10 to 20 minutes at a time, but no longer than that. Most cases of hematospermia resolve on their own. Keep an eye on your symptoms and alert your doctor if they get worse or persist for longer than one month.

Medical treatment

If the blood in your semen is caused by an infection, your doctor will probably prescribe antibiotics. Anti-inflammatory medications are available if inflammation alone is the cause. If the blood in your semen is caused by a blockage in your genitourinary tract, surgery may be necessary.

Potential surgeries include removal of a bladder stone that’s obstructing the urinary tract, of surgery to remove tumors.

If cancer is causing the blood in your semen, your doctor will probably refer you to a specialist (oncologist) who will determine the best treatment.

As startling as blood in your semen may be, it’s important to remember that in most cases it’s not a symptom of a serious condition.

Content licensed from:

Written by: Carmella Wint and Ana Gotter
Medically reviewed on: Jul 18, 2016: University of Illinois-Chicago, College of Medicine

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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