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Medical Video: Blood in Semen Medical Course
Seeing semen bleed can cause anxiety for men.
Fortunately, this does not always indicate a serious health problem - and is common in men of all ages, especially after puberty. In younger men (less than 40 years), the condition of bleeding semen that is not followed by other symptoms can be categorized as benign. Even in men aged 40 years and over, this condition also includes rarely associated with malignancy.
Bloody semen conditions in the medical world are called hematospermia or hemospermia. When men ejaculate, they usually don't check their semen to intentionally look for blood - so it's hard to know how common this condition is.
The main cause of semen bleeding
To understand the causes of hematospermia, it's good to first arm yourself about the relevant anatomy of the ejaculatory system.
The male reproductive system consists of the testicles, the duct system (tube), and the glands that open into the channel. Sperm is produced in the testis. During orgasm, contraction of the penis muscles releases sperm, which is accompanied by a small amount of fluid, from the testes through the vas deferens. Seminal vesicles and prostate contribute to releasing additional fluids to protect sperm. A mixture of sperm and ejaculatory fluid (semen) travels along the urethra to the tip of the penis, the place where the fluid comes out. Bleeding can occur anywhere throughout this process.
Blood in semen can be caused by inflammation, viral or bacterial infections - including sexually transmitted infections such as genital herpes, trichomoniasis, gonorrhea or chlamydia - blockages, or injuries at a location along the male reproductive system. Seminal vesicles (two pairs of glands such as sacs located on both sides of the bladder) and prostate are the two main organs that contribute to the production of sperm (semen) protective fluid. An infection, inflammation, or trauma in one of these organs can cause blood to appear in semen. Infection and inflammation are the main causes behind nearly four out of every ten cases of bleeding semen reported.
In addition, blood in semen is fairly common as a side effect after certain medical procedures. For example, as many as four out of five men, quoted from WebMD, may have temporary bleeding in semen after carrying out a prostate biopsy. Procedures that are carried out to deal with bladder system problems can also cause minor trauma which causes temporary bleeding. This condition usually goes away a few weeks after the procedure. Radiation therapy, vasectomy, and injection of hemorrhoids can also cause blood to appear in semen.
A number of these causes are generally not serious and most cases will gradually recover on their own without special treatment, or after taking antibiotics or painkillers / anti-inflammatory drugs.
Other causes of bloody semen are more rare
Physical trauma to the sex organs after a pelvic fracture, injury to the testicles, or other injuries can cause semen to bleed. Blood in ejaculatory fluid can be seen during / after having rough sex or excessive masturbation, but this is not the cause of bleeding. Severe trauma to the bladder can cause bleeding from the urethra, but this condition is different from hematospermia.
Other causes of bloody semen are less commonly found, including:
- Severe hypertension
- Blood clotting disorders, or blood vessel problems - All the fine structures involved in the ejaculation process, from the prostate to the tubes of the sperm transport pathway, contain blood vessels. This complex of blood vessels can be damaged causing blood to appear in semen.
- Cancer - including prostate cancer, testicular cancer, and bladder cancer; however, most men with prostate cancer will not show these symptoms unless they have had a prostate biopsy that causes bleeding.
- Seminal vesicle calculi - deposition of small rocks in seminal vesicles
- Other medical conditions - HIV, liver disorders, leukemia, tuberculosis, parasitic infections, hemophilia, and other medical conditions associated with bleeding in semen.
A number of the conditions above are more serious and may require specialist treatment.
When should I see a doctor?
Your doctor will try to determine whether the cause of your bleeding semen tends to be serious or not.
To diagnose blood in your semen, the doctor will take a complete medical history. This listing will cover each of your recent sexual activities.
In addition to recording medical history, doctors will also need to consider several things, such as:
- How often do you experience bleeding in semen
- Do you have other symptoms
- Your age
They may also need to carry out several tests, including:
- Check your blood pressure
- Urine and blood tests
- Physical examination, which includes examination of lumps or swelling of the genitals; and manual / digital rectal examination to detect swelling, pain, thickening, and other symptoms of the prostate.
If you are less than 40 years old, have only experienced 1-2 times of bleeding semen conditions, and the test results do not show you have a serious underlying medical condition, you do not need a hospital referral.
But if you are 40 or older, experience recurring and not disappearing bleeding symptoms, or the results of a test show that there are other potential medical causes that underlie your current condition, your doctor will refer you to a urologist, a specialist who handles urinary system problems. A follow-up urological examination may include conducting a biopsy from the prostate gland or digital scanning using an ultrasound scan.
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