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Blood in Sperm (Haematospermia)

Introduction

What is Blood in Sperm?

Blood in sperm, also called haematospermia, is when you notice red or brown spots in your semen (the fluid that comes out during ejaculation). It can be a little scary to see, but most of the time it is not serious.

Discussion
Causes

Many things can cause blood in your sperm. Some of these include:

  • Infections: Infections in the prostate (prostatitis), urethra (the tube you pee and ejaculate from), or the testicles can cause haematospermia. These infections may come from sexually transmitted infections (STIs) like gonorrhea or chlamydia.
  • Injury: If you've been hit or hurt around your groin or have had medical procedures like a prostate biopsy, you may see blood in your sperm.
  • Strenuous physical activity: This could be a blood vessel that ruptured, and it usually heal within a week or two.
  • Inflammation: Swelling or irritation in areas like the prostate, seminal vesicles (which produce some of the fluid in semen), or the urethra can cause this problem.
  • Blood Pressure Issues: High blood pressure and certain blood disorders can sometimes cause bleeding in the reproductive system.
  • Prostate cancer: You are likely to be more than 50 years old. You may have a male relative that has had prostate cancer. Contact your family physician.
  • After taking a piece of your prostate for investigation for prostate cancer could lead to blood in the sperm. This usually subsides after some days. Usually after this kind of test, your doctor advices you to avoid sexual intercourse in 1-2 weeks.
Symptoms
  • Blood in the semen may appear red or brown.
  • You may have pain when urinating, during sex, or during ejaculation.
  • Sometimes, there may be no pain or other symptoms.
Is it Serious? 

Most of the time, blood in sperm is not dangerous, especially if it happens only once or twice and goes away on its own. However, if you notice it happening regularly or if you have other symptoms like pain, fever, or difficulty urinating, you should see a healthcare provider.

When to See a doctor
  • If the blood in your sperm lasts more than a few weeks.
  • If you also have blood in your urine.
  • If you feel pain in your groin, testicles, or lower abdomen.
  • If you have a fever or other symptoms of infection.
Diagnosis

Your doctor may ask about your sexual history and check for signs of infections or injury. They may also suggest:

  • Urine and blood tests to look for infections or blood disorders.
  • An ultrasound or other scans to check your reproductive organs.
  • A prostate exam to see if there are issues with the prostate.
Treatment
  • Infections: If the blood is caused by an infection, antibiotics may be prescribed to clear it up.
  • Injuries: If it’s due to injury, rest and giving the body time to heal may be all that’s needed.
  • Other causes: If there are other underlying conditions like high blood pressure, the doctor will treat them accordingly.
Prevention
  • Safe sex practices: Use condoms to reduce the risk of sexually transmitted infections.
  • Good hygiene: Keeping clean can help prevent infections.
  • Regular check-ups: Regular health check-ups can help catch conditions early before they cause symptoms.
Important Note

In many cases, especially in rural areas, it can be hard to reach a doctor quickly. However, if you are worried about seeing blood in your sperm, try to get medical advice when possible. Ignoring symptoms may make things worse.

If you have any concerns or questions, reach out to a healthcare provider or clinic near you.

References
  • Mathers MJ, Degener S, Sperling H, Roth S. Hematospermia-a Symptom With Many Possible Causes. Dtsch Arztebl Int. 2017 Mar 17;114(11):186-191. doi: 10.3238/arztebl.2017.0186. PMID: 28382905; PMCID: PMC5387851.
  • Robert H. Drury, Brendan King, Bryan Herzog, Wayne J.G. Hellstrom, Hematospermia Etiology, Diagnosis, Treatment, and Sexual Ramifications: A Narrative Review, Sexual Medicine Reviews, Volume 10, Issue 4, October 2022, Pages 669–680, https://doi.org/10.1016/j.sxmr.2021.07.004
  • Fuse, H., Komiya, A., Nozaki, T. et al. Hematospermia: etiology, diagnosis, and treatment. Reprod Med Biol 10, 153–159 (2011). https://doi.org/10.1007/s12522-011-0087-4
  • https://www.nhs.uk/conditions/blood-in-semen/
  • https://www.praktiskmedicin.se/sjukdomar/hematospermi/