Haematospermia
Hematospermia refers to the presence of blood in semen. While this may be a frightening sight to behold for a man, it is usually benign and self-limiting, and is unlikely to be a sign of a major health problem. Men sometimes mistake blood in the urine or blood from a sexual partner for hematospermia.
Hematospermia can affect men of any age, but is known to be more common in men aged 30 to 40. It is not clear how common the condition is because men usually tend not to examine their semen after ejaculation.
What causes Haematospermia?
The most likely causes of Hematospermia are:
Leaking of blood from a tiny ruptured capillary during ejaculation - the same way that a nosebleed occurs after blowing your nose
Trauma from a prostate biopsy or vasectomy
Less common causes include:
Inflammatory conditions: Prostatitis, orchitis, epididymitis and urethritis. These may in turn be caused by underlying Sexually Transmitted Infections (STIs)
Vascular problems: varicocele, hemangioma and prostatic telangiectasia
Tumours: testicular, prostate and bladder cancer
Treatment of prostate cancer with radiation therapy
Chronic infections: Human Immunodeficiency Virus (HIV), tuberculosis and schistosomiasis
Systemic conditions: severe uncontrolled hypertension, liver disease, blood clotting disorders and leukemia
What can I expect at my visit?
During your visit, your doctor will first take a full and detailed medical history to try and establish any possible underlying cause. Following which, a physical examination is conducted to check your temperature and blood pressure, and genitalia abnormalities such as masses, swelling, redness, penile discharge and enlarged lymph nodes. A digital rectal exam is also performed to check the prostate gland for swelling, tenderness or irregular lumps.
Depending on the history and examination findings, your doctor will then recommend further investigations as appropriate, such as blood tests to check Hemoglobin levels, prostate tumor markers, and clotting factors; urine tests to screen for STIs; imaging tests such as prostate ultrasound scan, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI).
Can I still engage in sexual activity? Does Haematospermia affect my ability to have kids?
As long as STIs are ruled out, Hematospermia is not contagious and not dangerous to your sexual partner, therefore you may continue to engage in sexual activity. Also, Hematospermia does not affect a man’s fertility.
What is the treatment for Haematospermia?
As mentioned earlier, most cases of Hematospermia are benign and self-limiting. If you are under the age of 40, have no urinary tract symptoms, have no risk factors for other medical conditions, and there has been only a single episode of blood in your semen, usually no treatment is required and the condition will resolve spontaneously. It may however take anywhere from a few days to a few months for the semen to return to normal. For older men, it is advisable to continue with a period of follow-up, even in cases where imaging is initially clear.
If a cause for Hematospermia is identified, your doctor will prescribe appropriate treatments, including:
Antibiotics if there is an infection
Anti-inflammatory drugs
Finasteride, a medication used to shrink an enlarged prostate, can often resolve Hematospermia if due to fragile/friable blood vessels on the prostate
In cases of persistent or recurrent Hematospermia, it may be necessary to get a referral to a Urologist to undergo more invasive tests such as a urocystoscopy or prostate biopsy.
Get in touch.
If you or your partner have noticed blood in your semen, please call or email us to arrange an appointment. We are here to help.