Causes of Blood in the Semen – Hermatospermia

Causes of Blood in the Semen – Hermatospermia

Seeing blood in your semen can throw you off balance and cause havoc to your mental health. However, it’s not always a sign of any severe health condition.

Blood in the semen can occur only once, but it may be sporadic or chronic, and it most times goes unnoticed as men do not look at their ejaculate.

Most times, this symptom can disappear on its own without any medical treatment if you do not have any risk factors for underlying health problems. It’s a regular occurrence for men who are healthy and above 40 to spot tiny drops of blood in their semen occasionally.

However, that doesn’t apply to men who are 40 and above, because the odds are high that having blood in your semen could indicate a medical condition, and your doctor should do a quick evaluation.

You should see your healthcare practitioner if you:

  • Have frequent episodes of blood in the semen
  • Are at risk of cancer or a bleeding disorder
  • Have any related symptoms when urinating

Having blood in your semen is a condition called Hermatospermia or hemospermia. To diagnose this case can be quite tricky because men don’t always scan their semen for signs of blood after ejaculating, so it would be difficult to know how common this condition is.

The diagnosis of Hermatospermia is usually challenging for the men it affects because they get disturbed by sexually transmitted diseases or malignancy.

Historically, Hermatospermia was viewed as a result of abstaining from sexual activities for a prolonged time, or excessive sexual activities.

Even in recent happenings, the primary etiology of Hermatospermia is still unknown in over 75% of cases. But as a result of modern diagnostics, the etiology of blood in the semen has been identified in many cases.

Recurring or chronic Hermatospermia may be the outcome of various factors like:

  • Anomalies
  • Iatrogenic causes like urological interventions
  • Systemic disease

Causes of Hermatospermia

Several factors lead to the presence of blood in the semen. These include:

  1. Inflammation and Infection

This is one of the most common causes of blood in the semen. When there is an infection or inflammation in any of the glands and tubes responsible for the production and movement of semen in the body, it can cause blood to be present in your semen when you ejaculate.

These glands include:

  • The urethra responsible for transporting urine and semen from the penis
  • Seminal vessels that make the semen watery, by adding more fluid to it
  • The epididymis and vas deferens where the sperm stays and gets matured prior to ejaculation
  • The prostate responsible for the production of the fluid part of the semen

Blood in the semen can also occur due to sexually transmitted infections like Chlamydia and gonorrhea, or bacterial and viral infections.

About three out of every ten cases of Hermatospermia, inflammation, and infection are the culprits.

  1. Blockage

inflamed crotchThe tiny tube or ducts located in the reproductive tract cans sometimes be blocked. This obstruction can result in the breakage of blood vessels, causing blood to leak into the semen.

This condition is known as BPH – Benign Prostatic Hyperplasia, and it causes the prostate to swell and pinch the urethra, resulting in blood in the semen.

  1. Medical Procedure

Men who recently had a prostate biopsy might experience temporary blood in their semen; this is the same for other related medical procedures.

Procedures carried out to treat urinary tract infections can cause mild trauma, which may result in temporary bleeding. This can happen within a few weeks after the procedure has been done.

Radiation therapy and vasectomy can also cause blood to be in your semen. Physical damage to the testicles, injury to the sex organs, or rigorous masturbation can cause Hermatospermia.

  1. Blood Vessel Related Condition

All the fragile structures that partake in the ejaculation process contain blood vessels. Any damage or inflammation to any of these structures can result in blood in the semen.

  1. Medical Conditions

High blood pressure, leukemia, and HIV can also cause blood in the semen. Because about 20% of blood in the semen cases have no known cause, and many of these cases treat itself. With time, the traces of blood disappear by itself without any form of treatment or medical help.

  1. Deviant Sexual Behaviors

Certain sexual practices may cause bleeding as a result of trauma. For instance, an injury to the prostate by a stimulator, or damage to the urethra when using a tight penis ring can result in bleeding.

Sometimes even the introduction of foreign bodies can result in Hermatospermia.

  1. Systemic Causes

Certain systemic causes can be associated with Hermatospermia; these include refractory arterial hypertension and other hematological conditions such as hemophilia that may happen due to hepatic diseases.

Rare Causes of Blood in the Semen

  • Testicular cancer
  • Schistosomiasis
  • Benign growth
  • Amyloidosis

However, there are other related symptoms your doctor may ask you about, to identify the underlying cause of the condition. Symptoms such as:

  • Burning sensation when urinating
  • A throbbing bladder that feels bloated
  • Blood in the urine
  • Painful ejaculation
  • High blood pressure
  • Fever and racing pulse
  • Penis discharge

Other symptoms can accompany Hermatospermia, depending on the cause. Some of these symptoms include:

  • Lower back pain
  • Soreness in the testes and scrotum
  • Swelling in the groin area
  • Painful urination
  • Fever
  • Pain when ejaculating

When to See a Doctor

If you are below 40 years and notice blood in your semen, there is a high chance that it would resolve and disappear without any treatment.

However, it’s also good to see your doctor and make an appointment, so that a physical exam can be conducted to rule out a cause, such as STIs, or inflammation.

But if you have certain risk factors and are experiencing these symptoms, further testing would need to be done to rule out a more serious underlying health condition.

You should call your doctor if you are above 40 and experience frequent blood in your semen; you should immediately call your doctor.


For your doctor to make an accurate diagnosis, he needs your full medical history, including any recent sexual activity, whether partnered or solo.

A physical exam would also be conducted by examining your genitals for signs of swelling. A digital rectal exam would be ordered to check your prostate for swelling and other symptoms.

Other tests may also be carried out, like:

  • Urine culture would be done to detect if the semen’s blood is due to an infection or any other abnormality.
  • STD tests will be taken if your doctor suspects it’s a case of sexually transmitted disease.
  • PSA testing would also be done to test for prostate cancer
  • Several urological tests such as MRI, CT, and cystoscopy to further evaluate the condition of your body internally.


After a diagnosis has been made, and the cause of blood in the semen identified, your doctor would focus the treatment on the underlying cause.

Possible treatments include:

  • taking pillsAnti-inflammatory medications will be prescribed if some type of inflammation causes the condition
  • Antibiotics can be used if the underlying cause is an infection
  • If an STI or any medical condition causes blood in the semen, your doctor would need to treat the condition properly
  • When a urology procedure causes the semen’s blood, it will disappear by itself in a few weeks.

In younger men, blood in the semen can happen once in a while without any additional symptoms and resolve independently without any treatment. But if you have recent blood episodes in your semen, your doctor may refer you to a urologist.

If your doctor believes that you may have prostate cancer, another form of cancer, a test to evaluate the tissue for cancer would be ordered – prostate cancer.

The incidence of young men having prostate cancer is low. However, for men of any age who have a risk of cancer, a test is for prostate cancer would be to rule out the possibility.


Conducting further tests is a reasonable way to detect and exclude possible causes of blood in the semen, especially malignant causes. Hermatospermia can be an alarming occurrence, but in most cases, it is painless.

Hermatospermia is the presence of blood in the semen, and sometimes this blood can be visible to the naked eyes, but it can also mean microscopic amounts of blood in the semen. And this can mostly be detected in a spermiogram.

How much the blood would affect the semen’s color depends on the time estimate that has elapsed since the bleeding started. Fresh blood would usually have a light red color, while dark brown-red means that it has been a while since hemorrhage occurred.

If you notice anything unusual in your semen, you should see your doctor immediately, to rule out any underlying condition, and begin early treatment if required.