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Hematospermia

Why is there blood in my semen?

What is Hematospermia?

The term hematospermia describes the condition where blood is found in semen. It is not a typical occurrence and is an obvious source of concern for men especially those who are sexually active. There are several possible causes of hematospermia and fortunately most cases turn out to be benign. However, irregular bleeding or blood showing up where it is not supposed to be should never be ignored. Serious causes such as cancers, infections, trauma, obstruction, and systemic disease must all unequivocally ruled out. 


What are the possible causes of hematospermia?

The following are some of the common causes of hematospermia. It is by no mean an exhaustive list though:

Tumors 

testicular, prostate, bladder cancers, and benign cysts.

Infections 

Urethritis, epididymo-orchitis, prostatitis, gonorrhea, chlamydia, schistosomiasis, Tuberculosis (TB), and HIV. 

Vascular complications 

Hemangiomas, varicoceles and prostatic telangiectasia.

Trauma or iatrogenic 

Instrumentation and particular medications

Systemic diseases 

Bleeding disorders, hypertension, lymphoma, and leukemia.

It is also essential to differentiate between genuine hematospermia and other reasons for bleeding. These may include hematuria (blood in urine) or blood observed during or after sexual intercourse that could be from your sexual partner.

When should I see my doctor?

If you notice blood in your semen, we recommend making an appointment to see your doctor immediately. 

You should be extra cautious if you are over the age of 40, having recurrent bleeding episodes, at high risk for infection or cancer, experiencing weight loss, and feeling pain or discomfort during urination.

Further testing and treatment will be recommended depending on your clinical findings and history.

Is Hematospermia dangerous for my partner?

It is normal to worry about your sexual partner if you suspect you may have an issue. So, the first step is to check whether or not the hematospermia is being caused by a sexually transmittable infection.

Gonorrhea, Chlamydia, and HIV must all be excluded through testing and then a determination will be made that your partner is risk-free.

If your condition is indeed being caused by a sexually transferable infection, then you will be treated with the appropriate medications. It is also strongly recommended that your partner be tested as well, and STD treatments administered.

Will my fertility be affected?

Fortunately, in most cases, hemotospermia will have no adverse effect on male fertility. However, some varieties of testicular cancer can affect reproductive capabilities. This will of course have to be ruled out through investigations. If you are worried about your fertility after having a hematospermia episode, you can put your mind at ease by having a semen analysis to assess your fertility performed at your convenience.

All my tests came back normal, why am I not improving?

Once your initial tests have nothing adverse to report and your doctor agrees that there is nothing seriously wrong, you may simply have to wait for your ejaculation process to normalize. Sometimes, it may take quite a few ejaculations to clear the blood that is already present in your ejaculatory ducts. You should also be encouraged that most hematospermia cases disappear on their own and are benign.

However, if you seem to be plagued by persistent or recurrent episodes of blood in your sperm, it may be time to see a urologist. More invasive tests may be prescribed like urocystoscopy (a tiny camera on the end of a thin tube is inserted so that your doctor can examine your urethra and bladder), transrectal ultrasound, or biopsy.

Some success has been observed with the administration of antibiotic therapy even when the urine and semen cultures of some men came back negative for bacteria. However, caution is the recommended course of action for older men. Your doctor may advise that you come in for regular follow up surveillance tests for prostate cancer blood markers (PSA) even if previous imaging was clear. 

This condition can be a source of stress and anxiety in the men who have had the misfortune to experience it. However, the good news about Hematospermia is that there is usually nothing to worry about since most causes are benign and self-resolving. This knowledge should not lead to complacency since there may be the occasional case when this issue could be caused by malignancy or infection. As such, you should always visit your doctor for a thorough assessment.

Therefore, if you or your partner notice blood in the semen, we encourage you reach out to your doctor to guide you through your treatment process.

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