Overview, Causes, & Risk Factors
Blood in the semen is uncommon. Seeing it can make people quite anxious, but it is rarely serious.
Most cases of blood in the semen are from unknown causes. It usually goes away on its own.
Most cases are from an unknown cause. Known causes include:
Symptoms & Signs
Seeing blood in the semen can be quite frightening. Men with this symptom are often asked several questions by the doctor, including:
Other questions may be asked as well.
Diagnosis & Tests
Diagnosis begins with a medical history and physical. This may be all that is needed in some cases. In other cases, further testing may be done. Urine tests, including a urinalysis and urine culture, are commonly used to look for infection or bleeding. Imaging studies or X-ray tests may be used to look for a urethral stricture.
Prevention & Expectations
Most cases cannot be prevented because the cause is unknown. Urethral stricture and infection of the urethra are often due to sexually transmitted diseases. So practicing safer sex could prevent some cases of blood in the semen.
There are usually no long-term effects. Many affected men have repeated episodes of blood in the semen with no other symptoms or problems. Urethral strictures are usually permanent unless they are treated. Cancer is quite rare but could possibly result in death.
Blood in the semen itself is not contagious. If the cause is an infection such as a sexually transmitted disease, the infection may be contagious.
Treatment & Monitoring
Treatment is directed at the cause, if one can be found. A man may be given antibiotics for a short time in case there is an infection. A man with cancer or urethral strictures may need surgery.
Antibiotics may cause allergic reactions, stomach upset, or headaches. All surgery carries a risk of bleeding, infection, and other complications.
Many men continue to have occasional episodes of blood in their semen. Others may only have it once. Treatment doesn’t seem to affect this.
A man with a known cause for the blood usually gets better with treatment. After treatment, most men have no limitations on activities.
The man can monitor his semen at home for further episodes of bleeding. Changes or response to treatment can be reported to the doctor. Other monitoring is related to the cause. For example, a man who takes a blood thinner such as warfarin usually has regular prothrombin time, called PT, blood tests. Any worsening symptoms should always be reported to the healthcare provider.