Should a man worry about blood in his semen?

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When a man notices blood in his semen it is a condition known as hematospermia.  It can be unsettling and may cause worry but this fairly common condition is usually considered a benign issue and is rarely a problem.

Hematospermia occurring in men younger than the age of 40 will usually disappear on its own especially if a man has no other related symptoms or risk factors.  Men over the age of 40 who notice blood in his semen, are more likely to have the issue be related to another condition going on and should see if doctor right away to have it evaluated.  

Will a man know if he has it?

Unless a man is inspecting his semen after he ejaculates, he may not even know there is blood in his semen.  The process in which semen comes from begins with the testicles.  The testicles make sperm that are transported to the epididymis.  Then the sperm travels through a tube called the vans deferens where they go to the seminal vesicles and prostate.  These glands of the reproductive system make a white fluid mixed in with the semen at the time of ejaculation.  If blood is present in the semen, it has come from either the seminal vesicle or prostate.

What are the causes?

There can be several causes of hematospermia:

· The most common cause is considered to be a ruptured blood vessel in the seminal vessel of prostate at the time of erection and ejaculation.

· Infections

· Injury to the genitals

· Inflammation of the bladder or prostate

· Prostate gland biopsy – this may persist for three to four weeks

· Vasectomy- usually lasts about one week

· Polyps in the urethra

· Ejaculation duct obstructions

· Cysts, hemorrhage or abnormalities in the seminal vessels

What will happen at the doctor’s office?

Any man who notices blood in his semen should go see his doctor to rule out any serious condition.  This is especially true for any man who is having repeated episodes of blood in his semen, symptoms related to urinating or ejaculating or is at risk for cancer. 

A doctor will ask several questions about his symptoms, a man’s sexual history, and any possible risk factors he may have.  The scrotal area will need to be examined checking for any abnormalities.  A digital rectal exam and a urine test will be conducted to check for any presence of blood in these either one.  If a man is over 40, a PSA may be done making sure the problem is not due to prostate cancer.

Treating hematospermia

If all exams prove to be normal, then there is nothing further to check or needs to be done as hematospermia usually resolves on its own.  In rare cases, this condition will tend to continue to occur.  If it does, a transrectal ultrasound will be done to inspect the seminal vesicle and prostate to make sure there are no abnormalities such as cysts or calcifications.

Hematospermia that is ongoing can be treated for several months with a prescription medication called Proscar.  Proscar helps reduce the size of the prostate in men with BPH or benign prostatic hyperplasia and is also very successful at treating hemtospermia.

In general, for the vast majority of men hematospermia is a benign condition that usually goes away in time or can be treated effectively with Proscar.