What is blood in semen?

Blood in semen is called haematospermia. Finding blood in your semen (sperm) can be alarming. However, in most cases it is not serious and is reasonably common.

In most cases where blood in semen is the only symptom, it can clear up without the need for treatment.

Blood in your semen appears brownish-red or red in colour. It is usually painless.

What causes blood in semen?

There are many possible causes of blood in your semen.

Blood in semen can be caused by problems with your:

• testicles
• epididymis
• vas deferens
• seminal vesicles
• prostate gland
• urethra
• bladder

Infections

In younger males (under 40 years of age), infection is the most common cause of blood in semen. This can be due to a urinary tract infection or sexually transmitted infections (STIs) such as gonorrhoea or chlamydia.

Injury

Blood in your semen can happen after an injury to your genital area.

It can also happen after surgical procedures in the area, such as vasectomy or biopsy of the prostate.

Sexual activity

Blood in the semen can also be caused by sexual intercourse or masturbation. It's more likely to happen if you haven't had sex in a while, or if you have sex very often.

Prostate problems

Benign prostate enlargement (also known as benign prostatic hypertrophy or BPH) can sometimes cause blood in the semen.

Prostate cancer can also cause blood in the semen, but this is not a common cause.

Other causes

Other causes of blood in your semen, although rare, include:

• very high blood pressure
• tuberculosis
• parasitic infections
• testicular cancer or penile cancer
• diseases that affect blood clotting, such as haemophilia and chronic liver disease
• anticoagulant (blood thinning) medicines

When should I see my doctor?

You should see your doctor if you notice any blood in your semen. Because it can occasionally be caused by cancer, it's especially important to see your doctor if you may have a higher chance of cancer.

Your chance of cancer may be higher if you:

• are over 40 years of age
• have experienced blood in your semen more than once
• have lost weight without trying
• have a family history of prostate cancer

You should also see your doctor if you have had:

• an injury to your pelvis or genital area
• a health problem that affects blood clotting
• a urological procedure

How is the cause of blood in semen diagnosed?

To diagnose the cause of blood in your semen, your doctor will ask you about your symptoms. If you have noticed any other symptoms, such as blood in your urine or pain when ejaculating, let them know.

The doctor may also:

• do a physical examination of your genitals
• do a rectal examination to check your prostate, by inserting a gloved finger into your bottom
• take your blood pressure and temperature

Your doctor might refer you to a urologist.

Tests

Your doctor might arrange tests such as:

• a urine (wee) test
• a semen test
• blood tests — if you have a higher chance of prostate cancer, your blood tests may include a prostate-specific antigen (PSA) test

Your doctor or urologist may ask you to do further tests to look at your pelvic area. These may include:

• ultrasound of your prostate
• MRI (magnetic resonance imaging) scan
• CT (computed tomography) scan
• cystoscopy, where a thin tube with a camera is used to look at your bladder and urethra

How is blood in semen treated?

The treatment for blood in semen depends on the underlying cause. Blood in semen often has no obvious cause, and may not need treatment, especially if it only happens once and you are under 40 years of age.

If it is caused by an infection, you may need antibiotics.

If an enlarged prostate is causing blood in your semen, there are medicines that can shrink your prostate. This may take several months.

If blood in your semen is an after effect of a surgical procedure, ask your surgeon how long it is expected to last.

If the cause is a blockage, a urologist may carry out a surgical procedure to clear the blockage.

If it is caused by prostate cancer, treatment may include:

• surgery
• radiation therapy
• hormonal therapy

What are the complications of blood in semen?

Rarely, fertility may be affected by some causes of blood in semen, such as testicular cancer.

Can blood in semen be prevented?

Blood in semen can be caused by many things, which makes it hard to prevent.

It's important to protect yourself from sexually transmitted infections. You may also choose to avoid travelling to areas with tuberculosis or schistosomiasis (parasitic worms).

Resources and support

For more information, you can visit the Healthy Male website.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

The Australian Government has resources on sexually transmitted infections available in several community languages.

The Prostate Cancer Foundation of Australia has resources on prostate cancer available in many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

The Australian Government has a toolkit on sexually transmitted infections available for Aboriginal and/or Torres Strait Islander peoples.

Better to Know is a sexual health toolkit available for Aboriginal and/or Torres Strait Islander peoples.