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Blood in the semen

Definition

Blood in the semen is called hematospermia. It may be in amounts too small to be seen except with a microscope, or it may be visible in the ejaculation fluid.

Alternative Names

Semen - bloody; Blood in ejaculation

Causes

Most of the time, blood in the semen is caused by swelling or infection of the prostate or seminal vesicles. The problem may occur after a prostate biopsy.

Blood in the semen may also be caused by:

  • Blockage due to enlarged prostate (prostate problems)
  • Infection of the prostate
  • Irritation in urethra (urethritis)
  • Injury to urethra

Often, the cause of the problem cannot be found.

Depending on the cause, other symptoms that may occur include:

  • Blood in urine
  • Fever or chills
  • Lower back pain
  • Pain with bowel movement
  • Pain with ejaculation
  • Pain with urination
  • Swelling in scrotum
  • Swelling or tenderness in groin area
  • Tenderness in the scrotum

Home Care

The following steps may help ease discomfort from a prostate infection or urinary infection:

  • Take over-the-counter pain relievers such as ibuprofen or naproxen.
  • Drink plenty of fluids.
  • Eat high-fiber foods to make bowel movements easier.

When to Contact a Medical Professional

Always call your doctor if you notice any blood in your semen.

What to Expect at Your Office Visit

The health care provider will perform a physical exam and look for signs of:

  • Discharge from the urethra
  • Enlarged or tender prostate
  • Fever
  • Swollen lymph nodes
  • Swollen or tender scrotum

You may need the following tests:

  • Prostate exam
  • PSA blood test
  • Semen analysis
  • Semen culture
  • Ultrasound of prostate, pelvis or scrotum
  • Urinalysis
  • Urine culture

References

Barry MJ, Collins MM. Benign prostate disease and prostatitis. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 131.

Gerber GS, Brendler CB. Evaluation of the urologic patient: History, physical examination, and the urinalysis. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 3.

Small EJ. Prostate cancer. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 207.


Review Date: 9/25/2013
Reviewed By: Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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