Blood in the semen, also known as haematospermia, can be a concerning and alarming symptom for many men. While it is often harmless and resolves on its own, it can also be a sign of an underlying medical condition.
What are the causes of blood in the semen?
Infection
One of the most common causes of blood in the semen is an infection of the prostate gland or seminal vesicles. This type of infection is known as prostatitis and can cause inflammation and swelling of the prostate gland, leading to blood in the semen. In addition, infections of the urinary tract or sexually transmitted infections, such as chlamydia or gonorrhoea, can also cause blood in the semen.
Injury or Trauma
Injury or trauma to the testicles, prostate gland, or urethra can also cause blood in the semen. This type of injury can occur during sexual activity, athletic activity, or as a result of a physical injury. In some cases, blood in the semen may be the only visible symptom of an injury.
Medical Procedures
Certain medical procedures, such as a prostate biopsy or surgery, can cause blood in the semen. This is because these procedures can cause damage to the prostate gland or seminal vesicles, leading to blood in the semen.
Medications
Blood in the semen can also be a side effect of certain medications, such as blood thinners, aspirin, or anti-inflammatory drugs. These medications can increase the risk of bleeding and may cause blood in the semen.
Cancer
In rare cases, blood in the semen can be a symptom of prostate or testicular cancer. Men who experience blood in the semen, along with other symptoms such as pain, swelling, or a lump in the testicles, should see a healthcare provider to rule out cancer as a possible cause.
What are the investigations for blood in the semen?
While blood in the semen is usually not a serious condition, it is important to determine the underlying cause through appropriate investigations. Common investigations used to diagnose the cause of blood in the semen include:
Physical Examination
A physical examination is often the first step in investigating blood in the semen. During the examination, the doctor will evaluate the patient’s medical history and perform a physical exam to look for signs of infection or injury including a prostate and genitalia examination
Urine Tests
Urine and semen tests may be ordered to check for signs of infection or inflammation. The presence of bacteria or white blood cells in the urine may indicate an infection in the urinary tract, which can be a cause of blood in the semen.
Blood Tests
Blood tests may also be ordered to check for signs of infection or inflammation. In some cases, blood tests may be used to screen for prostate cancer, which can be a rare cause of blood in the semen.
Ultrasound
An ultrasound of the pelvic region may be ordered to check for abnormalities in the prostate gland or seminal vesicles. This non-invasive test uses high-frequency sound waves to create images of the internal organs and tissues.
MRI Scan
In some cases, an MRI scan may be ordered to provide more detailed images of the pelvic region. This test uses a powerful magnetic field and radio waves to create images of the internal organs and tissues.
Cystoscopy
A cystoscopy is a procedure in which a thin, flexible tube with a camera on the end is inserted into the urethra to examine the bladder and urethra. This procedure may be used to check for any abnormalities that may be causing blood in the semen.
Conclusion:
If you experience blood in your semen, it is important to talk to your GP. They may perform a physical exam and order tests to help identify the underlying cause. Depending on the cause, treatment may involve antibiotics or other medications, lifestyle changes, or further testing to rule out more serious conditions.
In most cases, blood in the semen is not a serious condition and resolves on its own without treatment. However, if you experience other symptoms, such as pain or swelling in the genitals, difficulty urinating, or fever, it is important to seek medical attention right away, as these symptoms could be a sign of a more serious condition.
In addition to seeking medical attention, there are steps you can take to help reduce your risk of developing blood in the semen. These include practising good hygiene, using protection during sexual activity, and avoiding trauma or injury to the genitals.
While blood in the semen can be a concerning symptom, it is often harmless and resolves on its own. By talking to your healthcare provider and taking steps to reduce your risk of developing blood in the semen, you can maintain good genital health and wellbeing.
Author: Mr Neil A Haldar MBBS MD FRCS
Consultant Urological Surgeon
The Pelvic Specialists