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    Blood in the semen

    Semen - bloody; Blood in ejaculation

    Blood in the semen, called hematospermia, is blood that is either too small to be seen (microscopic) or visible in the ejaculation fluid.


    Symptoms that may occur with this condition 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


    Blood in the semen is usually caused by inflammation of the seminal vesicles. It may also be caused by:

    • Blockage
    • Infection
    • Injury

    It may be a sign of disease or a problem in the urethra, testicles, epididymis, or prostate.

    Often, the cause cannot be found.

    Home Care

    You can treat minor injuries by resting, applying ice, and monitoring your symptoms. For major injuries you may need surgery.

    Infections can often be treated with antibiotics taken by mouth (or intravenous antibiotics if symptoms are severe).

    Blockages of the urinary tract system are usually treated with surgery. If cancerous tumors are causing the blockage, you may need radiation or chemotherapy.

    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 examination, looking for signs of:

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

    To diagnose the cause of the problem, your health care provider will ask medical history questions, such as:

    • How much blood was in the semen?
    • Did you ever have microscopic blood in the past when your semen was examined for another reason?
    • When did you first notice this problem? Is it present all the time?
    • Is there anything that seems to have caused this symptom?
    • What other symptoms do you have?

    Tests that may be done include:

    • Prostate exam
    • PSA blood test
    • Semen analysis
    • Semen culture
    • Ultrasound of pelvis and scrotum
    • Urinalysis
    • Urine culture

    If the blood does not clear, more tests should be done. These tests may include:

    • Semen analysis and culture
    • Urinalysis and culture
    • Ultrasound of the seminal vesicles, scrotum, and testes


    Barry MJ, Collins MM. Benign prostate disease and prostatitis. In: Goldman L, Schafer AI, eds. 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. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 3.

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


    • Blood in semen


      • Blood in semen


      A Closer Look

        Talking to your MD

          Self Care

            Tests for Blood in the semen

            Review Date: 9/16/2011

            Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Scott Miller, MD, Urologist in private practice in Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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