On an odd day, you may notice some red tinge in your semen. That red /pink tinge is often blood, which is a matter of concern. Hematospermia is an alarming situation where your seminal fluid contains a small amount of blood. The amount of blood can be visible from the naked eye or may have to be detected microscopically, but in both cases, it is tormenting.

It is absolutely painless and can occur infrequently. The color of the blood can tell the time lapsed since the bleeding. Fresh blood is bright red while the tone darkens as time passes by. Bleeding is very much self-limiting. You may not even notice it.

A lot of men are affected by hematospermia. It is distressing for men and women as it is often envisaged as a sexually transmitted disease like AIDS or gonorrhea. The old school of thought considered hematospermia as a consequence of excessive intercourse.

What are the causes of hematospermia?

Chronic hematospermia can have numerous causes. They can be-

  1. Infection- Urinary tract infection is the prime cause of hematospermia. Improper hygiene,perivesiculitis, or contact with any pathogen or virus predisposes to urinary tract infections. They are sometimes associated with burning and painful micturition.
  2. Trauma- Any accidental blow or strain would lead to internal hemorrhage, which can be painful and can cause hematospermia.
  3. Atypical sexual activity or introducing foreign objects can cause injury to the prostate gland or penile musculature.
  4. Underlying the presence of a tumor, hernia, or any obstruction due to cyst can evoke hematospermia. Malignant tumors rarely cause hematospermia
  5. Systemic diseases like bleeding disorders like hemophilia or liver cirrhosis are at increased risk of developing hematospermia.
  6. Iatrogenic trauma during cystoscopy or prostate biopsy can lacerate neighboring capillaries, which can cause hematospermia.
The right diagnosis for hematospermia-

The diagnosis of the actual cause helps you to seek proper treatment. Hematospermia is very much treatable. The detailed history of occurrence and other medical conditions should be recorded. A thorough physical and rectal examination must be done to rule out the presence of any form of a lump.

The noteworthy thing about hematospermia is misdiagnosis. The appeared blood can be from his partner during intercourse.

Relevant history of erection or ejaculation should be taken, and clinical investigations like blood and urine testing should be done.

Radiographic examination like Transrectal sonography (TRUS) is a safe way of investigating the individual structures that may likely to play a significant role. MRI can identify and localize the tumor or obstruction of the male organs and can also detect prostate cancers.

Treating it right -

Ignoring hematospermia could lead to some severe ailment later in life. One should always rule out the presence of underlying disease before proceeding for treatment.

The right way to fix up this over-hauling situation is to treat the etiological factor. One needs to see a urologist and explain the entire affliction. Sometimes, it gets resolved on its own and does not require to undergo therapy.

Any cyst or tumor would need surgical intervention. In the case of infection, the empirical administration of antibiotics and anti-inflammatories is indicated. In any case, if the cause isn’t ruled out yet, steroidal based preparations to be administered after calculating potential risks and benefits related to the patient.

Medically reviewed by Rishabh Verma, RP