Hematospermia, or blood in the semen, understandably causes a lot of worry, stress and anxiety. Fortunately in the majority of cases, the causes are benign or at least not dangerous or life threatening. Most times, the bleeding resolves on its own. But it is, however, the Doctor’s responsibility to ensure that there isn’t a more serious and sinister underlying cause. Want to know what these can be? Read on to find out more.
To understand the causes of hematospermia, it is useful to have an understanding of the anatomy of the male genito-urinary system.
The male reproductive system consists of 2 systems – urinary tract and the seminal tract. As these names suggest the Urinary tract carries the urine from the bladder out of the body via the urethra while the Seminal tract carries the sperm produced in the testicles, mixes it with fluid from the accessory glands and prostate gland to create semen that is also moved out of the urethra during ejaculation.
Hematospermia is when there is blood in the ejaculate. Most men are alarmed when they find that their ejaculate comes out red instead of the normal greyish white. In this article we outline the possible causes for hematospermia and what you can do.
Idiopathic
Idiopathic causes are the most common reason for Hematospermia. Up to 70% of men who come to a clinic reporting blood stained ejaculate usually are not able to find a cause. In such cases the hematospermia does resolve by itself. It can take 6 or more ejaculates before the semen returns to its normal color. This is because even a small amount of blood can stain the entire collecting system. Think of it as a drop of ink in a bucket of water. A similar situation is observed in patients who have experienced trauma/ impact to the area such as falling astride on a bicycle.
One of the predominant theories explaining idiopathic hematospermia is that there is a break in a small blood vessel surrounding the testicles, this break seals up by itself but not before releasing some amount of blood into the Seminal tract. Very much like a nosebleed. This leads to the blood getting mixed into the ejaculate for a short period of time and subsequently resolving by itself. In other words, seeing a color change for multiple ejaculates does NOT represent continued bleeding.
Infection
Infections are the next most common cause of hematospermia. Sexually transmitted diseases such as Chlamydia and Gonorrhea may not cause any symptoms early on but can gradually go on to infect the seminal tract. As the infection of the seminal tract progresses, the area becomes more irritated and swollen. This eventually leads to bleeding in the seminal tract and the blood is mixed into the semen during ejaculation.
This form of Hematospermia does NOT go away by itself.
Getting tested regularly is the best way to detect early infections and prevent progression into the seminal tract. However, if you are at a point where you see blood in your ejaculate and you have several casual partners, getting your semen tested instead of your urine will be able to determine if the infection has indeed progressed into the seminal tract.
Mechanical
Mechanical causes for hematospermia come in the form of abnormal growths/ tumors in the area. These growth disrupt the normal anatomy and can cause compress or rupture of blood vessels. An enlarged prostate – either benign or malignant are possible causes of hematospermia, recent studies have shown that prostate cancer was the cause of hematospermia in approximately 0.5% of the patients studied. More blood in the semen though did not mean that the cancer was more serious.
Medical Issues
Other chronic diseases can also cause blood in the semen. High blood pressure often results in blood traveling at a faster speed within your body as a result, the blood vessels are under more stress especially the smaller ones in the seminal tract. Hence when the blood pressure is not well controlled, it can cause the blood flow to damage and even break the blood vessels in the seminal tract leading to blood being found in the semen.
Clotting disorders such as hemophilia or severe liver disease can cause the blood to lose its natural ability to stop bleeding by forming a clot. As a result, minor trauma can cause a disproportionate amount of bleeding.
Chronic Pelvic Pain
Chronic Pelvic Pain Syndrome is a situation where men experience a deep/ dull and sometimes even constant pain in the groin. Unfortunately for many men, in many cases the causes of CPPS is unknown. Suspected causes for CPPS include long hours of bike riding and previous or current infections of the prostate. The long drawn nature of CPPS like an infection causes the components in the seminal tract to eventually become damaged and can cause blood to leak into the sperm duct and the ejaculate. Some patients undergo a range of treatments for CPPS but it is most important first to ensure that all other causes, especially infections or cancer, are ruled out before proceeding.
What to do now?
Investigating the cause of hematospermia involves a detailed conversation with your doctor to plot out the chronology of events leading to the appearance of blood in the semen. Following which scans can be done to evaluate the extent of injury.
Treatment is not needed in the majority of the cases of hematospermia. Especially in men below 40 years of age, it is rare to have any serious underlying disease. Many times, the hematospermia resolves by itself, we usually advised patients to continue to ejaculate regularly as this allows the body to clear any remnant blood in the system. For traumatic causes of hematospermia we will advise simple lifestyle changes such as good fitting underwear and care when doing physical activities or fitting your bike seat appropriately. If an infection is suspected, we will test the semen for any bacteria and treat it with a long course of antibiotics. If there is pelvic pain from chronic pelvic pain associated with hematospermia, we recommend using Electro-Shock Wave Therapy or medication to alleviate the symptoms.
In Summary
Hematospermia, or blood in the semen, is not an uncommon problem. Fortunately, in most cases the underlying cause is not a serious one. That said, it is still prudent to see a Doctor and rule out any possible sinister underlying disease.
Click here if you wish to make an appointment at our Men’s Health Medical Center.
Have a question? Feel free to put it in the comments section below.
Or visit us at our Men’s Health Clinic.
Have a question but need more privacy? Contact us on our Telegram channel. You can also follow us to get the latest news on STDs/HIV and Men’s Health.
Men’s Health – https://t.me/joinchat/uj8HDPzLtpk3NTA1
STD/ HIV Channel – https://t.me/joinchat/83vmPfDJa205ZTc1