Blood in semen, or hematospermia, is often caused by testicular or prostate surgery, including prostate biopsies and vasectomies. However, it can also be a symptom of underlying medical conditions such as cancer, sexually transmitted diseases, or genital infections. While most cases are harmless and resolve without treatment, severe or persistent bleeding should be checked by a doctor. Other symptoms such as pain, difficulty urinating, or blood in urine may indicate a more serious condition.
The most common causes of blood in semen, also called hematospermia, are testicular or prostate surgery. A prostate biopsy is perhaps the most common cause, while vasectomies can also lead to blood in the semen. Occasionally an underlying medical condition can be the cause of bleeding semen. These may include prostate, testicular, penile or bladder cancer, sexually transmitted diseases, and benign cysts or tumors found in the genitourinary region.
Most causes of blood in semen are harmless and resolve without treatment. These are usually related to some type of medical treatment. Men who have had a prostate biopsy or vasectomy are at higher risk, although other operations on or around the genitals can cause bleeding. The bleeding is usually temporary and can last up to four weeks. If bleeding becomes severe or if other symptoms are present, patients are advised to contact their physician.
Blood in semen that occurs without any operation having been done may be more serious. Sometimes cancer of the genitals or prostate can cause this. If blood is also present in the urine, this is another possible warning sign of a more serious health condition. Additional symptoms may include difficulty urinating, pain in the lower abdomen or when urinating, and cloudy urine.
There are also some sexually transmitted infections and other genital infections that can cause blood in the semen. Other symptoms such as smell, itching, redness, bumps or warts, discharge from the penis of an odd color or burning when urinating may be additional symptoms of a sexually transmitted disease. Most of these are treatable with antibiotic medications, although some have no cure, such as genital herpes.
Additional potential causes of blood in semen include a swollen prostate, injury to the testicles or penis, blockages in the penile or testicular ducts, polyps, stones in the seminal vessels, or a swollen urethra. While rare, because bloody semen can be a sign of a serious or life-threatening medical condition, it should always be checked by a doctor. This is especially true when other symptoms are present or if prostate or testicular cancer runs in one’s family.
Bleeding semen is not a common symptom of most of these conditions, aside from surgical procedures. Any severe or painful bleeding should be considered abnormal. Very rarely an injury to the penis itself can bleed and cause bloody semen to appear after ejaculation.
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