Blood in the sperm

Blood in semen often has harmless causes. What can be and when urgently a doctor's visit is advised, you can find out here!

Blood in the sperm

If suddenly Blood in the sperm turns up, scare many men. The sight is often worse than the usually harmless triggers. But sometimes even serious illnesses cause bloody sperm, the symptom should always be clarified by a doctor. Here you will learn everything important about the possible causes and consequences of blood in the semen.

Product Overview

Blood in the sperm

  • description

  • Causes and possible diseases

  • When do you have to go to the doctor?

  • What does the doctor?

  • You can do that yourself

Blood in the semen: description

Blood in the sperm (hematospermia, colloquially "blood in the seed") is when blood or blood components in the seminal fluid occur. The seminal fluid (semen) of a healthy man is white to yellowish and consists of a special secretion and the floating sperm (sperm).

The seed secretion serves primarily to transport and protect the sperm. It is formed by the sex glands, which include the prostate (prostate gland) and seminal vesicles. The production of sperm instead takes place in the testicles. In the epididymis, they finally ripen before they emerge in an ejaculation of the vas deferens together with the seminal secretion from the urethra. The leaked seminal fluid is called ejaculate.

Micro- and macrohematospermia

Under normal circumstances, there is no blood in the ejaculate. If so, sometimes there is so little blood that it is not visible to the naked eye, but only detectable in the laboratory (microhematospermia). Only above a certain amount does the seminal fluid turn visibly reddish (macrohematospermia).

Semen, which is rather light red in color or has lighter reddish streaks, contains fresh arterial blood. It typically comes from a broken vein on the glans or in the urethra. If, on the other hand, the ejaculate is dark red or even brownish in color, the blood probably lingers in the seminal fluid for some time and comes from the prostate or the epididymis or testes.

Is blood in the sperm connected with pain?

The appearance of blood in semen is in many cases not associated with pain. However, some causes are quite painful, especially inflammation of the prostate and epididymis.

Who is affected by blood in semen?

Blood in the ejaculate affects mainly younger men between the age of 20 and 40, but it can also occur in other age groups. Generally it is a relatively common symptom. Urologists report a number of cases each year, bearing in mind that many affected men do not go to the doctor out of shame. The dark figure should therefore be much higher. According to some estimates, almost every man has blood in his sperm at least once in his life.

Blood in semen: causes and possible diseases

In almost half of the cases of blood in the sperm, even after extensive diagnostics, there is no clear cause for it. This is called idiopathic hematospermia. As a rule, the symptom then disappears by itself again after some time, without the person concerned having to fear further consequences.

Most diseases that can lead to blood in the sperm are more or less harmless if treated properly. Only rarely are really dangerous triggers behind a hematospermia. Possible causes of blood in semen include:

inflammation: Among the known causes of blood in semen, they make up the largest share. In about 40 percent of affected men, for example, inflammation of the prostate (prostatitis), urethra (urethritis) or epididymis (epididymitis), the reason for blood in the semen. In turn, inflammation is usually caused by infections, including some sexually transmitted diseases.

Mechanical damage: These occur, for example, in the context of certain examinations (such as prostate biopsy) and surgery (such as a hemorrhoid surgery). Also, intense, prolonged sexual intercourse or autoerotic practices such as inserting objects into the urethra can cause injuries there and on the glans penis, which are then responsible for the appearance of blood in the semen.

Other benign causes: Sometimes the prostate or the seminal vesicles form stones that cause blood in the semen, similar to narrowing (strictures) on the vas deferens or urethra. Also pathologically enlarged veins (varices) and cysts on the prostate are among the possible triggers. The same applies to small outpourings (diverticula) in the vas deferens or in the urethra. The benign prostatic hyperplasia (benign prostatic hyperplasia), which frequently occurs in older men, may also be associated with a bloody seminal fluid, but this is rarely the trigger.

Malignant diseasesIn very rare cases, cancer such as carcinoma of the prostate, seminal vesicles or urethra is the cause of blood in the ejaculate. Testicular cancer can theoretically lead to this, but is usually caused by other symptoms.

Systemic diseasesSometimes, blood in the sperm is the result of diseases that affect the body in general, such as high blood pressure, blood clotting disorders or liver disease.

Depending on the cause, in addition to the blood in the sperm, other symptoms such as pain at the perineum and scrotum, frequent urinary urgency or a weak urinary stream.

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Blood in the semen: When do you need to see a doctor?

If you notice blood in the semen, you should first keep calm. It is not uncommon for a one-off event to have no identifiable cause. However, if the symptom has not disappeared after a few days, you should go to a doctor - preferably the specialist, the urologist. With the help of certain examinations, he can narrow down the possible causes and rule out malignant diseases.

Greater haste is always required when blood in the semen is accompanied by additional symptoms such as pain, urinary irregularities, or palpable changes in the testes. In such cases, you should go to the doctor as soon as possible so that he can start therapy promptly if necessary.

Diseases with this symptom

  • urinary infection
  • Hodenentzündung
  • Epididymitis
  • prostatitis

Blood in the sperm: What is the doctor doing?

The doctor asks the patient some questions first. He asks, for example, if the patient has noticed other symptoms (such as pain or swelling in the genital area) or if he has recently suffered a genital injury. In addition, the doctor asks if general diseases (high blood pressure, etc.) are known. Often, this information helps the physician to narrow down the possible causes of the blood in the sperm.

Blood in the sperm: investigations

During the physical examination, the doctor primarily inspects the genital area of ​​the patient, paying attention to externally recognizable changes such as a swollen scrotum. He will also scan the testicles and epididymis, looking for a possible pain response from the patient.

The condition of the prostate can be roughly assessed by the so-called digital rectal examination (DRU). The examiner inserts a finger into the anus of the patient and feels the side of the prostate that faces the intestine. Greater swelling or irregularity of the prostate gland can be detected in this way; but for more details it requires a more precise investigation technique. For example, there is the possibility of inserting an ultrasound device into the anus to represent the prostate (transrectal ultrasound, TRUS). In rare cases, magnetic resonance imaging (MRI) is also used.

Finally, the doctor takes a few more laboratory tests. These include:

  • Blood count including coagulation control
  • Measurement of liver enzymes in the blood
  • Measurement of PSA in blood (PSA = prostate-specific antigen, an enzyme associated with prostate disease)
  • Urinalysis with test for blood in the urine
  • Examination of sperm for possible pathogens (sperm culture) and possible disorders (spermiogram)

Although the diagnosis of blood in semen is now wide-ranging, it still often provides no clear results.

How does the doctor treat blood in semen?

The treatment of blood in semen depends on the trigger of the symptom (if it can be determined). If, for example, a mechanical injury is responsible (such as an injury to the penile vessels or a broken capillary), then you should protect the genitals and for a while to renounce intercourse.

Infection-related inflammation is usually treated with antibiotics if they are caused by bacteria. Also here is an additional protection and the renunciation of sex advisable, also not to infect the partner. Viral infections may involve specific antiviral drugs.

Anatomical anomalies such as strictures, varices or cysts can be operated in many cases. Also, malignant diseases are often treated surgically, possibly with the additional use of chemotherapy. Systemic diseases such as hypertension or coagulation disorders can usually be controlled well with medication.

In the many cases with unexplained cause, it ultimately does not need any therapy, the motto is: wait. The blood in the sperm then often disappears by itself again.

Blood in the sperm: You can do that yourself

If the blood in the sperm does not have other symptoms, such as pain or changes in the testicles, you can wait and see. If the symptom lasts longer, however, you should consult a urologist for treatment and a serious illness as the cause of Blood in the sperm excluded.


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