The most common causes of blood in semen, also called hematospermia, are operations on the testicles or prostate. A prostate biopsy is perhaps the most common cause, while vasectomies may also lead to blood in the semen. Occasionally an underlying medical condition may be to blame for bloody semen. These can include cancer of the prostate, testicles, penis, or bladder, sexually transmitted diseases, and benign cysts or tumors found in the genitourinary region.
Most causes of blood in semen are harmless and will resolve without treatment. These are usually related to some kind of medical treatment. Men who have had a prostate biopsy or vasectomy are at the highest risk although other operations on or around the genitals may cause bleeding. The bleeding is is usually temporary and may last up to four weeks. If bleeding becomes severe or if other symptoms are present, patients are advised to contact their doctors.
Blood in semen that occurs without any operations having been performed may be more serious. Sometimes cancer of the genitals or prostate may 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 trouble urinating, pain in the lower abdomen or during urination, and cloudy urine.
There are also some sexually transmitted infections and other genital infections that may cause blood in semen. Other symptoms such as odor, itching, redness, bumps or warts, oddly colored discharge from the penis, or burning during urination 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 for 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. Although rare, since bloody semen can be the sign of a serious or life-threatening medical condition, so it should always be checked out by a medical professional. This is especially true when other symptoms are present, or if prostate or testicular cancer runs in one’s family.
Bloody semen is not a common symptom of most of these conditions, aside from surgical procedures. Any bleeding that is severe or accompanied by pain should be considered abnormal. Very rarely an injury to the penis itself may bleed and make the semen appear bloody upon ejaculation.