What causes blood in semen? 11 possible conditions

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What Is Blood in the Semen?

For any man, seeing blood in his semen can be startling and even scary. Fortunately, it rarely signals a serious problem, especially in men under the age of 40. Blood in the semen, also called hematospermia, usually does not last long, and it is not uncommon for men to experience bloody semen during their lifetime.

What Should I Look For?

The amount of blood in your semen can vary from a small drop to enough to give your semen the look of blood. The amount of blood in your semen will depend on the cause of your bleeding. In addition to having blood in your semen, you might also experience:

  • pain when ejaculating
  • pain when urinating
  • tenderness or swelling in your scrotum
  • tenderness in the groin area
  • pain in your lower back
  • blood in your urine

Potential Causes of Blood in the Semen

Semen passes along a series of tubes on the way to the urethra for ejaculation. Any number of things can cause blood vessels along this path to break and leak blood into the semen.

In many cases, the exact cause for blood in the semen is never determined. According to Harvard Medical School, most cases of blood in the semen are not serious and can be attributed to six causes: inflammation/infection, obstruction, tumors, vascular abnormalities, systemic factors, or trauma/medical procedures. (Harvard)

Inflammation and Infection

Inflammation of the seminal vesicles is a common cause of bloody semen. Basically, inflammation or infection of any gland, duct, tube, or organ involved in the male genitourinary system can cause blood in your semen. This includes prostatitis (inflammation of the prostate gland), epididymitis (inflammation of the epididymis) and urethritis (inflammation of the urethra). Inflammation can also be caused by irritation from calcui (stones) in the prostate, seminal vesicles, bladder, or urethra.

Sexually transmitted infections like chlamydia, gonorrhea, or herpes can also cause hematospermia. Infections caused by viruses, bacteria, or fungi can also lead to this condition.


If ducts like the ejaculatory duct are blocked, surrounding blood vessels can dilate and rupture. If your prostate is enlarged, it can put pressure on your urethra, and that can cause hematospermia.


Benign polyps or malignant tumors in the prostate, testicles, epididymis, or seminal vesicles could lead to blood in your semen.

Vascular Abnormalities

Vascular abnormalities in the male genitourinary system could explain the blood you’ve seen in your semen.

Systemic Factors

Conditions that affect your whole body can cause blood in your semen. These include hypertension (high blood pressure), hemophilia, leukemia, and chronic liver disease.

Trauma/Medical Procedures

Physical trauma like being hit in your testicles while playing sports can lead to blood in your semen. Trauma can cause blood vessels to leak, and that blood may leave your body in semen. A medical procedure like a prostate exam or biopsy or a vasectomy can cause blood in your semen.

Knowing When to See Your Doctor

If You Are Over 40

Men age 40 or over have a higher risk of developing illnesses like prostate cancer. Because of this, you should tell your doctor any time you see blood in your semen. Your doctor will want to check for the cause of the blood as soon as possible.

If You Are Under 40

If you are under the age of 40 and don’t have any symptoms other than bloody semen, wait and see if the blood goes away on its own. If your semen continues to be bloody or if you start experiencing additional symptoms like pain or a fever, make an appointment with your doctor. He or she might perform a prostate exam or analysis of your semen and urine to determine the source of the blood.

Treatment: Resolving Your Symptoms

Depending on the cause of your bloody semen, you might be able to treat yourself at home. If the underlying cause requires medical treatment, your doctor will decide the course that is right for you.

Treatment at Home

If you have blood in your semen as a result of a trauma, simply resting and allowing your body to heal may help. If you also have swelling in your groin, you can apply ice to the area. Keep an eye on your symptoms and alert your doctor if they worsen.

Medical Treatment

If your bloody semen is caused by an infection, your doctor will probably prescribe antibiotics. If the blood in your semen is caused by a blockage in your genitourinary tract, surgery may be necessary. If the blockage is the result of a bladder stone, the stone may have to be removed surgically.

If cancer is causing the blood in your semen, your doctor will probably refer you to a specialist (oncologist) who will determine the best protocol for treating your cancer.

As scary and startling as blood in your semen may be, it’s important to remember that in most cases it’s not the sign of a serious condition.

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See a list of possible causes in order from the most common to the least.



Urethritis is an infection of the urethra, the tube that carries urine from the bladder and semen out of the body. Symptoms include burning while urinating, abdominal pain, and discharge.

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Prostatitis is inflammation of the prostate gland, which produces a fluid found in semen. The inflammation may spread to the area around the prostate. Causes include bladder infection, STDs, and injuries to the prostate.

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Orchitis is the inflammation of the testicles. It can be caused by either bacterial or viral infection such as the mumps or certain STIs. Symptoms are often restricted to just one testicle in most men.

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Torsion of Testes

This condition is considered a medical emergency. Urgent care may be required.

Torsion of the testes (testicular torsion) occurs when the spermatic cord becomes twisted, causing a restriction in blood flow to the testes, severe pain and possibly permanent damage. It is a medical emergency.

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Prostate Cancer Overview

Learn prostate cancer information, causes, symptoms and treatments.

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Epididymitis is inflammation of the epididymis, the tube located at the back of the testicles that stores and carries sperm. It's usually caused by a bacterial or sexually transmitted infection.

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Chronic Nonbacterial Prostatitis

Chronic nonbacterial prostatitis causes pain and inflammation in the prostate and the lower urinary tract in men. It's a common condition, especially in men between the ages of 35 and 50 and the cause is often unknown.

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Testicular Cancer

Testicular cancer is cancer that originates in one or both testicles (testes), the male reproductive glands located inside the scrotum responsible for producing sperm and the testosterone hormone.

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Urethral Stricture

The urethra is a tube that helps expel urine from body. When the urethra narrows, it's known as a urethral stricture. Abdominal pain, urge to urinate, and swelling are signs.

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Bladder Cancer

Bladder cancer occurs in the tissues of the bladder, which is the organ that holds urine. Fatigue, weight loss, painful or frequent urination, and abdominal or back pain are symptoms.

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Reactive Arthritis (Reiter's Syndrome)

Reiter's syndrome, also known as reactive arthritis or post-infectious arthritis, produces inflammation, swelling, and pain in the joints due to infection elsewhere in the body. Other parts of the body may also b...

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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