Blood in semen, also known as hematospermia, can occur for a wide range of reasons. Most causes of brown or bloody semen are not serious and will resolve without treatment. Your age and other accompanying symptoms, such as pain, blood volume, and recurrence, will provide clues to your doctor about the potential cause and possible treatment of your condition.

Read on to learn more about this symptom, what causes it, and how it’s treated.

In many instances, the cause of blood in semen will remain unknown. In other cases, your doctor will be able to identify an underlying condition responsible for this symptom.

There is a wide range of potential causes of blood in semen, including:

1. Prostate biopsy, or prostate surgery

These procedures are two of the most common causes of blood in semen. After a prostate biopsy or surgery, you may see small amounts of pink or rust-colored blood in your ejaculate. You may also see blood in your urine. These symptoms may last for several weeks. They are not typically accompanied by pain, and usually resolve on their own. Talk to your doctor if the amount of blood is increasing, the symptom lasts longer than a few weeks, or it’s accompanied by pain.

2. Sexually transmitted infections (STIs)

Infections, such as chlamydia, herpes, and gonorrhea, are a common cause of blood in semen, particularly in men under 40 years old. Additional symptoms of gonorrhea and chlamydia include:

  • pain or burning during urination
  • a colored or yellowish discharge from the penis
  • pain or tenderness in the testicles

Tiny, painful blisters are a common symptom of herpes.

3. Prostatitis

Semen is produced in the prostate gland. When this gland becomes infected, swollen, or inflamed, you may develop prostatitis. This condition may or may not be caused by a bacterial infection, and it can be acute or chronic (long lasting).

Prostatitis can cause pain in and around the:

  • penis
  • anus
  • testicles
  • lower back
  • lower stomach

It can also cause painful ejaculation, urination, and defecation. In some instances, difficulty voiding the bladder may also occur.

4. Urethritis

The urethra is the tube that carries urine and semen out of the body. If this tube becomes infected, irritated, or inflamed, you may develop urethritis.

Urethritis can cause blood to appear in urine and semen. It may also cause burning or itching during urination and discolored discharge from the penis.

5. Orchitis

Orchitis is inflammation of one or both testicles. It’s sometimes associated with the virus that causes mumps, but may also be caused by a bacterial infection.

In addition to blood in semen, this condition causes pain upon ejaculation and urination. You may also have:

6. Extremes in sexual activity

Being interrupted during sex prior to ejaculation occurring may cause blood to appear in semen. Extreme amounts of sexual activity, either with a partner or via masturbation, may also cause this symptom to occur. The opposite may also be true. Prolonged periods of time without orgasm may cause blood in semen, too.

These conditions do not typically include pain or other symptoms, and resolve when the underlying cause dissipates.

7. Testicular, prostate, or urethral cancers

A rare cause of blood in semen, this highly treatable cancer may also present with a dull ache or pain in the:

  • back
  • groin
  • abdomen
  • testicles
  • scrotum

8. High blood pressure

Blood in semen may be a symptom of severe hypertension (high blood pressure). This condition often presents with no symptoms at all. However, when high blood pressure is advanced or uncontrolled, additional symptoms may include headache, nose bleeds, or shortness of breath.

9. Bleeding disorders

Bleeding disorders, diseases that affect the whole body (like lymphoma and leukemia), and infections, such as tuberculosis or schistosomiasis, may also produce blood in the semen.

Men under age 40 may be more likely to experience this symptom as the result of STI transmission. Men over age 40 may be more likely to experience this symptom as the result of other medical conditions, such as urethritis or prostatitis.

Talk to your doctor if you regularly notice blood in your semen, or if you notice blood in your semen and are concerned about the underlying cause.

If you are under age 40, and blood in semen is your only symptom and it lasts for a short period of time, you may not require a doctor’s care.

If you’re over 40 and have additional symptoms, such as painful ejaculation or painful urination, talk to your doctor about your symptoms.

Regardless of age, if you’re sexually active, especially if you’ve had unprotected sex, it may be a good idea to ask your doctor to test you for STIs.

You should also seek medical help if blood in semen lasts for longer than three to four weeks.

Blood in semen often goes away without medical treatment.

If it’s caused by a bacterial infection, you may need to be treated with antibiotics. That’s why you should see your doctor if the symptom doesn’t resolve on its own.

Other conditions, such as cancer or high blood pressure, will require varying types of treatment to address the underlying cause.

Blood in semen may occur without an obvious, underlying cause. It often resolves on its own without the need for medical treatment.

Blood in semen may or may not be accompanied by other symptoms, such as pain with ejaculation or urination. If you have additional symptoms, are over 40 years old, or experience ongoing instances of blood in semen, discuss your condition with your doctor. If you are under 40 years old or have unprotected sex, make sure to rule out STIs, which may be the cause of blood in semen.