Haematospermia: blood in the semen

Haematospermia means blood in the seminal fluid: the semen looks pink, red or brown. It is very alarming, but in the vast majority of cases it is a benign condition that clears up on its own.

The causes

• under 40: inflammation and infection of the prostate and seminal vesicles, including sexually transmitted infections; very frequent or interrupted intercourse or, conversely, long periods of abstinence
• over 40: the most common cause is a prostate biopsy, after which blood may appear for a few weeks, roughly for about ten ejaculations; other causes include inflammation, stones or cysts of the prostate, very high blood pressure, clotting disorders or anticoagulant medicines
• rarely, a cancer of the prostate or of other genitourinary organs
• often, in the end, no specific cause is found

Is it really blood in the semen?

First of all, it must be confirmed that the blood is not coming from the urine (haematuria) or from the partner.

When to see a urologist

• age 40 or over
• episodes that recur or do not go away
• a large amount of blood
• associated symptoms: pain, difficulty passing urine, blood in the urine, fever, weight loss
• clotting disorders or previous cancers

Under 40, with a single episode and no other symptoms, reassurance and observation are usually enough.

The tests

A consultation with digital rectal examination of the prostate, urinalysis and urine culture, tests for infection, PSA after 40; where indicated, transrectal ultrasound or MRI.