What are the lesser known causes of hematospermia? Seeing blood in the semen (hematospermia) can be alarming, but in most cases it is nothing to worry about. Even when hematospermia is due to a more serious problem, seeking medical attention and getting prompt treatment can prevent the condition from getting worse. Hematospermia can be caused by a number of problems, but some less common causes of blood in the semen may include: Inflammation Inflammation refers to swelling and irritation. Sometimes this can happen along with an infection, but inflammation can also occur on its own. Prostatitis is one form of inflammation, but irritation elsewhere in the genitals or urinary tract can also cause blood to appear in the semen. Inflammation in the epididymis (testicle), which is a highly convoluted tube in which sperm are stored and matured after they are formed, can also cause blood to appear in the semen. The man may also experience accompanying complaints, such as: Pain when urinating; Pain in the penis or groin; Swelling and tenderness Tumor In rare cases, the cause of blood in the semen can be an oncological disease. The most common tumor that causes hematospermia is prostate cancer. When this happens, the affected man may sometimes notice repeated instances of hematospermia, as well as other symptoms, such as painful urination or pain in the groin. When blood in the semen occurs only once or occurs after an injury or lifestyle change, the cause of the hemorrhage is unlikely to be a tumor. Other Factors Although less common, there are some other problems that can cause blood in the semen. These include: HIV/AIDS; Taking medicines that sometimes cause bleeding, such as warfarin; High blood pressure; Hemophilia; Leukemia; Liver disease; Enlarged prostate; Obstruction of the ejaculatory duct (the final part of the vas deferens to which the outlet duct of the seminal vesicle joins); Infertility What are the risk factors for hematospermia? Blood in the semen can occur in any man, and doctors often cannot determine the cause. However, there are certain risk factors that increase the likelihood of hematospermia. These include: Intense sex, especially after a long period of abstinence; Age over 40 years; History (medical history) of prostate problems, such as prostatitis; Family history (case in the family) of prostate disease; Infection in the genitourinary system What is the diagnosis and treatment of hematospermia? Diagnosis is usually based on taking a patient’s history, such as the person’s sexual history, performing a physical examination, and performing laboratory and imaging tests. Tests may include:Rectal examination of the prostate gland; Urinalysis and urine culture; Prostate-specific antigen (PSA) blood test to evaluate for prostate cancer; Analysis of seminal fluid; Direct urethral visualization with cystoscopy; Ultrasound examination of the prostate; Prostate MRI In many cases hematospermia does not require treatment. When a patient is under the age of 40 and has few or no risk factors for cancer or other serious health problems, he may not need treatment for only a single case of hematospermia. However, the patient may need treatment if there is an infection or obstruction (blockage) of the urinary tract. Some potential treatment options for hematospermia include: Antibiotics for bacterial prostatitis and urinary tract infections; Anti-inflammatory drugs, for the treatment of inflammation; Surgery to remove blockages or treat blood vessel problems; Treatment of underlying conditions, such as sexually transmitted infections or chronic liver disease; Chemotherapy, radiation therapy, or surgery for tumors and other forms of cancer Some doctors may recommend antibiotics even when they can’t find an infection. In fact, a 2014 study found that a combination of antibiotics and an anti-inflammatory drug relieved symptoms 96 percent of the time. A single episode of blood in the semen is not an emergency. However, it is best to see a doctor to rule out more serious causes of hematospermia. It is also important to see a doctor for: Repeated cases of blood in the semen; Hematospermia that worsens over time; Pelvic pain; Difficulty urinating; Possible infertility; Swelling in the groin; Signs of prostatitis, such as frequent use of the toilet or problems urinating. References: 1. Lee, G. (2015). Chronic prostatitis: A possible cause of hematospermia 2. Mathers, MJ, et al. (2017). Hematospermia�A symptom with many possible causes 3. Medical News Today. Why is there blood in my semen?to treat inflammation; Surgery to remove blockages or treat blood vessel problems; Treatment of underlying conditions, such as sexually transmitted infections or chronic liver disease; Chemotherapy, radiation therapy, or surgery for tumors and other forms of cancer Some doctors may recommend antibiotics even when they can’t find an infection. In fact, a 2014 study found that a combination of antibiotics and an anti-inflammatory drug relieved symptoms 96 percent of the time. A single episode of blood in the semen is not an emergency. However, it is best to see a doctor to rule out more serious causes of hematospermia. It is also important to see a doctor for: Repeated cases of blood in the semen; Hematospermia that worsens over time; Pelvic pain; Difficulty urinating; Possible infertility; Swelling in the groin; Signs of prostatitis, such as frequent use of the toilet or problems urinating. References: 1. Lee, G. (2015). Chronic prostatitis: A possible cause of hematospermia 2. Mathers, MJ, et al. (2017). Hematospermia�A symptom with many possible causes 3. Medical News Today. Why is there blood in my semen?to treat inflammation; Surgery to remove blockages or treat blood vessel problems; Treatment of underlying conditions, such as sexually transmitted infections or chronic liver disease; Chemotherapy, radiation therapy, or surgery for tumors and other forms of cancer Some doctors may recommend antibiotics even when they can’t find an infection. In fact, a 2014 study found that a combination of antibiotics and an anti-inflammatory drug relieved symptoms 96 percent of the time. A single episode of blood in the semen is not an emergency. However, it is best to see a doctor to rule out more serious causes of hematospermia. It is also important to see a doctor for: Repeated cases of blood in the semen; Hematospermia that worsens over time; Pelvic pain; Difficulty urinating; Possible infertility; Swelling in the groin; Signs of prostatitis, such as frequent use of the toilet or problems urinating. References: 1. Lee, G. (2015). Chronic prostatitis: A possible cause of hematospermia 2. Mathers, MJ, et al. (2017). Hematospermia�A symptom with many possible causes 3. Medical News Today. Why is there blood in my semen?