Men, what's more frightening than seeing blood in your urine? If you answered, “seeing blood in my semen,” you're not alone. The truth of the matter is that hematospermia (as the condition is called) is usually a matter of very little consequence. It is actually considered common, and most times goes by unnoticed, and unreported. But since it can, in some rare circumstances, presage other urological diseases, it's worth taking a closer look.

Inflammation of any of the organs, glands, or ducts involved in seminal fluid production or storage may result in hematospermia. Included on the short list are the seminal vesicles, vas deferens, epididymis, prostate, and urethra.

The sources of the inflammation are varied, and may include irritation or trauma; infections with viruses, bacteria, fungi, or parasites; and stones or calcified deposits in the prostate, seminal vesicles, bladder, or urethra. And, yes, your first guess when seeingblood in your semen is also a possibility: hematospermia may be a sign of sexually transmitted diseases, such as herpes, gonorrhea, and chlamydia.

Blockages can also cause the condition. Obstructed ejaculatory ducts or cysts in the the seminal vesicles or prostate may result in hematospermia. An enlarged prostate may pinch your urethra, and that can cause blood in your semen as well.

Hematospermia may also be a symptom of a more systemic ailment. Cases of high blood pressure, hemophilia, leukemia and chronic liver disease have all reported instances of hematospermia.

Certainly, if you notice blood in your semen, see your doctor, even though the odds are that you are otherwise perfectly healthy. Your doctor will likely give you a physical examination, which may include a digital rectal exam to check for hard spots on the prostate gland and for cysts in the seminal vesicles. Your doctor will also likely give you a blood test, urine analysis, and urine culture. Often times, in patients who are experiencing hematospermia and are over the age of 50, a doctor will also perform a prostate specific antigen test.

If you chronically or consistently experience hematospermia, your doctor may schedule you for a transrectal ultrasound imaging. This will allow him to examine you for abnormalities in the prostate, seminal vesicles, and other tissues.

The treatment of your hematospermia – if your doctor, indeed, determines it requires such – will depend upon what is causing it. 

  Sources: Harvard Medical School