What Can Cause Blood in Semen (Hematospermia)?

Medically Reviewed By Meredith Goodwin, MD, FAAFP
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There are numerous possible causes of blood in semen, also known as hematospermia. They include urogenital infections and inflammation of the seminal vessels. In rare cases, it can occur as a result of a tumor. Fresh blood in semen can range from light red to brown. Darker red or blackish blood clots in semen usually mean that some time has passed since the bleeding occurred.

You may or may not be able to see blood in semen. It is typically painless.

Generally, blood in semen is from a noncancerous cause. However, an episode of hematospermia should be considered seriously and evaluated by your doctor.

This article looks at the possible causes of blood in semen. It also includes information about related symptoms, treatments, when to contact a doctor, and more.

What can cause blood in semen?

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There are numerous possible causes of blood in semen.

Urogenital infections and inflammation

Urogenital infection and inflammation are some of the most common causes of blood in semen. These are conditions that affect the genitals and urinary organs.

Examples of conditions that can cause blood in semen include:

Urogenital infections may have associated symptoms such as:

Learn about urinary conditions.


Blood in semen can be a symptom of trauma to the area. This can happen as a result of:

  • accidental injury
  • a medical procedure
  • sexual practices

Contact your doctor if you have experienced an injury that results in blood in semen. They will be able to recommend treatments for any associated pain or complications.

Physical trauma may cause pain in the groin or genital area. Learn about other possible causes of groin pain.


In rare cases, blood in semen is a symptom of cancer.

Studies in men over the age of 40 years showed that blood in semen was a symptom of cancer in 5.4% of the cases, mostly prostate cancer. Learn about prostate cancer.

Although blood in semen is rarely malignant (cancerous), it is important to contact your doctor so that they can determine what’s causing it.

No identifiable cause

It is possible to have no identifiable cause of blood in semen. If this is the case, your doctor may wish to monitor your symptoms if they recur to try and identify the possible cause.

Blood in your semen may not be the only symptom that you are experiencing.

Whether you experience associated symptoms will depend on the root cause. Other symptoms you may experience include:

  • blood in your urine
  • fever or chills
  • lower back pain
  • bowel movement pain
  • ejaculation pain
  • urination pain
  • scrotum swelling
  • tenderness or swelling in the groin area
  • scrotum tenderness

Your symptoms can help your doctor to reach an accurate diagnosis. It is important to let your doctor know about any other symptoms you are experiencing.

Learn more about urinary symptoms.

What are the treatments for blood in semen?

Treatment largely depends on the specific underlying cause. A few potential treatments include:

  • antibiotics for a bacterial infection or UTI
  • anti-inflammatory medication for inflammatory conditions
  • treatments such as chemotherapy and surgery for tumors

Your doctor will advise which treatments they recommend and answer any questions you may have so that you can make an informed decision about your treatment plan.

When should I see a doctor?

Every case of blood in semen should have an evaluation by a doctor.

After a medical evaluation and test results, your doctor will inform you if there is a need for further treatment.

How do doctors diagnose the cause of blood in semen?

To assist with reaching an accurate diagnosis, your doctor may begin by carrying out a physical examination, taking a full medical history, and asking you questions about your symptoms.

They may then perform tests to confirm the diagnosis and rule out possible causes.

This may include blood pressure tests and urinalysis to test for signs of infection. You may not require any further testing if you are under the age of 40 years.

For people over the age of 40 years or who have experienced multiple episodes of blood in semen, your doctor may recommend further testing. This can include additional laboratory tests and imaging tests.

Are there any possible complications of blood in semen?

Complications of blood in semen can occur as a result of the underlying condition.

For example, without treatment, an infection may lead to sepsis. A tumor may grow or spread without proper diagnosis and treatment.

To reduce your risk of complications, contact your doctor as soon as you experience blood in semen. This can help ensure you receive an accurate diagnosis and begin treatment as early as possible.


Blood in semen, or hematospermia, is a symptom that can occur due to infection or inflammation. It may also happen as a result of injury or, in rare cases, malignancy.

Your doctor may perform a physical examination and order tests, such as urinalysis. If you are over the age of 40 years or have had multiple episodes of blood in semen, your doctor may order additional laboratory and imaging tests to reach an accurate diagnosis.

Contact your doctor as soon as you experience blood in semen. Although it is not always possible to identify the cause, it is important to receive a diagnosis where possible and begin treatment to reduce your risk of complications.

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Medical Reviewer: Meredith Goodwin, MD, FAAFP
Last Review Date: 2023 Jan 31
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Epididymitis. (2021). https://www.cdc.gov/std/treatment-guidelines/epididymitis.htm
  2. Madhushankha, M., et al. (2021). Clinical characteristics, etiology, management and outcome of hematospermia: A systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8012833/
  3. Mathers, M. J., et al. (2017). Hematospermia—a symptom with many possible causes. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387851/
  4. Urinary tract infection. (2021). https://www.cdc.gov/antibiotic-use/uti.html
  5. Young, A., et al. (2021). Urethritis. https://www.ncbi.nlm.nih.gov/books/NBK537282/