What is hematospermia (bloody semen)?

Hematospermia is the medical term for blood in the seminal fluid. The color can range from light red to brownish or even black clots. It is mostly painless. It is reported in approximately 1 in 5,000 urological patients, and in over 70% of cases the exact cause remains unknown even with modern medical investigation.

What causes bloody semen?

Possible causes include prolonged sexual abstinence (which causes seminal vesicle distension and minor mucosal bleeding), urological trauma such as prostate biopsy or cystoscopy, infection of the prostate, bladder, or urethra, structural causes such as seminal vesicle obstruction or tumors, prostate polyps or calculi, testicular or urethral tumors, and systemic conditions such as hypertension, hemophilia, coagulation disorders, or severe liver disease.

Is bloody semen dangerous?

In most cases, especially in men under 40 years old with no underlying disease, hematospermia is caused by benign conditions and does not require aggressive investigation. However, in men over 40 or those with risk factors, further investigations are necessary to rule out serious causes such as prostate or other urological tumors.

Can prolonged sexual abstinence cause bloody semen?

Yes. Prolonged sexual abstinence — such as during a partner's pregnancy — can cause excessive distension of the seminal vesicles, leading to minor bleeding at the mucosal surface. This is a recognized benign cause of hematospermia.

When should I see a doctor for bloody semen?

You should consult a urologist or andrologist for any episode of bloody semen, particularly if you are over 40 years old, have an underlying medical condition, or if the symptom persists or recurs. A thorough history, physical examination, and tailored investigations are needed to identify the cause and rule out serious conditions.

What is the significance of age 40 in hematospermia evaluation?

Age 40 is a key threshold in hematospermia management. Men under 40 with no underlying disease and uncomplicated hematospermia can generally be reassured that the cause is benign without extensive investigation. Men over 40 require more thorough evaluation to exclude serious pathology such as prostate or urological cancers.

Hematospermia (Bloody Semen): Causes & Treatment

Dernière mise à jour : 18 mai 2026

Soarawee Weerasopone, Urologue

Siège de l'hôpital de Bangkok, Bangkok

Hôpital Samitivej Sriracha, Chonburi

LINE Contact

Bloody semen or in medical term “Hematospermia” is the top one concerning between the others at my Andrology clinic. This kind of Andrological-related problem absolutely terrified the patient and their partner because they will see the fresh blood in semen with naked eyes. So, in this topic it will be cleared along with clarifying for all aspects about this terrified condition.

Le sang dans le sperme a toujours terrifié celui qui en a souffert.

Définition de Hématospermie

The definition of hematospermia is blood presenting in seminal fluid. The color visible as blood can be varied from a light red to brownish or even black clots. Mostly, it is painless. There was a report on the hematospermia prevalence approximately around 1:5,000 among urological patients. The etiology was also still unknown in over 70% of patients.

Elle se présente parfois sous la forme d'une tache brunâtre dans le sperme.

Voici les causes possibles de l'hématospermie.

Prolonged sexual abstinence – seminal vesicle distension from prolonged abstinence can cause minor mucosal bleeding.
Trauma – history of urological procedures (TRUS biopsy, cystoscopy), unusual sexual practices, or perineal trauma.
Infection – prostate, bladder, or urethral infections.
Organ-related causes – seminal vesicle obstruction or tumor, prostate polyps/calculi/tumor, testicular tumor, urethral pathology.
Systemic causes – hypertension, hemophilia, coagulation disorders, liver cirrhosis.

Une éjaculation peu fréquente peut entraîner une hématospermie.

In term of hematospermia management, urologist must seriously do with a good history taking, physical examination and a tailor-made investigation. Surprisingly, 40 years old is the magic number to categorize the hematospermia protocol. Patients who are under 40 years of age with no underlying disease can be managed as benign causes. On the other hand, if the investigations are pointing to or indicated then the tailor-made protocol will be fit for individuals.

L'urologue doit s'appuyer sur une bonne anamnèse, un examen physique et une investigation sur mesure.

Le problème de l'hématospermie peut avoir un effet considérable sur la psychologie du patient, il est donc nécessaire de mieux comprendre l'aspect de la maladie. Si vous avez des questions, vous pouvez en discuter avec votre andrologue de confiance ou envoyer un message à moi. A bientôt dans le prochain article !

Foire aux questions (FAQ)

Q1: Is bloody semen (hematospermia) dangerous?

In most cases, hematospermia is not dangerous and resolves on its own, particularly in men under 40 with no underlying medical conditions. Over 70% of cases have no identifiable cause. However, hematospermia that is persistent, recurrent, or occurs in men over 40 should be thoroughly evaluated by a urologist to rule out underlying conditions such as prostate disease, seminal vesicle pathology, or rarely, malignancy.

Q2: What causes blood in semen?

Common causes include prolonged sexual abstinence causing seminal vesicle distension, trauma from urological procedures or perineal injury, urogenital infections (prostate, bladder, or urethral), structural causes such as prostate polyps or seminal vesicle obstruction, and systemic conditions like hypertension, coagulation disorders, or liver cirrhosis. In over 70% of cases, no specific cause is identified.

Q3: Does hematospermia mean I have prostate cancer?

Hematospermia alone is not a specific indicator of prostate cancer. While prostate pathology is among the possible causes, the vast majority of hematospermia cases in younger men are benign. However, men over 40 or those with additional symptoms such as urinary difficulties, pelvic pain, or elevated PSA should undergo a comprehensive urological evaluation including PSA testing and possible imaging to exclude serious underlying conditions.

Q4: How is hematospermia investigated and managed?

The investigation approach depends on the patient’s age and associated symptoms. Men under 40 with no underlying disease and isolated hematospermia can often be reassured and monitored conservatively. Men over 40 or those with recurrent episodes require a thorough workup including PSA blood test, urine analysis, semen culture, transrectal ultrasound, and possibly MRI of the pelvis to identify any structural cause.

Q5: Will hematospermia go away on its own?

In the majority of younger men with no underlying cause, hematospermia resolves spontaneously without treatment. Regular ejaculation may help reduce the recurrence associated with prolonged abstinence. However, if symptoms persist beyond a few weeks, recur frequently, or are accompanied by other urinary or systemic symptoms, a urological consultation is strongly recommended.

If you are experiencing bloody semen and are concerned about an underlying cause, Dr. Soarawee Weerasopone offers specialist andrology consultations at Bangkok Hospital Headquarters. Prendre rendez-vous.

Avis de non-responsabilité : Ce contenu est rédigé et revu par le Dr Soarawee Weerasopone, urologue certifié au siège de Bangkok Hospital. Il est destiné uniquement à des fins éducatives et ne constitue pas un avis médical. Consultez toujours un professionnel de la santé qualifié avant de commencer tout traitement médical.

Rédigé et révisé par des médecins : Dr. Soarawee Weerasopone (Dr. Pom) – Urologue certifié, Hôpital de Bangkok (siège). Fellowship international : Baylor College of Medicine (États-Unis) · Juntendo University (Japon) · Chang Gung Memorial Hospital (Taïwan).

Dr. Soarawee Weerasopone

Le Dr Soarawee Weerasopone (Dr Pom) est un urologue certifié au Bangkok Hospital Headquarters, spécialisé dans la santé masculine, la chirurgie robotique (système Da Vinci) et le traitement des calculs rénaux. Il a effectué des bourses internationales au Baylor College of Medicine (États-Unis), à l'hôpital universitaire Juntendo (Japon) et à l'hôpital commémoratif Chang Gung (Taïwan). Tout le contenu médical de ce site est rédigé et révisé par le Dr Soarawee, sur la base de son expérience clinique et de sa formation internationale.