Is blood in semen real?
Yes. Blood in semen is medically called haematospermia. It describes a reddish, pink or brown discolouration of the ejaculate caused by blood mixed into the semen.
It is important to classify it correctly: some people confuse blood in semen with blood in the urine or with bleeding from a partner. If you are unsure, it is sensible to check whether the blood really comes from the ejaculate.
Reliable patient information emphasises that blood in semen is worrying but often not due to a serious cause and should nevertheless be investigated. NHS: Blood in semen.
What happens in the body
Semen is a mixture of secretions from several glands, mainly the prostate and seminal vesicles. If small blood vessels there or in the urethra become irritated or inflamed, blood can mix into the ejaculate.
That does not automatically mean something is badly damaged. Mucous membranes are well supplied with blood and respond sensitively to inflammation, pressure or small injuries.
Common causes clinicians consider first
In practice the most common causes are inflammatory or mechanical. The symptom often resolves on its own, especially if it is a single episode and there are no warning signs. Mayo Clinic: Blood in semen.
- Inflammation or irritation in the prostate, seminal vesicles or urethra
- Infections, sometimes with burning on urination, more frequent urination or pain
- Small vascular injuries, for example after vigorous sex or after a long break
- After procedures or investigations in the urological area, such as biopsies
- Less commonly, stones, cysts or vascular abnormalities in the seminal tract
Many urology information pages cite low-grade inflammation as the most common explanation, especially when there are no serious accompanying symptoms. BAUS: Blood in the semen.
When it is likely to be harmless
A single episode without other complaints is often not dangerous. This is especially true for younger men without risk factors and without further symptoms.
However, it is worth not simply ignoring the event. A brief medical assessment can help exclude infections, provide reassurance and avoid unnecessary worry.
Warning signs that merit timely assessment
Certain combinations increase the likelihood that further investigation is sensible. This is not a reason to panic, but to prioritise assessment.
- Recurrent blood in semen or persistent discolouration over several weeks
- Fever, shivering or feeling very unwell
- Significant pain in the pelvis, perineum, testicles or on ejaculation
- Blood in the urine or pain when urinating
- Blood clots, urinary retention or severe difficulty passing urine
- Known bleeding disorder or medications that affect blood clotting
- New-onset haematospermia at an older age or abnormal findings on examination
Clinical guidance emphasises that age, duration and accompanying symptoms determine the pathway for investigation. MSD Manual: Blood in semen.
How medical assessment typically proceeds
Most assessments are straightforward. The aim is not to test everything but to assess risk appropriately and identify treatable causes.
- Medical history: frequency, duration, triggers, pain, fever, urinary symptoms, sexual history, medications
- Physical examination, including prostate examination when indicated
- Urine testing and, if infection is suspected, further tests
- For higher-risk situations or persistent symptoms, additional investigations such as imaging
Many practice recommendations summarise it similarly: a single episode without risk factors often needs only brief assessment, while persistence, older age or symptoms prompt targeted investigation. AAFP: Evaluation and Treatment of Hematospermia.
What you can do until the appointment
Simple, safe steps can help until you are assessed. They do not replace diagnostics but often improve day-to-day management.
- Monitor the course and frequency and note accompanying symptoms such as fever, burning or pain.
- If you feel unwell, rest and ensure adequate fluids, without drinking excessively.
- If there is STI risk or you have new sexual partners, use condoms or avoid sex until assessment to prevent further uncertainty.
- Do not stop blood-thinning medication on your own; if you take anticoagulants, discuss this with a doctor.
If severe pain, fever or urinary retention occurs, prompt urgent assessment is advisable.
Myths vs facts
- Myth: Blood in semen almost always means cancer. Fact: The cause is often inflammatory or temporary; cancer is possible but rare, and assessment depends strongly on age, duration and symptoms.
- Myth: If it does not hurt, I can ignore it. Fact: Lack of pain does not reliably rule out significant causes, especially if it recurs or if other risk factors are present.
- Myth: It is definitely caused by too much sex. Fact: Intense activity can cause minor irritation, but the most common clinical explanations are inflammation or irritation in the seminal tract.
- Myth: It is automatically an STI. Fact: Infections can be a cause, but not every case is sexually transmitted; assessment determines whether tests are needed.
- Myth: Once it happens, it will always recur. Fact: Many episodes are one-off and resolve; the course is often self-limiting.
- Myth: Blood in semen means infertility. Fact: Haematospermia does not automatically affect fertility; the underlying cause and whether treatment is needed are decisive.
- Myth: An antibiotic is always the right answer. Fact: Antibiotics are only appropriate when a bacterial infection is likely or proven; otherwise they can cause side effects without benefit.
- Myth: Everything must be scanned immediately. Fact: Good medicine is risk-adjusted; a single episode without warning signs often warrants a calm, stepwise approach.
- Myth: I can reassure myself by stopping blood thinners. Fact: That can be dangerous and should always be managed by a clinician.
- Myth: If the urine looks normal, it cannot come from the urinary tract. Fact: Blood in semen can occur without visible blood in the urine because the bleeding source may be elsewhere.
When professional help is particularly important
If blood in semen recurs, if fever or severe pain develops, or if there is also blood in the urine, you should have it assessed promptly. New onset at an older age or relevant pre-existing conditions also warrant a structured assessment.
If you are uncertain, early assessment is often the quickest way to relief. Many patient information sources therefore recommend having blood in semen checked by a clinician, even though it is often harmless. Mayo Clinic: When to see a doctor.
Conclusion
Blood in semen is real, often explainable and frequently temporary. However, it is a symptom you should not ignore over the long term, especially if it recurs or if warning signs appear.
The best approach is calm and professional: assess the symptoms, rule out infections, consider risks and pursue structured investigation if the problem persists.
