Blood in Semen

Certain symptoms and characteristics are cause for concern. They include

Men who have warning signs should see a doctor. Timing is not critical, and a delay of a week or so is not harmful. Men who do not have warning signs and are younger than age 35 do not need to see a doctor unless they have other symptoms, such as pain in the scrotum Scrotal Pain Pain in the scrotum (the sac that surrounds and protects the testes) can occur in males of any age, from newborns to older men. The testes are very sensitive, so even minor injuries may cause... read more or groin or pain during urination Pain or Burning With Urination Burning or pain during urination may be felt at the opening of the urethra or, less often, over the bladder (in the pelvis, the lower part of the abdomen just above the pubic bone). Burning... read more . Men who do not have warning signs and are over 35 should see a doctor within a few weeks.

Doctors first ask questions about the man's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the blood and the tests that may need to be done.

Doctors ask

Doctors examine the genitals for redness, a lump, or tenderness. A digital rectal examination is done to examine the prostate for enlargement, tenderness, or a lump.

Doctors can often determine what causes are likely after taking a history and doing an examination. For example, the following kinds of information can provide clues. In men with an abnormal prostate detected during a digital rectal examination, a prostate disorder is likely, such as prostate cancer Prostate Cancer Prostate cancer begins in a small area of the prostate gland, an organ found only in males. The risk of prostate cancer increases as men age. Symptoms, such as difficulty urinating, a need to... read more , benign prostatic hyperplasia Benign Prostatic Hyperplasia (BPH) Benign prostatic hyperplasia (BPH) is a noncancerous (benign) enlargement of the prostate gland that can make urination difficult. The prostate gland enlarges as men age. Men may have difficulty... read more , or prostatitis Prostatitis Prostatitis is pain and swelling, inflammation, or both of the prostate gland. The cause is sometimes a bacterial infection. Pain can occur in the area between the scrotum and anus or in the... read more . In men with urethral discharge, urethritis Urethritis Urethritis is infection of the urethra, the tube that carries urine from the bladder out of the body. Bacteria, including those that are sexually transmitted, are the most common cause of urethritis... read more is likely. In men with tenderness of the epididymis, epididymitis is likely. However, such abnormalities may not be the cause of blood in semen. For example, most older men have benign prostatic hyperplasia, yet few of them have blood in semen.

In men who have bleeding that has lasted less than a month, have not been in areas where schistosomiasis Schistosomiasis Schistosomiasis is infection caused by certain flatworms (flukes), called schistosomes. People acquire schistosomiasis by swimming or bathing in fresh water that is contaminated with the flukes... read more is prevalent, and have no warning signs or abnormalities on examination, a cause cannot usually be found.

In most cases, especially in men younger than 35 to 40 years and in men who recently had a prostate biopsy, blood in semen is not serious and resolves on its own. Urinalysis Urinalysis and Urine Culture Urinalysis, the testing of urine, may be necessary in the evaluation of kidney and urinary tract disorders and can also help evaluate bodywide disorders such as diabetes or liver problems. A... read more and urine culture Urinalysis and Urine Culture Urinalysis, the testing of urine, may be necessary in the evaluation of kidney and urinary tract disorders and can also help evaluate bodywide disorders such as diabetes or liver problems. A... read more are usually done. Further testing is not usually needed unless there are urinary symptoms that suggest an infection or other disorder. However, if the doctor suspects certain potentially serious disorders, further testing is done, for example, some doctors typically do tests for prostate cancer on men over 40.

Testing includes prostate-specific antigen (PSA) testing Diagnosis Prostate cancer begins in a small area of the prostate gland, an organ found only in males. The risk of prostate cancer increases as men age. Symptoms, such as difficulty urinating, a need to... read more and transrectal ultrasonography (TRUS). Occasionally, magnetic resonance imaging (MRI) and cystoscopy Cystoscopy A doctor can diagnose some disorders of the bladder and urethra (for example, bladder tumors, stones in the bladder, benign prostatic enlargement) by looking through a flexible viewing tube... read more (which involves inserting a thin, flexible viewing tube through the urethra to enable doctors to see inside the urethra and bladder) are needed. Semen inspection and analysis are rarely done.