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Hematospermia.com

Diagnosis

Tests for blood in semen

Most men need only an exam and a urine test. Here's the full list, from first visit to specialist.

By the Hematospermia.com editorial teamUpdated Medical review pending
Illustration of laboratory test tubes with teal caps, a sample cup and a microscope.

Educational information only, not a diagnosis. Know when to get help.

On this page
  1. History and examination
  2. Common first tests
  3. Specialist tests
  4. Sources

For most men the workup is short and simple: a conversation, an examination, and a urine test. Mayo Clinic notes that a physical exam and simple blood or urine tests are often all that's needed [Mayo Clinic].

History and examination

Expect questions about when you noticed it, how often, sexual activity, medicines and recent procedures [Cleveland Clinic]. The exam usually includes checking your blood pressure, examining the genitals and testicles, and often a digital rectal exam (a gloved finger to feel the prostate), especially if you're 40 or older [RACGP] [review].

Illustration of a man talking with a clinician across a desk in a bright consulting room.
The first visit is mostly conversation and a physical exam.

Common first tests

TestWhat it looks for
Urinalysis and urine cultureInfection and blood in the urine [AAFP].
STI testing (often a urine sample)Chlamydia, gonorrhea and others [RACGP].
PSA blood testUsually for men 40+, or with risk factors or an abnormal prostate exam [RACGP] [StatPearls].
Blood count and clotting testsBleeding disorders, especially if bleeding persists [RACGP] [NICE].
Illustration of a clinician explaining a simple diagram on a tablet to an older man.
Specialist tests are usually only needed when the first checks raise questions.

Specialist tests

If it persists, recurs, or you're over 40 with no cause found, a urologist may arrange [AAFP] [MSD] [review]:

  • Transrectal ultrasound (TRUS) to look at the prostate and seminal vesicles.
  • MRI of the prostate and pelvis.
  • Cystoscopy, a thin camera passed into the urethra and bladder, particularly if there's blood in the urine.
  • Scrotal ultrasound if a testicular problem is suspected.
  • Semen analysis, occasionally, for example when travel history suggests schistosomiasis [MSD].

Sources

  1. Blood in semen: when to see a doctor Mayo Clinic
  2. Blood in Semen (Hematospermia) Cleveland Clinic Health Library, reviewed Jan 2024
  3. Haematospermia Australian Family Physician (RACGP), Dec 2015
  4. Hematospermia: etiology, diagnosis, and treatment Review article, PubMed Central (PMC5904639)
  5. Evaluation and Treatment of Hematospermia American Family Physician, 2009;80(12):1421-1427
  6. Prostate Cancer Screening StatPearls, NCBI Bookshelf (NBK556081)
  7. Haematospermia: management NICE Clinical Knowledge Summaries
  8. Hematospermia MSD Manual Professional Edition

We link to primary medical sources so you can check our work. See the editorial policy and the full reference list.