What is hematospermia?

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

Hematospermia (also spelled haematospermia, and sometimes called hemospermia) means blood in the semen, the fluid released when you ejaculate [Cleveland Clinic]. ICD-10-CM codes it as R36.1.

What it looks like

Blood in semen can look bright red if the bleeding is recent, or brown or reddish-brown when it's older blood clearing out. Sometimes there are small clots [NHS]. Pink-tinged semen is also common [Cleveland Clinic]. Many men only notice it once, on a condom or after masturbation.

Is it common?

Nobody knows exactly how common it is, because most men don't look closely at their semen and many episodes go unreported [AAFP]. In clinics it is seen most often in men between 30 and 40 [Cleveland Clinic], and one review estimates it accounts for about 1–1.5% of urology referrals [review].

Where does the blood come from?

Semen is a mix of sperm from the testicles and fluid from the seminal vesicles, prostate and other small glands. Bleeding anywhere along that pathway can tint the semen [MSD Manual]. The most likely explanations are a small blood vessel that bursts during ejaculation (a bit like a nosebleed), a recent procedure such as a vasectomy or prostate biopsy, an injury, or an infection or inflammation [Cleveland Clinic]. See all causes.

Is it dangerous?

Usually not. Mayo Clinic notes that the cause is most often not cancer and that it most often goes away on its own [Mayo Clinic]. NHS advice is that it isn't usually caused by something serious, but you should get it checked by a doctor just in case [NHS].

The picture is different if you are 40 or older, if it keeps happening, or if you have other symptoms. Doctors are more thorough in those cases because a small number turn out to have a more important cause, such as prostate problems [NICE CKS] [AAFP]. See under 40 vs 40 and over.

Does it affect fertility or sex?

NICE advises reassuring men that most causes don't affect fertility, with the exception of sexually transmitted infections such as chlamydia or gonorrhea [NICE CKS]. The MSD Manual notes that hematospermia doesn't affect sexual function [MSD Manual].

What to do next

1. Note when you first saw it, how many times, and any other symptoms.
2. Use the should-I-worry checklist to see how soon to get seen.
3. Book an appointment with your GP, primary care clinician or a urologist. Read what tests to expect.