The presence of blood in semen is called hemospermia in medicine. It is defined by a pinkish (even red or brown) tint of semen due to the presence of blood. It can be intermittent or systematic, or occur during a single episode. Hemospermia is worrying but you should know that it is rarely indicative of a serious condition, especially if it occurs in a young man. However, it is recommended to consult a doctor to find the cause.

The presence of blood in semen is a sign that bleeding is taking place in one of the structures that produce semen, namely the prostate, seminal vesicles or epididymis (which contain the ducts that carry semen), or more widely in the urogenital system.

This bleeding is most often caused by:

• an infection, especially in men under 40: this is the diagnosis mentioned in 30 to 80% of hemospermia cases. Infections can be bacterial, viral or parasitic, and affect the prostate, seminal vesicles or urethra. Infection with HPV (human papillomavirus) can sometimes be involved.

• A cyst, located somewhere in the urogenital tract, causing dilation of the seminal vesicles, or a cyst of the ejaculatory ducts, etc.
• More rarely, a tumor, malignant or benign, of the prostate but also of the seminal vesicles, bladder, urethra, etc.

If in doubt, the doctor may order an ultrasound to view the prostate, seminal vesicles and ejaculatory ducts and make sure everything is normal.

Other pathologies, such as a blood clotting disorder, varicose veins or pelvic arteriovenous malformations, can sometimes lead to hemospermia.

Trauma (to the testes or perineum) or recent prostate biopsy, for example, can also cause bleeding.

If hemospermia appears after traveling abroad, it is important to mention it to the doctor: certain tropical diseases such as bilharzia can cause this type of symptoms.

More often than not, when the presence of blood in semen is found in a young man, uniquely there is no need to worry, although a medical consultation is recommended.

If the hemospermia is recurrent, evolves, is accompanied by pain, sensations of heaviness in the lower abdomen, it may reflect a serious pathology, such as prostate cancer, and should be the subject of a clinical investigation .

Remember that in the vast majority of cases, hemospermia is a sign of a benign, infectious or inflammatory pathology, especially in men under 40 years of age.

The first step is to go see your doctor or urologist to determine the cause of the bleeding.

Most often, a simple clinical examination, sometimes supplemented by an examination of the prostate (by digital rectal examination) and a urinalysis, will be sufficient. If the cause is infectious, appropriate antibiotic treatment will usually resolve the problem within a few days. Sometimes the presence of a bulky and painful cyst may require surgery.

In men over 40, the presence of blood in the semen, especially if it is recurrent, will often lead to a more complete examination, with the performance of an ultrasound or an MRI, to rule out the hypothesis. prostate cancer.