OK, so picture this....imagine you’re a guy having one of those sexual episodes like you’d see in an adult DVD---you’re hot, the person you’re with is hot and the two of you are having the hottest sex ever.  The "moment of truth" has come---the proverbial money shot.  Channeling your inner porn star, you really go for the gold when suddenly you realize something is very wrong:  your semen is blood red!

You can imagine how traumatic a scene like this might be and how you might feel:  Grossed out by the sight of blood.  Embarrassed by your partner’s reaction.  Frightened that something is seriously wrong.  These are all feelings that person with a condition called hemospermia (or sometimes “hematospermia”) might experience.  Hemospermia, the presence of blood in the semen, is a relatively uncommon condition---but if you were ever one of the unlucky guys it DID happen to, you'd probably want some answers!

This condition can affect men of any age but is most common in men under 40.  Symptoms can present in a variety of ways:  Some men produce semen that looks nothing like semen and is, in fact, as red as fresh blood (this is possibly the scariest and most dramatic version of the experience for many men).  Others may see “blood spotting”…meaning it will look like drops of blood are mixed into semen. Still others may not see red blood at all---instead the blood will cause discoloration to an orange or even a brownish (like dried blood) color.

The length of symptoms can vary.  Some men will see the blood on only one occasion while still others may notice the symptoms for several days, weeks or, in extreme cases, perhaps even a month or longer.  Additionally, many men who experience hemospermia may have repeated episodes---meaning that the symptoms will subside but may reappear again at a later time.  The good news is that in most cases hemospermia, while perhaps distressing, is usually not a serious health problem.  

So what, then, causes hemospermia?  The truth is that physicians aren’t completely certain what causes the condition---and it appears that there is no one single cause OR, for many, that no cause can be identified at all.  The blood being seen in the semen is generally a symptom of bleeding occurring inside the body along the tract of organs that produce the semen.  These organs include the testicles, epididymis, vas deferens, seminal vesicles, prostate, and urethra.  The cause of this bleeding may be physical (meaning caused externally) or physiological (caused by an internal physical problem).

Some examples of physical causes of hemospermia might include a trauma to the genital or groin area that bursts blood vessels inside the body (such as being hit or kicked, a sports injury, etc.).  Additionally men who we wear a cock-ring that is too tight or for too extended a period of time may burst blood vessels inside the body and experience symptoms…as may men who engage in particularly aggressive sex or try too hard to ejaculate.  Some men have reported that extended periods of "edging"---repeatedly geting sexual stimulation (either masturbation or sex with a partner) just up to the point of ejaculation and then stopping.  medications and/or recreational drugs may cause the condition  (in specific some literature references the use of crystal meth with hemospermia…this may, however, be a result of the drug OR because many meth users engage in prolonged sexual encounters that increase the risk of rupturing blood vessels).  In most or all of these cases, symptoms should clear on their own.

Some physiological problems that can cause this condition include systemic diseases, hemophilia or other blood disorders, or damage/disease in any of the reproductive organs where semen is produced (i.e. prostatitis, urethral infections, epididymitis and some cancers like testicular or prostate cancer).  When one of these is the likely cause, the blood in the semen is usually also accompanied by tenderness, pain, blood in the urine, or some other physical complaint. In order to rule out the possibility of disease…and to properly diagnose and treat any of the conditions that may cause hemospermia, a doctor and/or urologist should be consulted whenever blood is visible in semen AND accompanied with any of the listed symptoms.