Haematospermia means blood in the semen. It is frightening to see, but in most men it is harmless and settles on its own within a few weeks. It is worth a consultant check when it keeps coming back, when you are over 40, or when it comes with other symptoms such as blood in the urine, pain or fever.
Seeing blood in your semen is one of the most alarming things a man can notice, and many men worry about it alone for weeks before saying anything. The reassuring news is that in the great majority of men it is harmless and clears up by itself. Mr Vinod Nargund sees men with haematospermia regularly, and a single calm consultation is usually enough to find the cause, rule out anything serious and put your mind at rest.
What causes blood in the semen?
Most often, a small blood vessel in the prostate or the seminal vesicles has bled, and no single cause is ever found. The common causes are:
- A recent prostate biopsy, after which blood in the semen is expected and can last for several weeks.
- Inflammation or infection of the prostate, seminal vesicles or urethra, including some sexually transmitted infections.
- A vasectomy or other minor procedure in the area.
- Long gaps between ejaculation, or particularly vigorous sexual activity.
- An enlarged prostate, where small surface vessels can bleed.
Less commonly it is linked to high blood pressure, blood thinning medication or a bleeding disorder. Rarely, particularly in older men, it can be a sign of prostate cancer, which is why it is worth getting checked rather than simply waiting.
When should I get it checked?
A single episode in a younger man with no other symptoms is very unlikely to be serious. It is worth seeing a urologist if:
- it happens more than once, or keeps coming back over several weeks;
- you are over 40;
- you also have blood in your urine, pain, fever, or difficulty passing urine;
- you have a partner who may be at risk of infection, or you are trying to conceive.
What does the assessment involve?
- A conversation about your symptoms, sexual and medical history and any medication.
- An examination, including a gentle check of the prostate.
- A urine test, and tests for infection where appropriate.
- A PSA blood test in men over 40, and a blood pressure check.
- A scan, such as an ultrasound or MRI of the prostate, only where the history or the tests suggest it is needed.
If there is also blood in the urine, Mr Nargund will arrange the full investigation described on the blood in the urine page.
What happens next?
For most men the tests are normal and the answer is reassurance: the bleeding will stop without treatment. Where an infection is found it is treated, and where there is a more specific cause Mr Nargund explains it and the options plainly. You leave knowing what has happened and what, if anything, needs to be done.
Sources
The British Association of Urological Surgeons patient information on haematospermia, the European Association of Urology guidelines, and NHS patient information on blood in semen.
Reviewed by Mr Vinod Nargund, MBBS, PhD, FRCS(Urol), FEBU. Last updated 2 October 2026.