What are the symptoms of hematospermia?

Hematospermia may be caused by factors such as prostatitis, seminal vesiculitis, urethral injury, reproductive system tuberculosis, and tumors. It usually presents as pink or bloodshot semen, which may be accompanied by symptoms such as pain during urination and perineal swelling and pain.

1. Prostatitis:

Prostatitis is one of the common causes of hematospermia. Inflammation causes congestion and edema of prostate tissue, capillaries rupture and bleed, and blood is mixed into semen. Patients may experience frequent urination, urgency, and burning sensation during urination, and some people may experience dull pain in the lower abdomen or perineum. Acute prostatitis may also cause systemic symptoms such as fever.

2. Seminal vesiculitis:

The seminal vesicles are adjacent to the prostate, and inflammation often occurs at the same time. The walls of the seminal vesicles are rich in blood vessels. The fragility of blood vessels increases during inflammation, and they are prone to rupture and bleeding during ejaculation. Typical symptoms include pain during ejaculation, swelling in the perineum, and some patients may experience hematuria. Chronic seminal vesiculitis may result in reduced semen volume.

3. Urethral injury:

Damage to the urethral mucosa can cause blood to mix with semen. Commonly seen after rough sex and urethral instrumentation. Symptoms are mostly sudden hematospermia, which may be accompanied by a tingling sensation during urination. Minor injuries usually heal on their own within 1-2 weeks, but other causes of repeated bleeding need to be ruled out.

4. Reproductive system tuberculosis:

Tuberculosis of the genitourinary system can invade the seminal vesicles, prostate and other parts of the body, forming tuberculous ulcers and causing bleeding. Most patients have a history of tuberculosis and present with chronic hematospermia accompanied by systemic symptoms such as low fever, night sweats, and weight loss. A semen test may reveal acid-fast bacilli.

5. Tumor lesions:

Malignant tumors such as prostate cancer and seminal vesicle tumors can cause persistent hematospermia. There may be no symptoms in the early stage, but as the disease progresses, difficulty urinating and pelvic pain may occur. Benign tumors such as prostatic hyperplasia may also cause intermittent hematospermia due to rupture of superficial blood vessels.

If hematospermia occurs, it is recommended to avoid strenuous exercise and sexual life, and keep the perineum clean and dry. Eat a light diet and consume more fruits and vegetables rich in vitamin C to enhance blood vessel elasticity. To avoid oppressing the perineum due to prolonged sitting, you can take a warm sitz bath to promote local blood circulation. If hematospermia lasts for more than 2 weeks or is accompanied by other symptoms, you need to seek medical attention promptly for routine semen and ultrasound examinations to determine the cause. Men over 40 years old who have recurrent hematospermia need to focus on excluding the possibility of tumors.