Written and clinically reviewed by Mr Daniel Swallow, Consultant Urologist (GMC 6128674). Last reviewed: .
Is blood in semen normal?
It is not normal, but it is common and rarely serious. Semen may look pink, red, brown or streaked, and it is often noticed once and never again. In most cases no cause is found, or it is linked to a minor infection or inflammation of the prostate or the glands that make semen.
Common causes
- Low-grade infection or inflammation in the tubes and glands that carry semen, especially the prostate (the most common cause). Urine infections and, less often, sexually transmitted infections can also be responsible
- A recent urological procedure such as a prostate biopsy, cystoscopy, TURP or vasectomy
- Blood-clotting disorders, or blood-thinning and antiplatelet medicines
- Rarely, cancer of the prostate or testicle. Often no clear cause is found and the bleeding settles by itself
The NHS advises seeing your GP if you have blood in your semen, so that it can be checked. Referral to a urologist is usually considered if the bleeding keeps coming back despite treatment (particularly over the age of 45), if you also have blood in your urine, or if the prostate, PSA test or a testicle is abnormal. A single episode with no other symptoms is usually reassuring.
What happens at an assessment
A history and examination (including the prostate and testicles), a blood pressure check, a urine test, and blood tests that may include kidney function, clotting and PSA. Depending on the findings, a kidney and bladder or scrotal ultrasound, and occasionally an MRI or a cystoscopy, may be offered. If bleeding persists, a course of antibiotics or anti-inflammatory medicine is often tried first. The aim is to rule out anything that needs treatment and, in most men, simply to reassure.
Common questions
Does blood in semen mean cancer?
Rarely. Cancer of the prostate or testicle is an uncommon cause. It is looked at more carefully in older men, or when bleeding keeps coming back, which is why an assessment is worthwhile.
Does it affect fertility?
Fertility is not usually the main concern, but if you are trying for a baby, or an infection is suspected, mention it at your appointment so it can be looked at.
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Further reading from trusted sources
- NHS: Blood in semen
- BAUS: Blood in the semen (haematospermia)
- NICE NG12: Suspected cancer, recognition and referral
Information on this page follows patient guidance published by the British Association of Urological Surgeons (BAUS). External links open on the NHS and NICE websites, which are not run by Mr Swallow.