Patient's question:
What is the reason for blood in semen when not frequently having sex?Doctor's answer:
Analysis of the Condition: Hello, blood is mixed in the semen. Medically, this is known as hematospermia. Normal semen has a light grayish-white color, and after abstinence for a while, it may turn light yellow, slightly viscous. It turns into a liquid within about 20 minutes after being expelled, known as semen liquefaction. The main components of semen include seminal fluid (50%-80%), prostatic fluid (15%-30%), as well as small amounts of epididymal fluid, sperm, bulbourethral gland fluid, and paraurethral gland fluid. Therefore, if there is bleeding in any part of the seminal vesicle, seminal duct, ejaculatory duct, or posterior urethra, the semen may appear brownish-red; bleeding in the posterior urethra is usually fresh blood, making the semen appear red or pink. Hematospermia can be intermittent or persistent for months or even years. It may occur without any other symptoms, or it may be accompanied by pain during ejaculation, initial hematuria, or difficulty urinating.Causes: There are three types of causes: pathological, functional, and idiopathic. Pathological causes include:
① Inflammation, most commonly seminal vesitis and prostatitis, which often occur together and are usually caused by bacterial infections, but mycoplasma infection should also be considered.
② Seminal vesicle or prostatic cysts, stones, tuberculosis, or filariasis.
③ Varicose veins or angiomas on the posterior urethra or hypertrophied prostate, or polyps.
④ For individuals over 40, malignancies of the seminal vesicle, prostate, or posterior urethra should be considered.
Functional causes are primarily due to long-term abstinence leading to excessive distension of the seminal vesicles, followed by excessive indulgence, which results in repeated contractions of the seminal vesicles and rupture of blood vessels in the mucosa.
Idiopathic hematospermia refers to blood in the semen with no known cause.
Guidance:
Treatment: Hematospermic patients often experience significant psychological distress, so doctors should conduct a thorough examination to rule out pathological causes. For patients over 40, the primary focus should be on ruling out tumors. If the cause is inflammation, antibiotic treatment may be used. If the bleeding is due to seminal vesitis without bacterial infection, mycoplasma infection should be ruled out. It is also known as hemorrhagic seminal vesitis, and under the guidance of a doctor, low-dose female hormones may be used, often leading to a cure.
For symptomatic treatment of hematospermia, some vitamin K and hemostatic agents like Anluo blood may be administered.
When treating hematospermia, the underlying cause must first be addressed. For seminal vesitis or prostatitis, antibacterial and anti-inflammatory treatment may be used. During the acute phase, broad-spectrum antibiotics can be administered intravenously, followed by oral antibiotics once the condition stabilizes. Warm baths with high-manganese potassium permanganate solution (1:5000) can also be used. Local heat therapy through the perineum or rectum, or applying hot compresses, can improve local microcirculation and promote inflammation resolution. Weekly massage of the seminal vesicles and prostate can help expel fluid from the seminal vesicles.
After active treatment, if seminal vesitis is cured, hematospermia will disappear, and it will have no significant impact on fertility. Sexual activity should be avoided until hematospermia resolves. If hematospermia is caused by stones, varicocele, or tumors, surgical treatment may be considered. For hematospermia caused by systemic diseases, the underlying condition should be treated aggressively.
I hope my response is helpful. Wishing you good health.