Harvard Perspectives on Prostate Disease

Hematospermia demystified

Editor in Chief Marc B. Garnick, M.D., explains why spotting blood in semen probably isn't cause for alarm

Several weeks ago, an anxious colleague came into my office and closed the door. "I think I might have prostate cancer," he said quietly. After a moment of stunned silence, I asked him about his prostate-specific antigen (PSA) level and whether he had had a biopsy. "I haven't had a PSA test recently, and I've never had a biopsy," he replied. "What makes you think that you might have prostate cancer?" I asked. "Well," he said, "my wife and I had sex last night, and she noticed that there was blood in my semen."

Few things alarm a man and his partner more than seeing bloody ejaculate, a condition called hematospermia, or hemospermia. It conjures fears of cancer or a sexually transmitted disease. While it's true that hematospermia may indicate prostate cancer or another urologic disease, that's usually not the case. In many instances, it has no apparent cause. Just as puzzling, the condition can be limited to a single episode or can occur repeatedly over several weeks or months before disappearing completely.

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