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Blood in semen
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Blood in semen

I've been experiencing blood in my semen for about 3-4 months now. I went to my doctor and did some preliminary tests in the middle of December. My PSA came back as 0.54 which my doctor stated is good, however the protein level in my urine was reasonably high, not sure of the numbers. The bleeding stopped untill recently it started again? Are these symptoms of Prostatic Cancer and should I seek help from a Urologist immediately. Also, Im a 38 year old african-american male.
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Thank you for your question. From your description you are experiencing blood in your semen or hematospermia.

Hematospermia, is a fairly common urologic symptom. Understandably, the sight of blood in semen is alarming. While, hematospermia can be associated with malignant disease, there are a host of causes. These include:

Inflammation or infection
Inflammation of any of the organs, glands, or ducts involved in the production or storage of seminal fluid can lead to hematospermia. These include the prostate, urethra, epididymis, etc. In turn, inflammation can be caused by irritation or trauma; stones or calcifications, infection, etc. Herpes, gonorrhea, and chlamydia, have also been implicated in hematospermia.

Obstructed ducts near can cause nearby blood vessels to rupture.

Urologic tumors, prostate, testis, can also cause hematospermia.

Biopsies or other medical procedures can cause trauma resulting in hematospermia.

In addition, proteinuria could be the sign of either 1) blood in the urine or 2) chronic kidney disease from high blood pressure, diabetes, or other inflammatory conditions of the kidneys.  

Followup with a urologist is recommended. Some relevant questions to keep in mind would be 1) when and how did you notice blood in your semen? 2) how many episodes have you had? 3) have you had any tests done recently 4) what medications are you currently (or recently) taking? 5) are there other symptoms you are experiencing (fever, weight loss, pain, urinary frequency)?

Do you have a positive family history of prostate cancer?

Best of luck,

Ashutosh (Ash) K. Tewari, MD

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