brown semen

For the past few years, my semen has been brown, each year getting darker.  It is now a very dark brown.  Analysis 5 years ago indicated occult blood. Ultra sound then indicated an enlarged prostrate but normal otherwise. I'm 74.  My PSA has been on the high side of the normal range. It takes a long time to urinate, about 5 minutes.  I'm taking saw palmetto extract twice daily. Can you make any recommendations?  Thanks!!

[Kevin Pho, MD]

Occult blood in the semen (or urine for that matter) deserves further attention.  The prostate would be the most common source of blood in someone your age.  Other causes include infection, bladder  or kidney diseases.  

I would suggest a transrectal ultrasound to evaluate the prostate as a reasonable first step.  If negative, you can consider a cystoscopy to comprehensively evaluate the bladder.  If the PSA is in an indeterminate range, you may want to consider obtaining a "free PSA" level, which can suggest malignancy if the levels are low.  

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[DickieDo]

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[clinical chris]

I'm twenty four and within the last 6 months my ejaculations have become deep redish brown in color. My first thought was a UTI but the test was negative. My recent labs show my thyroid is really out of whack. The tsh levels were 21.1 and kidneys were fine. I have really low cortisol levels and am diabetic for 22 years. My doc is at a loss. I also have really bad back pain and fatigue easily. Any suggestions would be great.

[goarmy_bp]

A related discussion, just turned 40 with blood in semen was started.

[bazik]

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