Male InfertilityMale Sexual HealthWhat causes retrograde ejaculation?


Sounds strange but true. Hematospermia is a condition where blood is present in the semen (male ejaculate). It is not noticeable usually, so it is difficult to tell in the initial stages.

What causes blood to mix with semen?

As you can see, there are many parts in the men’s reproductive system such as Bladder, Urethra, Testicles, the tubes that transport semen from the testicles (knows as seminal vesicles), the epididymis (a place which stores sperms to mature for fertilization) and the prostate gland. Problem can exist with any of these organs leading to Hematospermia.  If the person hasn’t had any prostate biopsy or vasectomy, a number of other factors in his genital system can lead to Hematospermia.

What causes retrograde ejaculation?

Following are such conditions:

  1. Benign (not cancerous) tumors of prostate, bladder, testes or the seminal vesicles
  2. Infections such as Chlamydia, Herpes, Cytomegalovirus, Trichomoniasis
  3. Prostatitis – Inflammation of prostate, (Epididymitis) inflammation of epididymis or the inflammation of Urethra (Urethritis).
  4. Stones in Seminal Vesicles or Prostate. (These are different from Kidney Stones)
  5. Polyps in the Urethra
  6. Obstructions in the ejaculatory ducts
  7. Metastatic Cancers in the genital system. (Cancer is termed ‘Metastatic’ when it originates in one part of the body and spreads to other regions/parts).
  8. Cysts, Hemorrhage or other problems in the Seminal Vesicles.

Symptoms of Hematospermia (blood in semen):

    1. Pain during ejaculation
    2. Pain during urination
    3. Visible amount of blood in urine
    4. Lower back pain
    5. Fever
    6. Tenderness (pain when touched) or swelling in the testes and/or scrotum
    7. Swelling and/or tenderness in the groin area.

Evaluation of Hematospermia condition:

Your sexologist/andrologist will enquire your clinical history and may perform a physical examination. Urinalysis and other cultures to identify any Sexually Transmitted Diseases or infections may be performed. Imaging, Ultrasound or MRI may have to be performed to detect tumors or other abnormalities. In some cases, your semen may be collected to observe it under a microscope.

Treatment options for Hematospermia at Metromale Clinic & Fertility Center:

During the diagnosis, if the underlying cause is found, appropriate treatment will be started by the doctor.  Antibiotics may be prescribed in presumptive diagnosis of prostatitis because, 25% of men with Hematospermia have prostatitis. 

If no valid cause is found in cases where there are no tumors or abnormalities, we offer no treatment as we believe that the condition will improve on it’s own. In cases, where there is still blood in semen even when no particular cause is identified, you will have to follow-up with the doctor for further checkups and tests.


    • Dear Ponnusamy, if you have tumors but not paining, they should be in the begining stage.
      You need to get checked and tested to make sure they are not cancerous and get appropriate treatment.
      The sooner, the simpler and easier for you.

      Thank you,
      Dr. Karthik Gunasekaran, Sexologist

  1. Hi sir
    I was camed our hospital 10 days before for STI check up .all result was neagtive.but i had a problem of my meatus is like fish mouth.when i was masterbate or sex with partner..this is any serious sir .please advice me

Leave a Reply

Your email address will not be published. Required fields are marked *

Post comment