Blood in the semen, called hematospermia, may be undetectable (microscopic) or visible in the ejaculation fluid.

Associated symptoms may include:

• Pain with urination
• Pain with ejaculation
• Pain with bowel movement
• Tenderness in the scrotum
• Swelling in scrotum
• Swelling or tenderness in groin area
• Lower back pain
• Fever or chills
• Blood in urine

Blood in the semen may be caused by inflammation, infection, blockage, or injury anywhere along the male reproductive tract. It may indicate disease or a problem within the urethra, testicles, epididymis, or prostate.

Blood in the semen is usually the result of inflammation of the seminal vesicles, and will almost always go away on its own. Often, the cause cannot be determined. If the blood does not clear and ejaculate is persistently stained with blood, more tests should be done. These tests may include urinalysis and culture, semen analysis and culture, and ultrasound of the seminal vesicles.