Hematospermia is one of the most common symptoms in the field of male medicine, often seen in sexually active young men or middle-aged men with irregular sexual activity or long-term abstinence. In Chinese medicine, it falls under the category of blood disorders. In the early stages, there are no noticeable symptoms, only a small amount of blood or a rusty color in the semen. If not treated in time, it can lead to congestion and swelling of the seminal vesicles, and in severe cases, infertility due to seminal vesiculitis or abnormal sperm quality. According to Chinese medicine theory, the semen is stored in the seminal chamber, which is governed by the kidneys. Bleeding in the seminal chamber is often due to the invasion of heat, which damages the blood vessels, causing blood to flow along with the semen or stagnant blood to block the blood vessels, preventing blood from returning to the semen. It can also be caused by deficiencies in the spleen and kidneys, which are unable to regulate blood flow, resulting in hematospermia.
According to the ancient Chinese medical book "Zhu Bing Yuan Hou Lun - Xu Lao Xue Jing Chu Hou," it states, "This is due to kidney qi deficiency. The kidneys store essence, and essence is formed from blood. If there is deficiency and exertion, both qi and blood will be depleted, causing kidney deficiency and inability to store essence, leading to the discharge of both essence and blood." In "Jing Yue Quan Shu," it describes, "The blood in the semen must come from the seminal chamber and blood sea. It is often caused by excessive sexual activity, leading to yin deficiency and fire agitation, resulting in erratic blood circulation." Experts point out that hematospermia is often a combination of deficiency and excess. Deficiency syndrome is often due to kidney yin deficiency, excessive fire, downward pressure on the seminal chamber, and damage to blood vessels. Excess syndrome is often due to the invasion of damp heat, blood stasis, blood not returning to the meridians, causing hematospermia. In the later stages of hematospermia, if left untreated for a long time, both semen and blood will be depleted, affecting the spleen and kidneys, which will lead to blood disorders and the inability of the spleen to regulate blood, resulting in the discharge of both semen and blood.
Where does the blood in hematospermia come from?
Hematospermia is generally more common in young adults in the prime of their sexual activity, and in some cases, it can occur intermittently. The blood in hematospermia mainly comes from the seminal vesicles, which are located between the bladder and rectum. Inflammation of the seminal vesicles caused by bacterial infection or excessive sexual activity can lead to the formation of hematospermia, where blood mixes with semen. Hematospermia is both a disease name and a symptom, recognized in both Chinese and Western medicine. Semen is composed of sperm and seminal plasma, with seminal plasma mainly coming from the seminal vesicle gland and prostate gland. 60% comes from the seminal vesicle gland, 30% from the prostate gland, and the remaining 10% from other tissues such as the epididymis, urethral bulb, and ampulla of the vas deferens. Therefore, when the seminal vesicle gland, prostate gland, or other organs involved in the production and transport of semen have pathological changes leading to bleeding, it can easily result in hematospermia. Seminal vesiculitis is the most common cause of hematospermia. Additionally, hematospermia can cause changes in the composition of semen, leading to male infertility. The color of hematospermia can vary depending on the location and timing of the bleeding. Fresh blood in the semen appears bright red or pink, while coffee-colored semen indicates old seminal vesicle bleeding. Semen with blood streaks on the surface may indicate bleeding in the posterior urethra.
Hematospermia is usually classified as functional or organic. Functional hematospermia occurs when there is a long period without sexual activity, and once sexual intercourse occurs, hematospermia can easily happen. However, its duration is short and it is prone to recurrence. The main reason is that during the moment of orgasm, the ejaculatory duct contracts rhythmically, causing spasms and subsequent relaxation of the seminal vesicle gland, resulting in a rapid increase in pressure in the gland and damage to the capillaries on the wall, leading to bleeding and discoloration of the semen. Organic hematospermia is caused by certain diseases, with seminal vesiculitis being the most common. Inflammation of the seminal vesicles caused by invading pathogens leads to congestion and rupture of delicate blood vessels, resulting in hematospermia.
The causes of hematospermia:
1. Inflammation and infection: Inflammation and infection are the most common causes. In most cases, the root cause of hematospermia in young men is inflammation and infection, with seminal vesiculitis and prostatitis being the most common. Most cases are caused by non-specific bacterial infections, but infections caused by gonorrhea, tuberculosis, viruses, chlamydia, and mycoplasma can also lead to hematospermia, although such cases are relatively rare.
2. Obstruction of the reproductive tract and cystic obstruction: Obstruction of the reproductive tract or cysts can cause rupture of blood vessels in the reproductive tract or cyst wall, leading to hematospermia. In clinical practice, hematospermia can occur with ejaculatory duct obstruction or cysts, seminal vesicle duct dilation, seminal vesicle cysts, and small prostatic cysts.
3. Benign tumors and proliferative lesions: Some benign tumors and proliferative lesions, such as prostatic polyps, proliferative urethritis, and ectopic prostatic tissue in the posterior urethral mucosa, can also cause hematospermia.
4. Vascular abnormalities: Abnormalities in the arteries and veins of the prostate and seminal vesicles, as well as venous varices in the posterior urethra and bladder neck, can lead to both hematuria and hematospermia.
5. Poor diet and frequent masturbation: Excessive consumption of spicy food and excessive alcohol consumption, excessive sexual activity, excessive masturbation in young men, and vigorous friction on the penis can cause congestion and edema in the urogenital tract, potentially leading to hematospermia along with urinary tract infections.
6. Malignant tumors: Malignant tumors of the male reproductive system can cause hematospermia, with prostate and seminal vesicle tumors being the most common.
Prevention and treatment of hematospermia:
Hematospermia patients should pay attention to genital hygiene, especially during sexual activity. Regularly clean the external genitalia and maintain cleanliness of the urogenital tract to prevent ascending urinary tract infections. If there are underlying conditions such as prostatitis, balanitis, or urethritis, they should be treated at the source. Especially during the acute phase of hematospermia, sexual intercourse and sexual stimulation can exacerbate congestion and edema of the prostate and seminal vesicles, leading to increased bleeding. Therefore, it is important to avoid sexual stimulation and abstain from sexual activity during the acute phase. For patients with bleeding disorders or abnormal coagulation function, underlying diseases should be resolved in a timely manner. In some cases, it may be necessary to rule out the possibility of malignancy. Targeted treatment should be provided based on the patient's condition by a specialist.
In daily life and work, hematospermia patients should engage in appropriate physical exercise, balance work and rest, avoid prolonged sitting, and avoid horseback riding and cycling. Maintain a moderate frequency of sexual activity, with 2-3 times per week being appropriate. It is important for young men to avoid excessive sexual activity. Additionally, hematospermia patients should pay attention to a light and balanced diet, avoid alcohol consumption, avoid eating lamb and seafood, and avoid spicy foods such as chili peppers, garlic, onions, and ginger. Furthermore, it is important to maintain regular bowel movements to prevent compression of the rectum, which can increase the probability of developing hematospermia.
