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Concerned about blood in semen - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Men Sexual Problems
Answered by

General & Family Physician
Practicing since : 2004
Answered : 37 Questions
User :   I noticed blood in my semen around 1.5 months back. Went to urologist. He conducted urine routine test and that came out fine. He asked me to wait for 1 week or so and gave anti inflammatory drug. Then I came to US from India. I tried to masterbate 2-3 times in 3 weeks and usually it came out brown colored and somewhat dark. I consulted a doctor here and he asked me to wait for 2-3 weeks to give time to heal. And as I have never been sexually active, he said there are no chances of STD or so. After waiting fr 2 weeks(where i had 2 nightfalls which were whitish and brownish in color), i tried to masterbate today and it came blood red like fresh new blood. And all the rest of semen was blood red. Now what should I do? Should I go to ER?
Doctor :   Hi
Doctor :   Let me read the query.
User :   I have an appointment scheduled for 24th Dec with an internal medicine doctor
Doctor :   Did you sustain an injury?
Doctor :   May I know your age?
User :   I dont think so..
User :   my age is 25
Doctor :   Do you have any problem while passing urine?
User :   I went for climbing today..
User :   nope
Doctor :   Is the urine normal incolour?
User :   well hav tried to urinate once after that.. and it was normal in color
User :   this happened just 30 mins before
User :   hav drank a lot of water.. within next 30 mins or so i shud get a burst of urine and shud say conclusively
Doctor :   Ok
Doctor :   Let me brief you.
User :   in last 2 mnths as well.. urine was normal in color.. I drink around 3L+ water daily.. so urinate quie a lot.
User :   for my history.. i have single kidney found out 8 months ago.. which is normal as i had mri, kft and other blood tests
User :   and all were fine
User :   i am hypertensive when i am anxious.. otherwise bp remains around 120-130/75-80
Doctor :   Do you smoke or consume alcohol or use illicit drugs?
User :   nope..
User :   i dont drink.. dont smoke..
Doctor :   Ok
User :   took mebendazole tablets for last 3 days.. for stomach parasites..
User :   and am vegetarian as well
Doctor :   Let me brief you.
User :   yeah.. please
Doctor :   Presence of blood in the semen can occur from a prostrate pathology.
User :   hmm
Doctor :   It's difficult to predict what kind of prostrate problem is the cause, without a perrectal examination and tests.
User :   hmm
Doctor :   One episode of blood in the semen(without trauma, and urine clear) is not an indication that you need to visit an ER.
User :   as i told u it started 1.5 months back
User :   today its blood red..
Doctor :   however, if you develop bloody urine, or frank blood coming out from the urethra, you need to visit the ER immediately.
User :   i did climbing today here.. they had some artifical mountain structures and asked us to wear belts bt that shudnt be the cause of this..
Doctor :   Continue drinking plenty of water.
User :   hmm
Doctor :   In the mean time, get an appointment from an urologist, who will perform a per rectal examination and the tests to assess the prostrate.
Doctor :   At this point of time, I would like to point you out that
User :   just urinated and it was fine.. clear color..
User :   hmm?
Doctor :   most often the cause for the bloody semen is prostratits, which is a self limiting condition.
Doctor :   Hence you need not worry much about it.
Doctor :   Watch your urine out.
User :   yeah.. just did that and it was of clear color..
Doctor :   If its clear, then consult an urologist for the examination and the test.
Doctor :   Have you followed what I have suggested?
User :   it all started suddenly 1.5 mnths back
User :   yeah..
User :   will take appointment with urologist
User :   and consult him and he probably will do whatever is necessary
User :   so no need to go for urgent care or ER as of now?
User :   i have PPO plan so will do that first thng tomorrow to take appointment for urologist
Doctor :   If there are no further episodes, and you don't have pain or injury/ and your urine is fine, then you can wait till you consult the urologist.
User :   i wont masterbate again now until i meet doctor
User :   so thats fine..
User :   in last 7 weeks i tried 4 times and it was always whitish or brownish and today is was blood red
User :   btw.. one more question
Doctor :   Yes proceed.
User :   i had stopped masterbating as of now.. bt if it continues to bleed.. i mean as if its bleeding right now as well.. will it spill over or what will happen?
User :   i have heard that semen gets collected somewhere below prostate and it gets ejaculated during sexual activity.. if that container gets full of blood because of continuos bleeding sort of thing
Doctor :   If there was no trauma, then the likely chances of you bleeding again without masturbation is unlikely.
User :   and if it is?
User :   how will i know that there is trauma?
User :   or something for which i need to go to urgent care? because if i dont masterbate i wont know anythng whats happening inside..
Doctor :   Absence of injury rules out trauma.
Doctor :   Absence of blood in the urine rules out bladder/kidney problems which may need immediate attention.
User :   so for any other kind of issue ER is not required ?
User :   btw if it continues to bleed.. then it may spill over and as it lies in urine pathway urine may get bloody right?
User :   so that way i will come to know to go ER or not right?
Doctor :   If your symptoms are stable, and you don't have any further episodes, then you can directly consult an ER.
Doctor :   You can visit the ER If there are further episodes, abdominal discomfort or have problems passing urine.
User :   further episodes wont happen without masterbation right?
User :   and wont know of any symptoms too right as i m nt doing any related activity
Doctor :   Yes.
Doctor :   i don't expect that to happen.
User :   hmm
User :   by discomfort u meant pain right?
Doctor :   However, if you have discomfort or bloody urine or frank blood from the urethra, then visit the ER for evaluation.
Doctor :   Yes,
User :   one more thng..
User :   btw if it continues to bleed.. then it may spill over and as it lies in urine pathway urine may get bloody right?
User :   that will happen right in that case?
User :   i am a hypocondriac.. thats why asking so many q sorry for that
Doctor :   Yes.
Doctor :   I can understand taht.
User :   i m nt feeling any pain.. bt somethng strange in one testicle.. bt may be coz i m sitting on the floor :| i need to comeover my anxieties.. :|
Doctor :   As mentioned earlier, its probably the prostratitis, which usually is a self limiting illness.
Doctor :   You can visit the ER directly now, if getting an appointment from an Urologist is going to be late.
User :   hmm
User :   it may take 3-4 days i guess.. but i can wait that long right?
Doctor :   Yes.
User :   sorry.. package expired
Doctor :   Have you followed what I have suggested?
User :   went to urinate again.. and it was fine as well..
User :   yeah..
User :   consult urologist
User :   and go to internam med doc as well as its already scheduled
User :   both combined will surely be able to take care of issue
User :   continue drinking water
User :   in case i feel pain or bloody urine.. i shud go to ER
User :   unless i can wait till consultation
Doctor :   Yes, you go my point now.
User :   i meant "otherwise i can wait till consultation"
User :   yeah got it..
Doctor :   Yes, you should be doing fine.
Doctor :   Do you have any other query?
User :   yeah..
User :   as i have told u that i have single kidney
User :   what precautions shud i be taking for that
User :   one doc told me that i shud limit my protein intake..
Doctor :   A single kidney doesn't cause much disadvantage.
User :   and as i am vegetarian.. that shudnt be an issue i guess
Doctor :   It can perform the functions similar to both kidneys.
User :   usual pulses, beans shud be fine i guess
User :   btw.. any limit on exercising because of that.. as i usually jog fr around 30 minutes daily
Doctor :   However since you don't have the second kidney, problems can occur if there are any injurious agents.
User :   injurious agents like?
User :   i mean i dont do any other heavy sort of exercise like wieghts etc
User :   i just jog and walk on the crosser
Doctor :   Injurious agents like certain drugs, infections, diabetes, hypertension and so on.
User :   hmm
Doctor :   Hence you need to take precautions as and when you get infections,
Doctor :   report to all your doctors about your single kidney so that they can avoid giving you injury causing medications,
User :   hmm..
Doctor :   and watch out/monitor regularly for diabetes and hypertension.
Doctor :   That should do.
User :   i checked fr diabetes twice in last one year
User :   fasting was one time 92, and one time 86, one time 98..
User :   pp was 103,97
User :   i mean after food
User :   range is 70-140 fr pp i guess
User :   i have machine for blood pressure measurement
User :   and measure daily..
User :   so when i am anxious it jumps to 135/88 or so.. and when i am really hyper anxious it jumps to 153/98 or so.. bt these event dont happen frequently.. usually its around 116-127/70-80
User :   other than that dont know what i can do about infection unless it presents symptoms..
Doctor :   A single reading as long as its not very high is fine.
User :   hmm
User :   i guess bp jumps that much even while exercising as well
User :   so i assumed its fine to have sometime these kind of readings.. overall average shud be fine
Doctor :   Yes, and that is normal.
User :   i am taking amlodipine 2.5mg/daily...
User :   few times i tried to measure bp after exercising immediately and it was around 138/89 and pulse 120 which i guess shud be normal
User :   first timt it came high it was 145/98 though previous measurements were 124/84 and 120/80
User :   doc put me on telma 40 od and ciplar la 40 bd
User :   my bp then started being low around
User :   i changed doc and new one gave me amlodipine 5mg/daily..
User :   then one time i was anxious it came to 150/90 and he changed it to 5mg BD/daily..
User :   then when i stabilized and found that i can sort of control anxiety i reduced medication.. and now its amlodipine 2.5mg and i usuallly show doc 1 month bp charts
User :   which i measure at home
User :   and doc says its fine..
User :   even when i was taking 10mg/daily.. bp used to shoot when i was anxious and otherwise be normal.. which means like no effect on me..
Doctor :   Ok
User :   so thats why i reduced the dosage
User :   so to get back, i can exercise fr 1 hr or so daily i guess? becoz one doc told me even to limit my exercising
User :   not sure why..
Doctor :   Are you diagnosed as hypertensive?
User :   i mean yeah.. i have told u all about it..
User :   my bp rises when i am anxious otherwise it remains normal
User :   it all started 1 year back..
User :   my first 2 readings were normal 124/84 and 120/80
Doctor :   Anxiety can cause high BP readings.
User :   then i went to a doc and i was kinda anxious it caame 145/98 and my pulse was 106
User :   my pulse usually remaains around lower 60
Doctor :   However, it usually reduces withing few minutes.
User :   and sometimes even 55 0r so
Doctor :   Persistently high BP will need hypertensive medications.,
User :   then i got tested fr various thngs.. ECG, Echo for heart
User :   KFT, lipid profile
User :   Diabetes
User :   Cholestrol
Doctor :   Ok
User :   and all were fine.. i got 3 ecg and one showed probable LVH.. but others were normal and echo was normal so cardiologist said its fine..
User :   i guess my heart rate of 55 or so is coz of jogging and cardio related activity..
User :   shudnt be a cause of concern..
Doctor :   Presence of LVH indicates persisting hypertension and that needs medications.
User :   hmm..
User :   but my eco later was normal
User :   *Echocardiogram
User :   and it was probable LVH.. and as i was anxious at the time of tests.. doc said its fine.. i mean cardiologist
User :   i even showed reports to many doctors after that and no one showed any concern
Doctor :   I would suggest you to consult a cardiologist, who will re assess you,
User :   and i have already told u my usual blood pressure readings..
Doctor :   and if there are signs of hypertension, then you will need medications.
User :   i am already taking medication..
User :   amlodipine 2.5mg
User :   i dint get by signs of medication?
Doctor :   You can continue with the medications as suggested by your doctor,
Doctor :   in the mean time, involve in de stressing measures.
User :   yeah.. usually im fine.. un less these kind of events happen.. like today
Doctor :   I can understand that.
Doctor :   But you need not worry.
Doctor :   Good sleep, regular food, and mild physical exercises can help in reducting anxiety and stress.
User :   right now my bp is 121/86 and pulse 78
User :   and im still somewhat anxious..
User :   usually lower number is
Doctor :   This reading is fine.
User :   when that even happened.. i guess it wud have been around 150/95 coz i felt sudden heart beat and anxiety etc..
Doctor :   Practise deep breathing exercises /counting breathes during time of anxiet.
Doctor :   They will help in controlling the anxiety.
User :   so yeah anxiety raises my bp and i need to do some relaxing exercises
User :   and when i go to doc.. then also i get very anxious. specially when doc measures my bp..
User :   and till i have been to urinate 2-3 times and its fine.. so i guess i will wait, take appointment and tell the urologist about it..
Doctor :   Practise the exercises that I mentioned to you.
User :   yeah..
Doctor :   you will find the difference.
User :   *till now
User :   i meant color is fine..
User :   so yeah.. i dont have any more questions..
User :   and thanks for answering all my questions patiently
Doctor :   Thanks for consulting me.
Doctor :   Bye for now.
Doctor :   Wish you good health and happy new year in advance..
User :   thnks and same to you
User :   one more thing i forgot to ask..
User :   during blood tests i had.. my esnophile came high..
User :   i asked many doctors and no showed any concern.. one gave me mebendazole tablets to eat 6 tablets BD for 3 days every month for 3 months
User :   should i be concerned for that?
User :   one said that when u have cold ur esnophile count goes high as well
Doctor :   Mebendazole are antihelminthic drugs.(deworming drugs)
Doctor :   Worm infestation is one of the cause for high eosinophil.
Doctor :   The medications will help if the cause is an helminthic infection.

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