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I have been experiencing pain when urinating and ejaculating. Noticed

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Posted on Thu, 14 Mar 2019
Question: I have been experiencing pain when urinating and ejaculating. Noticed blood in my semen. Also itching that feels like it is coming from inside my penis. Tip of penis seems redder than normal. Maybe some clear discharge.
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Answered by Dr. Aaron Branch (49 minutes later)
Brief Answer:
Urethritis

Detailed Answer:
Hello and welcome to Ask A Doctor service.

I have reviewed your query and here is my advice.

The symptoms you are describing would most likely be due to urethritis, which is inflammation of the passage from your bladder to the head of your penis. A prostatitis is also possible, and is sometimes associated with blood in the semen, but given your symptoms of feeling itchiness from inside the penis along with possibly a clear discharge, I would be most suspicious of a urethritis at this time.

If you are sexually active, the most common causes of this would be gonorrhea or chlamydia, and then after that are less common causes such as mycoplasma genitalium. I would recommend that you get tested for these so that you can hopefully get started on treatment as soon as possible.

I hope that helps, please let me know if you have any questions about any of that and I would be glad to discuss it with you further.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Follow up: Dr. Aaron Branch (10 minutes later)
I have not been sexually active. Should Amoxicillin work? What about Cephalexin?
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Answered by Dr. Aaron Branch (3 hours later)
Brief Answer:
See below

Detailed Answer:
Urethritis that is not sexually transmitted would be a little more unusual, so I would say that it would be important to get tested to make sure what the cause is. You probably should be evaluated for prostatitis as well with the blood in your semen. That being said, the most common organisms aside from sexually transmitted ones would include E. coli and other bacteria that commonly cause urinary tract infections, and these are normally treated with something like Bactrim or Ciprofloxacin. Amoxicillin and Cephalexin would not be ideal in this situation.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Aaron Branch (18 hours later)
What about Doxycycline?
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Answered by Dr. Aaron Branch (3 hours later)
Brief Answer:
Maybe

Detailed Answer:
There are reports of doxycycline successfully treating a UTI but it is not usually used for that and typically they only used it if the urine culture showed that the bacteria was able to be treated with doxycycline, so I guess all I can say is that it might work, but I couldn't guarantee it since we don't have much experience treating UTIs with doxycycline. The best thing would be for you to get a urine culture so that you know what you are treating; especially as a male it is abnormal to get a urinary tract infection so I would want to know what the cause was.
Above answer was peer-reviewed by : Dr. Nagamani Ng
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Dr. Aaron Branch

General & Family Physician

Practicing since :2011

Answered : 917 Questions

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I have been experiencing pain when urinating and ejaculating. Noticed

Brief Answer: Urethritis Detailed Answer: Hello and welcome to Ask A Doctor service. I have reviewed your query and here is my advice. The symptoms you are describing would most likely be due to urethritis, which is inflammation of the passage from your bladder to the head of your penis. A prostatitis is also possible, and is sometimes associated with blood in the semen, but given your symptoms of feeling itchiness from inside the penis along with possibly a clear discharge, I would be most suspicious of a urethritis at this time. If you are sexually active, the most common causes of this would be gonorrhea or chlamydia, and then after that are less common causes such as mycoplasma genitalium. I would recommend that you get tested for these so that you can hopefully get started on treatment as soon as possible. I hope that helps, please let me know if you have any questions about any of that and I would be glad to discuss it with you further.