Unexpected Hematuria in Semen
I am a 22-year-old man, standing at 5’11” and weighing 195 pounds. I maintain a clean lifestyle, avoiding alcohol, smoking, or illicit drugs. My medical background includes a diagnosis of papillary thyroid cancer, for which I underwent a partial thyroidectomy in March 2024. After a follow-up, my endocrinologist concluded that I do not require levothyroxine. I have no family history of this condition. Currently, I am taking Nexium to manage silent reflux, which I began in January, and Descovy for PrEP since June. Previously, I used Truvada for several months, but after my alkaline phosphatase (ALP) levels rose to the high-normal range, I stopped taking it for a period. My doctor later recommended switching to Descovy, and my ALP levels have stabilized since then. Two days ago, I noticed blood mixed in with my semen. It wasn't a significant amount, as it appeared more like a subtle discoloration rather than noticeable streaks. Interestingly, there was no blood present during my morning masturbation session, but it appeared in the evening. I have since engaged in three more sessions without any further blood present. There has been no pain during ejaculation or urination, and no additional symptoms have developed. I consulted with my primary care physician, who conducted a physical examination of my testicles. She found nothing alarming but recommended a testicular ultrasound due to my history of varicose veins and a previous bump near the junction of the scrotum and skin that a urologist had diagnosed as an inclusion cyst. Given my frequent shaving in that area, I hadn't been particularly anxious about it. An ultrasound and consultation with a urologist are scheduled for next week, but I am experiencing significant health-related anxiety, which is exacerbating my worries. I would appreciate insight into what typical evaluations look like for someone my age and advice on the potential causes of these symptoms. My concern often leans towards worst-case scenarios, especially considering my medical history with thyroid cancer. Any guidance would be immensely helpful. Thank you.
Answers (1)
6/21/2025, 9:40:50 PM
OpenHealth AI
It's understandable to feel anxious about noticing blood in your semen, especially given your medical history. While this can certainly be a concerning symptom, it’s important to remember that there are many potential causes, many of which are benign.
Key Points
- Blood in semen, or hematospermia, can have various causes, some of which are not serious.
- Regular evaluations and testing you are undergoing are essential for accurate diagnosis.
- There are steps you can take to manage new symptoms and your anxiety.
Explanation
Hematomaspermia can occur for several reasons, including:
- Infection or Inflammation: Conditions like prostatitis or seminal vesiculitis can cause bleeding.
- Trauma: Any injury to the genital area or even rigorous sexual activity can lead to bleeding.
- Vascular Issues: Varicose veins or other vascular conditions might contribute.
- Cysts or Other Growths: As noted in your history, cysts may also play a role.
- Benign Prostatic Hyperplasia (BPH): Though less common at your age, it’s still a possibility.
Your upcoming ultrasound and urologist consultation will help clarify the situation. Typically, doctors will:
- Conduct a physical examination.
- Order imaging studies, like an ultrasound, to look for abnormalities.
- Possibly perform additional blood tests or cultures to check for infections.
Next Steps
-
Stay Calm and Observe: Continue to monitor for any additional symptoms such as pain during urination or ejaculation, fever, or changes in urinary patterns.
-
Prepare for Your Appointment: Note any other symptoms you might have experienced, no matter how minor, and bring them up with your healthcare provider. Be ready to discuss your medical history thoroughly.
-
Manage Anxiety: Find ways to cope with your health-related anxiety, such as:
- Practice relaxation techniques (deep breathing, meditation).
- Engage in activities you enjoy to distract yourself from worrying.
- Reach out to friends or support groups for emotional support.
-
Follow Doctor’s Advice: Don’t hesitate to ask your doctor for guidance or clarification on the tests and next steps. Understanding what’s happening may alleviate some of the stress and anxiety.
It’s great that you’re taking proactive steps and seeking evaluation. Try to maintain open communication with your healthcare provider, and let them know how you’re feeling. Keep in mind that many causes of hematospermia are manageable, and timely responses are important for your health and peace of mind.
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