A: Ejaculating blood-tinged semen is simply the body’s way of saying something is wrong.

Called hematospermia, haematospermia, hemospermia and haemospermia in the medical community and tomatospermia by internet slang-lovers, the presence of blood in semen can indicate many different ailments. So, how can you narrow down the root cause of this red menace?

Be a Blood Sleuth

First of all, if you had unprotected sex (without the barrier of a condom) be sure that your partner isn’t menstruating or bleeding from microtears caused by rough penetration of their mouth or anus. Without the use of a male or female condom, it can be very difficult to discern where the blood originated from, especially in the dark.

If you played it smart and used a condom, which is always the safest way to go, it will be much easier to determine where the blood came from, as it will either be on the inside or the outside of the condom. If the blood is strictly on the outside of the condom, be happy that you kept one another safe from sharing bodily fluids, and kindly let your partner know that they are bleeding. Be extra careful while removing the condom, and avoid direct contact with any open wounds on your hand while throwing it away.

If the blood occurs only on the inside of the condom, you can be certain that it originated from within your own body. This will inevitably lead to distress and panic, and there may be a temptation to assume the worst, like you have advanced prostate cancer. As difficult as it may be, try to relax and realize you do not know the cause. Then, make an appointment with a Urologist or your Primary Care Physician for examination and testing.

Reasons For Bloody Semen

There are a slew of things that can cause bloody ejaculate, but the most common ones stem from infections. Be sure to note any additional symptoms like fever, chills, pain or testicular swelling and report them to your doctor. As always, this list is a cursory glimpse into the probable causes of this somewhat shocking symptom, and is not intended to be used as a professional diagnosis.

Most Likely Causes: Infections

• Urinary Tract Infection

Wear condoms during anal sex, stay hydrated and urinate both right before and right after sex, guys. Blood in the semen can be a sign of a serious urinary tract or bladder infection. Antibiotics are required to kill bacteria causing the UTI, so make sure you see a doctor immediately.

• STDs/STIs

The most common reason men under the age of 40 would ejaculate bloody semen is due to an untreated STD/STI. Chlamydia, HIV, trich and cytomegalovirus can all cause this stressful and embarrassing symptom. The good news is, all FDA approved condoms (except for Trojan NaturaLambs) prevent the transmission of these STDs, so get yourself and your partner tested and treated use protection from here on out and you’re cum will be in the clear.

• Prostate Infection/ Prostatitis

Again, an infection in the reproductive system, like in the male G-Spot a.k.a. the male prostate gland, can cause blood to mixed with your semen. Called prostatitis, this infection requires antibiotics.

• Tuberculosis

If you’ve been exposed to TB at some point in your life, you’re more likely to experience blood in your semen than those who have not. This is because this bacterial infection can remain dormant for years within the body, and in some people, it becomes active again later on-- much like herpes or HPV.

Rare Causes: Other Medical Issues

Again, do not assume you have a life-threatening condition without first verifying your reproductive health with a specialist.

• Kidney Stones/Calculi

Crystallized minerals and acid salts can join forces and create excruciatingly painful stones in the bladder which have to be passed through urination or surgical removal. Similar to kidney stones, but only found in men, calculi are small jagg

ed formations that are passed through the male urethra, causing rips and bleeding.

• Hemorrhoid Injections

Internal hemorrhoids can be treated with an injection made from a solution which will create scar tissue and eliminate the hemorrhoid. However, be aware that this can temporarily cause blood to appear in semen.

• Liver Disease

The liver produces most of the chemicals used by the body for blood clotting functions, so if it’s damaged by chronic drinking or other maladies, liver disease can cause the blood in the semen symptom.

• Hypertension

High blood pressure is no joke. Known as the silent killer, and proven to cause severe heart conditions, seeing blood in your semen could be the only indicator of chronic hypertension.

• Congenital Bleeding Disorder

Bleeding disorders like hemophilia can cause blood in the semen because the blood is unable to clot after any trauma.

• A Growth is Obstructing the Duct

A urogenital obstruction, such a polyp or benign cyst can cause blood to appear in your load. A MRI, x-ray, ultrasound or a scope inspection can determine if there is something is growing where it shouldn’t be.

• Testicular Cancer/Leukemia

Yes, cancer is a possibility as well, but this is the least common contributor to this symptom, so don’t jump to any false conclusions before being checked by an expert.

• Blood Thinning Medications

If you’ve had blood clots or thrombosis before and you’ve been on, or are currently on: Warfarin, Coumadin, Jantoven, Marevan or Uniwarfin, these blood thinning medications all have the same side effect-- the potential to shoot out bloody semen. This is considered normal, but you should still bring it up with your doctor.

• Post-Surgical Bleeding

If you’ve recently had an internal operation or biopsy, like a vasectomy or a prostate biopsy, it’s likely that you will have blood in your semen for up to 4 weeks after this procedure.

Sources: [MedicineNet, Harvard Prostate Knowledge, WebMD, Wikipedia]