Why is my semen volume suddenly reduced and still bloody?

A sudden decrease in semen with blood in it may be related to seminal vesiculitis, prostatitis, urethral injury, varicocele, urinary system tumors and other factors. It usually presents with symptoms such as pain during ejaculation, perineal swelling and pain, frequent urination and urgency. It is recommended to seek medical examination promptly and follow the doctor's instructions for treatment after the cause is determined.

1. Seminal vesiculitis

Seminal vesiculitis is mostly caused by bacterial infection, which may cause congestion and edema of the seminal vesicle mucosa, reducing the amount of semen and mixing it with the blood. Patients often experience symptoms such as dull pain in the lower abdomen after ejaculation and dark red semen. You can use cefixime dispersible tablets, levofloxacin tablets and other antibiotics as directed by your doctor, and use warm water sitz baths to relieve symptoms. Sexual intercourse should be avoided during the acute phase and the perineum should be kept clean and dry.

2. Prostatitis

Prostatic inflammation may compress the ejaculatory ducts, resulting in reduced semen discharge, while prostate congestion may cause blood to mix into semen. Patients may experience symptoms such as urinary bifurcation and increased nocturia. Tamsulosin hydrochloride sustained-release capsules can be used to improve urination, and Qianlieshutong capsules can be used to reduce inflammation. Predisposing factors such as prolonged sitting and drinking should be avoided in daily life.

3. Urethral injury

Mechanical damage to the urethral mucosa, such as urinary catheterization, stone friction, etc., may cause bleeding, and blood will be discharged with semen. It is usually accompanied by a tingling sensation during urination, and the bleeding is mostly bright red. For mild injuries, you can flush the urethra by drinking more water. In severe cases, tranexamic acid tablets are needed to stop bleeding, and urethroscopy is performed if necessary.

4. Varicocele

Obstruction of spermatic vein return may cause local congestion in the testicles, affecting semen production. In severe cases, blood vessel rupture may cause hematospermia. Patients often experience scrotal swelling, which worsens after standing for a long time. After diagnosis, Maizhiling tablets can be used to improve circulation. Severe varicose veins require high ligation of the spermatic vein.

5. Urinary system tumors

Prostate cancer, seminal vesicle tumors, etc. may erode blood vessels and cause hematospermia. At the same time, tumor compression can gradually reduce the amount of semen. It is often accompanied by systemic symptoms such as weight loss and bone pain. A clear diagnosis needs to be made through PSA testing, MRI, etc., and radical surgery or endocrine therapy can be selected according to the stage.

When symptoms of hematospermia occur, strenuous exercise and sexual life should be avoided, and drinking water should be maintained at more than 2000 ml per day to promote metabolism. Eat a light diet, eat more zinc-rich foods such as tomatoes and pumpkin seeds, and avoid spicy food. It is recommended to record the frequency of symptoms and accompanying manifestations, and bring routine semen and urine examination reports with you for the doctor's reference. If hematospermia persists for more than two weeks or is accompanied by fever or weight loss, immediate review is required.