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Urology/yellow seman


I am 62 years old and diabetic for 35 years. Some years ago I noticed my semen changed color and become reddish- brownish. I use to take aspirin and simenstatin and liseniprol (sorry for spelling), and I also noticed    during ejaculation, a burning and sensational in my rectum. I got worried and I once read liseniprol leaflet which indicate that in (symptoms)if sees blood in semen and urine, stop it. I also noticed that i could not climb stairs and terrible muscle spasm/cramps, somehow i stooped taking these tablets. After 3/4 months not taking these tablets, i noticed that the blood stops in my semen, but now it is yellowish in color, I can climb stairs, no burning sensations during ejaculation and no cramp in muscles. Please advise.

Asad, I did a medical research and found no documented cases of Lisinopril causing blood in the semen.  There was one medical report on Simvastin and blood in the semen.  However, they survey included over 77,000 men and only one had this condition.  It is concluded, therefore, that the blood was unrelated to the medication.

I suspect that you had an episode of prostatitis (inflammation of the prostate gland) causing the burning with ejaculation, burning in the rectum, blood in the semen and perhaps even the muscle spasms.  This would be unrelated to the medication. It apparently cleared on its own.  

Blood in the semen usually comes from the prostate gland. It is generally due to a tear in one of the fragile veins of the prostate gland or an inflammation of the prostate (prostatitis).   Bleeding may occur during sexual excitation, ejaculation, from straining with bowel movements, or during urination.  The prostate is the organ that produces the majority of the seminal fluid in response to sexual stimulation. When the prostate contracts at the time of ejaculation, a vein may tear and blood mixes with the semen (hematospermia).  Red blood indicates new and dark (brownish) discoloration indicates previous bleeding. 

In addition, prostatic bleeding frequently is associated with gross blood during urination.  This typically will occur with initiation or at the end of urination (as opposed to being throughout the entire stream). With the latter, it is often manifest as spots of blood on the underwear, pajamas or bed sheets.  Irritation of the gland (prostatitis) can also cause it to become inflamed and predisposed to bleed.  An inflamed or congested prostate gland, especially one with varices, can start bleeding if ones strains during a bowel movement.  This occurs because hard stool can actually push on the adjacent gland precipitating bleeding or straining in itself may cause the varices to rupture.  Some factors leading to inflammation include too frequent or too infrequent ejaculation, sexual arousal without ejaculation, withdraw at the time of ejaculation, excessive alcohol or spicy foods, prolonged sitting or bike riding, etc. The prostate may then become secondarily infected and require antibiotic therapy for cure. Sometimes as the prostate gradually enlarges with age, friable veins called varices develop on its surface.   These are also prone to tearing.  In such cases, Proscar or Avodart is sometimes prescribed to shrink both the prostate and the veins.  These are not generally recommended in men less than 40-50 years of age.  Although hematospermia is not a typical sign of prostate cancer, its presence may indicate an increased risk of prostate cancer.  Therefore, it is advisable to seek consultation with a urologist to evaluate this condition.

Now for a few comments on the color of one's semen.  During sexual arousal the prostate gland manufactures fluid that accounts for about 2/3 of the volume of ejaculate.  The seminal vesicles are paired structures located behind the prostate gland that also manufacture fluid.  Sperm from the testicles (which account for only 1-2% of the semen) travel up a series of tubes (epididymis and vas deferens) on each side to join the seminal vesicles forming the paired ejaculatory ducts.  These structures empty into the prostatic portion of the urethra.  At the time of ejaculation, fluid is discharged from the prostate gland and ejaculatory ducts into the urethra (urinary canal) forming the semen.  The normal semen volume is in the 2-6 cc range.  In addition to this, with the onset of sexual excitement, specialized glands in the urethra called Cowper glands, produce a clear, somewhat sticky fluid to lubricate the urethra. this is called this pre-ejaculate (precum).  

Normally the semen is somewhat viscous, opalescent and whitish gray in color.  However, depending on many factors including frequency of ejaculation, diet, medications, general health, etc., the volume, consistency and color (yellow, orange, brown) of the semen can vary.  Thickened semen usually occurs if one ejaculates infrequently and is due to concentration of that portion formed in the seminal vesicles.   If portions of the semen are retained in the seminal vesicles, one often will notice coagulated, waxy particulate matter in the semen or urine.  This does not imply disease.  Infrequently, a low testosterone may cause abnormal semen viscosity.  There are normal enzymes in the semen that cause it to liquefy in about 20 minutes. This process is necessary so as to allow the sperm to move more freely through the fluid.  A persistently increased viscosity that does not liquefy may cause fertility problems.  Fertility specialist have various treatment options for this unusual condition.  

Likewise, occasional clear semen is not a specific sign of disease.  A brown or red tint to the semen is a sign of bleeding, usually from the prostate gland.  Although prostate bleeding is generally  of a benign nature, it is best to have this evaluated by a urologist.  Good luck.


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Arthur Goldstein, M.D.


Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.


I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

American Medical Association, American Urological Association, American College of Surgeons

College degree - BS Medical degree - MD Master of Science - MS

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