When the semen discharged appears pink or red upon visual inspection, it is termed hematospermia or seminal hematuria. “Treatise on the Origins and Manifestations of Various wellness · Candidate for Hematospermia Due to Consumptive wellness” states: “This is caused by overstrain injuring the Kidneys. The Kidneys store essence, and essence is formed from blood. Consumptive wellness leads to the seven injuries and six extremes, with both qi and blood being impaired. The Kidneys are particularly deficient and unable to store essence, hence both essence and blood are discharged.” This indicates that the occurrence of hematospermia is attributed to Kidney deficiency. However, the onset of this condition is not limited to Kidney deficiency; in general, both downward flow of damp-heat and excessive heat in the seminal chamber can also cause hematospermia.
Hematospermia should be differentiated from bloody strangury and hematuria: Hematospermia refers to the presence of blood in semen during ejaculation, which appears pink or red, or may only contain blood streaks, often accompanied by painful ejaculation; bloody strangury is characterized by hematuria accompanied by signs of imbalance of dribbling and painful urination; hematuria, on the other hand, does not present with painful signs of imbalance.
I. Causes of Hematospermia
The most common cause of hemospermia is seminal vesiculitis. The seminal vesicles have two functions: one is to store sperm, and the other is to secrete fluid that is part of the semen composition. If the seminal vesicles become inflamed, swelling, congestion, and bleeding of the seminal vesicles can occur, leading to hemospermia. In addition, prostatitis can also cause hemospermia.
In traditional Chinese medicine, there are three causes of hemospermia:
1. Heat injuring the blood collaterals: A person with a congenital Yin Deficiency, or engaging in excessive sexual activity leading to Kidney essence deficiency, or suffering from yin injury due to pathogenic heat, or overconsuming warm and drying yang-boosting substances resulting in yin injury, allows heat to invade the essence chamber, scorching the blood collaterals and causing hemospermia.
2. Failure of containment and consolidation: Overexertion leads to damage of the Spleen qi; insufficient nourishment results in deficiency of both qi and blood, causing a failure of regulation and control. The Kidney is responsible for containment, and if Kidney qi is not firm, semen will not be properly stored. When qi fails to control blood, both semen and blood are discharged, leading to hemospermia.
3. Damp-heat injuring the essence chamber: Excessive consumption of alcohol or spicy, fatty, and sweet foods damages the Spleen and stomach, leading to abnormal transportation and transformation, and the generation of damp-heat; damp-heat in the Liver and gallbladder flows downward to the lower jiao, where heat stagnates, injures the blood vessels, and damages the blood vessels of the essence chamber, resulting in hematospermia.
II. Syndrome Differentiation and Dietary Therapy
1.Yin Deficiency with collateral injury
It is often caused by excessive sexual activity and unrestrained lust, which depletes Kidney yin; or by the late stage of warm-heat wellness, or overconsumption of warm and dry substances, leading to Kidney Yin Deficiency. Kidney yin is the foundation of the body’s yin fluid. When yin fluid is deficient, yang becomes hyperactive, and hyperactive yang leads to excessive fire. Fire is urgent in nature, causing blood to flow irregularly and damaging the blood vessels, resulting in injury to the collateral vessels of the seminal chamber and blood in the semen, as well as painful ejaculation. It is also accompanied by signs of imbalance such as a sensation of fullness and discomfort in the genital area, restlessness and insomnia, dry mouth and throat, a thin white tongue coating, and a wiry and rapid pulse. The supports should focus on nourishing yin, clearing heat, cooling blood, and stopping bleeding. Jinzhen Qincai Decoction can be taken.
Formula and Preparation Method: 120 grams of Hemerocallis citrina (daylily), 100 grams of fresh Apium graveolens (celery), 15 grams of Chrysanthemum morifolium (chrysanthemum), 30 grams of Nelumbo nucifera rhizome nodules (lotus root nodes), and an appropriate amount of brown sugar. Place all the above ingredients into a pot, decoct with water to obtain the juice, add brown sugar, and take it immediately in one dose.
In the formula, daylily and celery can clear heat and calm the Liver, suppress the fire caused by excessive yang; lotus root nodes clear heat, generate body fluids, cool blood, and stop bleeding; chrysanthemum clears heat and detoxifies. The entire formula works together to nourish yin, clear heat, cool blood, and stop bleeding.
One can also take Jima Decoction. Formula and preparation method: 100 grams each of shepherd’s purse and purslane, decocted in water to make a soup. Seasonings such as salt, vinegar, and sesame oil can be added. Drink the soup and eat the vegetables.
In the formula, shepherd’s purse can pacify the Liver, clear heat, cool blood, and stop bleeding; purslane can both clear heat and detoxify, as well as cool blood and stop bleeding. The combination of these two herbs can enhance the effects of nourishing yin, clearing heat, cooling blood, and stopping bleeding. Vinegar has an astringent property and helps stop bleeding.
2.Qi fails to control blood; Kidney qi is not astringed.
It is often caused by chronic wellness, fatigue, and other factors leading to qi deficiency, which fails to govern the circulation of blood, causing it to overflow outside the vessels; or by aging leading to Kidney qi weakness, or by Kidney qi insufficiency in the young, impairing the Kidney’s ability to contain and store, resulting in the simultaneous loss of essence and blood. signs of imbalance include reddish semen, dizziness, blurred vision, and fatigue.
Fatigue, insomnia with frequent dreaming, lumbar pain, decreased libido, white tongue coating, and thin and feeble pulse. The supports principle is to replenish qi and nourish blood, fortify the Kidneys and strengthen the Spleen. One can take Lycium barbarum and mutton soup with Astragalus membranaceus.
Formula and Preparation Method: 30 grams of Lycii Fructus (Gou Qi Zi), 30 grams of Astragali Radix (Huang Qi), 250 grams of mutton, 2 pairs of lamb Kidneys. Add five-flavor seasonings and boil together until the mutton is thoroughly cooked. Then add salt and other seasonings. Drink the soup and eat the mutton and lamb Kidneys. It can be consumed at will.
In the formula, Lycii Fructus (Gou Qi Zi) nourishes essence and replenishes blood, serving as a key herb for tonifying the Kidneys; Astragali Radix (Huang Qi) replenishes qi and stabilizes the exterior, powerfully invigorating primordial yang and meeting the needs for strengthening the Spleen; when combined with Mutton and Ovis aries Kidney, they can strengthen the Spleen and tonify the Kidneys, warm the middle-jiao and warm the Kidneys, thus achieving rapid effects.
One can also consume Gui Di Mutton Soup. Recipe and preparation method: Wrap 10 grams of Dang Gui (Angelicae Sinensis Radix), and 15 grams each of Sheng Di (Rehmanniae Radix) and Pao Jiang (Zingiberis Rhizoma Praeparatum) in a cloth bag, and cut 500 grams of mutton into small pieces. Put them all into a pot and cook until the meat is tender, then remove the herb bag and add an appropriate amount of salt. It can be consumed at will.
This formula is the Gui Di Yang Rou Tang from Qian Jin Yao Fang. In the formula, Rehmanniae Radix (Sheng Di) nourishes the Kidney and Heart; Angelicae Sinensis Radix (Dang Gui) replenishes blood, promotes blood circulation, and helps with occasional pain; mutton strengthens the Spleen and Kidney, and warms the middle-jiao and Kidneys; added with prepared ginger to warm the meridians and check bleeding. The entire formula works together to replenish qi, strengthen the Kidney and waist, and stop excessive bleeding.
In addition, one can choose to alternately take diet therapy prescriptions that warm the Kidney and strengthen yang and those that nourish qi and blood.
3.Damp-heat in the lower jiao injuring the essence chamber
Damp-heat mostly originates externally but can also be generated internally. Overconsumption of rich, sweet, alcoholic, and hot foods can produce damp-heat, which descends to the seminal chamber; or damp-heat in the Liver and gallbladder descends, causing heat stagnation in the lower energizer. Both conditions can damage the blood vessels, force blood to flow irregularly, and result in blood accompanying semen, leading to hemospermia. This is often accompanied by irritability, dizziness, red face and eyes, bitter taste in the mouth, dry throat, chest oppression, constipation, yellow urine, swelling and pain in the testicles and perineum, a yellow and greasy tongue coating, and a slippery and rapid pulse. supports should focus on clearing damp-heat from the lower energizer and cooling blood to stop bleeding; Cheqianye Porridge can be consumed.
Formula and Preparation Method: Fresh Plantaginis Herba leaves 500 grams, fresh Cirsii Herba-Segeti 500 grams, a bunch of scallion whites, 100 grams of japonica rice, an appropriate amount of fermented soybean, and a little refined salt. First, chop the Plantaginis Herba leaves and scallion whites, decoct them in water to obtain the juice and remove the dregs. Then, add the japonica rice to cook into porridge. When it is almost cooked, add a little refined salt and take it on an empty stomach.
In the formula, Plantain Leaf (Plantaginis Folium) and Lesser Cephalanoplos Herb (Cirsii Herba) can clear heat, eliminate dampness, cool blood to stop bleeding, and detoxify; Fermented Soybean (Sojae Praeparatum Semen) disperses heat and helps with occasional restlessness; Japonica Rice (Oryzae Sativa Semen) harmonizes the stomach. After taking the formula and the semen examination returns to normal, one should still consume dietary therapy formulas that nourish the Liver and Kidney to consolidate the therapeutic effect.
One can also take Grape Decoction. Formula and preparation method: Extract 100 milliliters of juice each from fresh grapes and fresh lotus roots by pounding, and extract 50 milliliters of juice from fresh rehmannia by squeezing. Put them all into a pot, bring to a boil, add an appropriate amount of honey, and take it by mixing with the decoction.
In the formula, the combination of grapes and Rehmanniae Radix (Sheng Di) can clear heat, generate body fluids, promote diuresis, and helps with occasional stranguria; fresh lotus root cools blood and stops bleeding; honey is added to moisten dryness and helps with occasional pain. Therefore, taking it is effective.
Interesting read! I’ve always been curious about how TCM links physical symptoms to organ imbalances. The kidney connection makes sense—overwork really does take a toll. Anyone tried specific dietary changes for this? Would love to hear real experiences.
Interesting read! I’ve heard about TCM approaches for reproductive health, but never specifically for hematospermia. The link to kidney essence makes sense. Are there any simple dietary changes you’d recommend for mild cases? Would love to see recipe examples.
Sehr interessant! Ich wusste gar nicht, dass TCM bei Hämatospermie so spezifische Empfehlungen hat. Die Nieren scheinen eine zentrale Rolle zu spielen – klingt nach einem tiefen Verständnis für Körperzusammenhänge. Danke für den Einblick!
Interesting read! I’ve always been curious about how TCM views things like hematospermia. The link to kidney essence makes sense from that perspective. Are there specific foods you’d recommend to tonify the kidneys for this? I’d love to try incorporating some into my diet.