[Question #5434] Pink semen after encounter

20 months ago
Doctors - I am in my early 40s and last week I went to get a message here in Germany. At the end, the massage therapist put a condom on my penis, covering it in it's entirety down to the base. After about 3 minutes of oral sex, I was done.  I removed the condom, inspected that it was completely intact and was on my way. Other than that, there was no other sexual contact whatsoever. No kissing or licking, and I wasn't anywhere close to vaginal or rectal penetration. Since this isn't normal for me, I left there feeling a little concerned at the activity and noticed some tightness in my testicles (which I think continues to persist a few days later). In order to check myself out the following day, I inspected my equipment (no discharges, etc). To make sure everything was working OK, I masturbated and noticed that the semen was pink, against a white tissue.  Not bright red, but I could distinctly tell that there was a certain amount of blood in the semen and it looked very different from what I have always seen in the past. 

As a married man who didn't expect to get himself in this situation, it's clear that I have a high degree of anxiety from the event. Part of me feels like the fluid around my testicles has a more thicker consistency than normal. However, I often don't examine myself like that so maybe this is how I normally am. Do any STDs present with blood in semen? And would blood in semen from an infection happen so quickly (the following day)? Although as men we don't always inspect our semen, this is first time I've ever seen this and it's really the only objective symptom (or rather difference) I've noticed since the event.

I tried to make an appointment with my urologist, but they can't get me in for two weeks. Should I be concerned about an STD? Based on what you've heard can I resume unprotected sex with my wife?
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
20 months ago
Welcome to the forum. Thanks for your question.

You needn't worry about any STD or any other health effect from your masage and oral sex. First, even without a condom, oral sex is pretty safe, with low risk of any and all STDs and virtually zero risk for some. Second, with a condom there is simply no chance of STD transmission.

But perhaps most important, blood in semen is a fairly common problem and rarely if ever due to STD. Most episodes occur just once or twice, then the semen gradually returns to normal appearance. It can fake a few ejaculations, however, for all blood color (overtly bloody, pink, brown) to fade. Some cases result from trauma to the perineum (the area between anus and scrotum), due to pretty obvious causes:  this is a common problem in bycylists, motorcyclists (perhaps especially after rough rides), horseback riding, etc. (I speak not only as a seuxal health physician, but from personal experience!) 

What do do now? Don't cancel your appointment with the urologist, at least not yet. If you're still seeing obvious blood as the appointment approaches, go ahead with it. But if the color fades as I have predicted, I see no need -- especially if you in fact have an obvious cause of the sort I have mentioned. In any case, you don't need STD testing or further evaluation on account of this, assuming a) no other potential exposures (e.g. you are confident in your wife's sexual fidelity), and b) no additional sympotms appear (knowing if they do that they cannot be from the massage experience). If I were you, I would tell my wife of the symptom -- especially if she questions why you might not be having sex with her. But I would also continue sex with her anyway. This has absolutely nothing to do with your oral sex event in the massage parlor.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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20 months ago
Thanks Doctor. I ran a test and you were right on. Pink is almost gone!