DOI: 10.1093/jsxmed/qdae001.071 ISSN: 1743-6095

(075) Treating Idiopathic Hematospermia with Oral Tranexamic Acid

B Le, A Shekar, A Lee, O Raheem
  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health



Hematospermia can be a challenging medical condition to treat for the urologist. While almost universally benign, it causes considerable patient stress and anxiety. There are no standardized treatments and while many cases may resolve on their own the duration can be quite variable. Tranexamic acid (TXA), an antifibrinolytic, has been used to control bleeding in various settings including heavy menstrual bleeding, traumas, and intraoperatively to prevent and control bleeding.


We sought to investigate the safety and efficacy of tranexamic acid, an oral anti-fibrinolytic for the treatment of idiopathic hematospermia.


A cohort of patients presenting to urology clinic within the past year for primary complaint of hematospermia without other clear etiology (trauma, radiation, prior surgery, prostatitis) were prescribed TXA 1300 mg BID for 7 days. Patients were followed as part of routine care and resolution of hematospermia and side effects were observed and documented.


Eight patients (median age 42.1 years) met criteria and were treated with the TXA protocol for idiopathic hematospermia. All had immediate resolution at completion of the 7-day course. Two patients had a recurrent episode within follow-up period (Median follow-up of 5.4 months) which resolved with a second treatment course. No adverse events were noted, and all patients were able to tolerate TXA treatment.


TXA appears to be a safe and efficacious treatment for idiopathic hematospermia where often the main goal is to rule out other etiologies and expeditious resolution to relieve patients’ stress and anxiety.



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