Blood in Ejaculate (Hemospermia): Symptoms, Complaints, Signs The following symptoms and complaints may indicate hemospermia: Leading symptom Hemospermia (blood in the ejaculate; blood in the semen). Warning signs (red flags) Anamnestic information: Men > 40 + recurrent (repeated) occurrence of hemospermia → think of: malignant neoplasms (prostate, seminal vesicles, etc.). Pain during defecation (bowel emptying) → think of: Prostatitis (inflammation of the prostate).