A case report on aspirin-induced hematospermia

Abstract: Hematospermia, also known as hemospermia, is a condition in which blood is found in the semen. Aspirin is an antiplatelet drug belonging to the class called nonsteroidal anti-inflammatory drugs. It works by inhibiting the cyclo-oxygenase-1 enzyme, which reduces the production of thromboxane A2, a potent platelet aggregator, reducing platelet aggregation and blood clotting. This mechanism, although beneficial in preventing thrombosis, can also predispose individuals to bleeding complications, including nose bleeds, gastrointestinal bleeding, and rarely hematospermia. Although hematospermia is typically benign, self-limiting, and rare, it may alarm the patient. We highlight the case of a 49-year-old male patient who developed hematospermia as a result of long-term aspirin use while reviewing the potential mechanisms, diagnostic approaches, and management considerations.