Implicated pathogens include; Gram-negative bacteria (often E. coli), gonococci, T. pallidum, C. trachomatis, N. gonorrhoeae, echinococcus (rarely), HSV type 1 or 2, and HPV.

Additionally, testicular, prostate, and epididymal inflammation in general may present with haematospermia as feature.

[4][5] Systemic conditions like malignant hypertension, liver dysfunction, or bleeding disorders, and amyloidosis may sometimes be present with hematospermia as symptom.

[4] The main focus of an evaluation should be to determine its cause (if possible) and rule out infection and malignancy.

[4] Though the exact incidence is unknown, haematospermia has been reported in one per 5,000 patients in initial examinations at urological out-patient clinics.