Blue Balls (epididymal Hypertension): Myths And Facts

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Medical News TodaySubscribeBlue balls: Is it a real condition and when should a person contact a doctor?

Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP — Written by Beth Sissons — Updated on February 12, 2024

Definition
Myths
Treatment
Other causes
FAQ
Summary

“Blue balls” is the slang term for a real condition called epididymal hypertension. It refers to aching or painful testicles. Some people may experience this after sexual arousal that does not result in orgasm.

This symptom may occur because blood builds up in the testicles during arousal, causing them to ache if the person remains aroused for too long.

Although blue balls may be uncomfortable, it does not usually last long. Ejaculation may also bring relief.

In this article, learn more about what blue balls is, other causes of testicular pain, and how to relieve discomfort.

What is “blue balls?”

Lots of blue balls.-1 — Juanjo McLittle/Stocksy United

Blue balls can happen when a male remains aroused without orgasm. This causes a temporary buildup of blood in the testicles. The medical term for this is epididymal hypertension.

Blue balls is a controversial topic because there is no medical consensus on its existence. There has also been very little research into this topic.

People with blue balls may describe the following symptoms in their testicles:

heaviness
aching
discomfort or mild pain

Sexual arousal causes the arteries that carry blood to the male genitals to expand, increasing blood flow to this area. The veins that usually take blood away from the genitals restrict, trapping blood and causing an erection.

After ejaculation, or if a person ceases to feel aroused, the blood vessels return to their usual size, together with the swollen penis and testicles.

People may be able to relieve the sensation of blue balls by ejaculating or by distracting themselves with an activity that is not arousing until the symptoms pass.

Myths about blue balls

Blue balls is not dangerous. Any discomfort should subside once the erection passes and blood flow to the genitals returns to its typical state.

A person does not need a partner to relieve blue balls through sex. They can get rid of the symptoms by ejaculating through masturbation or by engaging in a nonarousing activity to distract them.

The testicles do not actually turn blue but may take on a faint bluish hue. This is due to the increased volume of blood in the area.

When are blue balls a medical emergency?

If a person does notice the testicles turning blue or purple, this could indicate a more serious issue called testicular torsion. Healthcare professionals consider this a medical emergency.

Treatments for blue balls

Blue balls is a temporary aching sensation in the testicles that should pass once the extra blood flows away from the area and blood pressure reverts to its typical state. It does not usually last for long.

People can relieve blue balls by ejaculating through masturbation or during sex with a consenting partner.

If a person cannot or does not wish to masturbate, they can use other techniques to relieve the blood pressure and end the arousal.

Some ways to reduce arousal include:

taking a shower or bath
exercising to encourage natural blood flow in the body
lifting something heavy to exert pressure on other areas of the body, if possible
applying a warm compress to the testicles to ease the pain
focusing on work or problem-solving as a distraction

People may find that taking over-the-counter (OTC) pain relief medication, such as ibuprofen (Advil), may help treat more intense pain.

Anyone who experiences severe or prolonged pain in the testicles or has any symptoms of the conditions below should seek medical attention.

Other causes of testicular pain

Pain in the testicles may signal a more serious condition. The following sections look at some other conditions that cause testicular pain in more detail.

Kidney stones

Kidney stones can cause pain in the groin and testicles.

People with kidney stones may also experience the following symptoms:

a burning sensation while urinating
blood in the urine
nausea and vomiting

Testicular torsion

Testicular torsion happens when the spermatic cord that holds the testicles becomes twisted, causing extreme pain. Testicular torsion is a medical emergency, as it cuts off blood flow to the testicles.

Anyone with the following symptoms needs immediate medical help:

extreme pain in the scrotum, usually on one side
one testicle that becomes larger than the other
the scrotum appears red or darker than usual
nausea and vomiting

A person with testicular torsion will require surgery to untwist the spermatic cord.

Injury

Any injury to the testicles, such as a sports injury or an object impacting the groin, can cause pain, swelling, and bruising.

People can often manage the symptoms of minor injuries by taking OTC pain relievers and resting.

For more serious injuries, people should seek medical attention.

Epididymitis

Epididymitis occurs when the tube behind the testicles, called the epididymis, becomes swollen. This swelling can be due to a sexually transmitted infection or urinary tract infection.

Some symptoms of epididymitis include:

tenderness or pain in the scrotum
swelling and inflammation of the scrotum
a fever
a burning sensation while urinating

A person should contact a doctor to treat epididymitis. The doctor may prescribe antibiotics or other medications.

Varicocele

A varicocele occurs when the veins in the testicles become enlarged. A person may be able to see the enlarged veins. A varicocele usually happens on the left side of the scrotum.

Frequently asked questions

Below are some commonly asked questions about blue balls, which is known as epididymal hypertension.

How long does epididymal hypertension last?

Epididymal hypertension appears to resolve on its own within a few minutes to hours or following an orgasm.

Is epididymal hypertension dangerous?

Epididymal hypertension is not dangerous, though it may cause temporary discomfort or pain.

Can epididymal hypertension affect females?

According to a 2023 cross-sectional study, females may also experience pain or discomfort following high levels of sexual arousal without achieving orgasm. This may be called “blue vulva” or “pink pelvis,” among other terms.

Summary

“Blue balls” is the colloquial term for aching testicles after sexual arousal that does not result in orgasm. Doctors refer to this symptom as epididymal hypertension.

Epididymal hypertension is not dangerous, and any pain should pass once the person has an orgasm or stops feeling aroused.

Anyone who experiences lasting or severe pain in the testicles should contact a doctor, as it may be due to a medical problem.

Read this article in Spanish.

Men's Health
Sexual Health / STDs

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10155057/
Levang S, et al. (2023). “Blue balls” and sexual coercion: A survey study of genitopelvic pain after sexual arousal without orgasm and its implications for sexual advances.
https://www.ncbi.nlm.nih.gov/books/NBK442014/
Leslie SW, et al. (2023). Renal calculi.
https://www.ncbi.nlm.nih.gov/books/NBK448113/
Leslie SW, et al. (2023). Varicocele.
https://www.ncbi.nlm.nih.gov/books/NBK513278/
Panchatsharam PK, et al. (2023). Physiology, erection.
https://www.ncbi.nlm.nih.gov/books/NBK430814/
Rupp TJ, et al. (2023). Epididymitis.
Schick MA, et al. (2023). Testicular torsion.https://www.ncbi.nlm.nih.gov/books/NBK448199/

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Medically reviewed by Avi Varma, MD, MPH, AAHIVS, FAAFP — Written by Beth Sissons — Updated on February 12, 2024

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