Blue Balls

What is blue balls?

Blue balls, known medically as epididymal hypertension (EH), is a condition that can affect people with male genitals. It’s not serious, but causes pain and aching in the testicles after having an erection without an orgasm. It’s often accompanied by a blueish hue in the testicles. Most men do not get EH frequently.

What are the main symptoms?

EH symptoms affect the testicles and include:

  • pain
  • discomfort
  • heaviness
  • aching

You may also have a blueish hue visible in the scrotum. 

Why does EH occur?

When people with male sexual organs are aroused, the blood vessels to the penis and testicles expand to allow a greater volume of blood flow. Over time, this blood causes the penis to expand and stiffen, leading to an erection. The testicles also increase in size, causing them to feel heavier. 

Typically, this blood is released after orgasm or as a result of a decreased physical arousal. Too much blood may stay in the genital area of some people who become aroused for an extended period without a release or decrease of arousal. This can cause pain and discomfort. The testicles may even start to turn blue due to the excess blood and increase in blood pressure. 

You are more likely to develop EH if you’re easily stimulated. Masturbation techniques that delay orgasm also increase the chances of EH. 

Other causes of pain in the testicles

If you have pain and discomfort in the testicles only when you’re aroused, it’s most likely a result of EH. If you regularly experience painful symptoms when not aroused, it may indicate another problem, such as:

It may also be a sign of testicular torsion. This occurs because of a rapid twisting of the testicles and causes pain and swelling. This often requires emergency surgery. 

Should you see a doctor?

Typically, you do not need to see a doctor or clinician about EH. If it’s causing you intense pain regularly or impeding your sexual performance, talk to your primary care doctor, urologist, or a sexual therapist. 

If you experience strong, persistent testicular pain not associated with sexual activity, see your doctor. They can rule out other conditions that may be causing your pain.

You should also see your doctor if you have the following symptoms in addition to pain:

  • a lump or enlargement in either testicle
  • dull aching in the groin area
  • pain in the lower back 

These symptoms may indicate a more serious problem, such as testicular cancer.

How is blue balls treated?

Doctors and researchers have not studied EH extensively. There aren’t many established treatments for it. A case study of a teenage boy suggests that the simplest, quickest remedy for blue balls is to ejaculate during an orgasm. One can achieve this through masturbation, oral sex, or protected sexual intercourse. After an orgasm, the pain will go away slowly.

Another quick remedy is to become unaroused. You can achieve this through a variety of ways, including:

  • taking a cold shower
  • thinking of something nonsexual 
  • distracting yourself with music
  • working or doing another activity that keeps you busy 

Exercise may also help because it can move the blood flow away from your testicles to your muscles. Applying an ice pack or other cold substance to the area may also help by constricting the blood vessels and reducing additional blood flow to the area. 

Bottom Line:

Blue balls refers to the pain or heaviness caused by a delayed orgasm. Most males don’t regularly experience it, and it’s not generally serious. Talk to your doctor or a sex therapist if EH causes you significant pain or affects the quality of your sex life. Consistent pain in the testicles, especially if it’s unrelated to sexual stimulation, may indicate a more serious problem if accompanied by other symptoms. 

Chalett JM, et al. (2000). “Blue balls”: A diagnostic consideration in testiculoscrotal pain in young adults: A case report and discussion.
Rockney R, et al. (2001). Blue balls.
Written by Neel Duggal — Updated on September 17, 2018

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