What is 'blue balls'?

Reviewed by our clinical team

Many men will have  heard about or even experienced “blue balls” when they’re teenagers. It’s normally used to describe a sexual situation that doesn’t result in orgasm, leading to pain and discomfort the testicles. The name itself comes from the fact that some men find that their scrotum (the skin that covers the testicles- the "ballsack") turns a slightly blueish colour.

Though “blue balls” is often used in a jokey context, it’s a real condition known medically as epididymal hypertension (EH). EH is thought to be caused by pressure building up in the epididymis – the coiled tube that joins the site of sperm production with another tube (the vas deferens) that eventually leads to the outside world. The blood vessels around the epididymis can become congested giving the area a blueish-grey tinge.

The good news? Blue balls is completely harmless, and won’t cause any long-lasting effects – even if it’s a bit uncomfortable in the short term. To find out how to manage your symptoms, and when to see a doctor, read on.

What are the main symptoms of blue balls?

The symptoms of blue balls occur after sexual arousal, but before ejaculation.

You’ll probably feel an aching, heavy sensation in and around your testicles, and might find that they’re extra sensitive and feel painful when touched or moved around. You might also notice that your scrotum takes on a slightly blueish colour.

Why does EH occur?

When you’re aroused, there’s an increase in blood flow to your penis and testicles so that you can get an erection. 

If you’re able to orgasm and ejaculate, blood flow will return to normal and you shouldn’t feel any discomfort. If you’re not able to ejaculate, you might find that you develop “blue balls”, due to a build-up of pressure in the epididymis and increased blood flow in the testicles.

You’re more likely to experience blue balls when you’re sexually inexperienced and more easily sexually aroused. This is why it’s more common in teenagers. It might also be a problem for men who use masturbation techniques such as edging to delay ejaculation.

How to treat blue balls

If you’re experiencing blue balls and you feel really uncomfortable there’s an easy solution – allow yourself to ejaculate by masturbating or having sex.

If you’re not in a situation where you can do this to get relief, the best thing to do is wait for symptoms to pass. 

You may be able to speed up this process by doing the following:

• Having a cold shower 
• Exercising  
• Working on a complex task 
• Listening to music 
• Finding another distraction to keep you busy

It should go without saying that you’ll need to avoid anything that might heighten your sexual arousal!

Should I see a doctor about blue balls?

A classic case of blue balls doesn’t require medical attention, as it’s not harmful and won’t cause any damage. Most of the time you can make yourself feel better by masturbating or having sex, or by waiting for the symptoms to pass on their own.

However, if you’re regularly experiencing pain in your testicles – and not just when you’re sexually aroused – it’s worth speaking to your GP. There are a number of conditions that can cause symptoms similar to blue balls, including:

• Sexually transmitted infections such as gonorrhoea, which can cause inflammation of the epididymis 
• Mumps, a virus that can cause inflammation of the testicles 
• Testicular torsion, where the testicles twist in the scrotum and cut off blood supply 
• Kidney stones 
• Urinary tract infections

Sometimes, the cause of the pain might be trauma to the testicles due to an injury or from wearing overly tight underwear or trousers. Rarely, pain or tenderness in the testicles is a sign of testicular cancer.

Other symptoms that should always be checked out by a doctor include:

• Lumps in the testicles 
• An enlarged testicle 
• Chronic (ongoing) pain in the groin 
• Unusual discharge from the penis 
• Pain when urinating or ejaculating 
• Blood in your urine or semen 
• Blisters, sores, or growths around your genitals

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References

https://www.netdoctor.co.uk/healthy-living/sex-life/a36199736/blue-balls/
https://www.nhs.uk/conditions/testicle-lumps-and-swellings/
https://www.mayoclinic.org/tests-procedures/testicular-exam/about/pac-20385252