How long do blue balls last?

Have you ever been so aroused and for such a long time that it actually hurts? If so, you may have experienced blue balls, the slang name for a real medical phenomenon that is sometimes called epididymal hypertension. The pain and discomfort associated with blue balls can last from a few minutes to a few hours. 

Read on to learn more about the causes of blue balls and how to help the phenomenon subside.

"Blue balls," sometimes known as epididymal hypertension, is an uncomfortable condition that can result from having an erection for a prolonged period of time without ejaculation.  

Blue balls can occur any time there is prolonged arousal without orgasm — whether during sexual activity with a partner, during an extended masturbation session without ejaculating (sometimes called edging), or during a prolonged period of mental or emotional arousal.

While blue balls are a very real phenomenon, little has been written about them in medical journals. A literature review reveals very few journal articles written about this condition. Additional research would undoubtedly be beneficial to help understand more about this common phenomenon. 

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There are no published studies documenting exactly how long blue balls last. Some people may experience discomfort for only a few minutes, while others may experience symptoms for up to three hours. 

Again, if you experience discomfort or pain that lasts for hours, seek emergency medical attention to ensure your symptoms are actually due to blue balls and not due to a more serious condition that may require treatment. 

Symptoms of blue balls vary from person to person. Some may describe them as mild, while others experience moderate to severe symptoms such as: 

• Swollen, slightly enlarged scrotum, where testicles are located 

• Aching or throbbing sensation in the scrotum 

• Heaviness or pressure in the groin area 

• Dull ache in the lower abdomen 

During an erection, the erectile tissue in the penis fills with blood, causing the penis to elongate and harden. Blood flow also increases to the testicles during arousal, causing them to increase slightly in size. After orgasm (or a decline in arousal if orgasm doesn’t occur), the blood drains from the penis and testicles back into the body.

But when that excess blood stays in the genitals for a long time without being released, that increased blood pressure (the "hypertension" part of “epididymal hypertension”) sticks around. This prolonged pressure in the testicles and scrotum can become painful, leading to an ache not so fondly known as blue balls.

The discomfort you experience with blue balls is a natural response to sexual arousal without release. The good news is there's no need for medical intervention for the most part, and there are several ways to find relief:

• Ejaculation: The most straightforward way to resolve the discomfort is to achieve orgasm through masturbation, sexual intercourse, or other forms of sex with a consenting partner. This relieves built-up tension, and symptoms typically fade quickly afterward.

• Distraction: If achieving orgasm isn't an option, diverting your attention can be helpful. Engaging in non-arousing activities like exercising, watching a movie, playing a game, or listening to music can take your mind off the discomfort and allow your body to calm down.

• Relaxation techniques: Techniques like deep breathing or meditation can help reduce overall tension and discomfort. Focus on slow, deep breaths and progressive muscle relaxation to help your body unwind.

• Cooling down: A cool shower or bath can help relieve achiness and discomfort.

Remember, the discomfort associated with blue balls is temporary and should subside within a few hours. If the pain is severe or persists, seek emergency medical attention to rule out other potential causes of testicular pain.

How to tell the difference between blue balls and other testicular conditions

Aside from so-called epididymal hypertension, several other conditions can cause testicular pain — some of which can be serious and require immediate medical attention. 

Here’s a breakdown of possible causes of testicle pain and how they compare to blue balls: 

Epididymitis: Inflammation of the coiled tube (epididymis) at the back of the testicle that carries sperm. Sexually transmitted bacterial infections, such as gonorrhea and chlamydia, are the most common cause of epididymitis in a younger population, while organisms like E. coli are more common in older men. Symptoms include testicular redness, pain, swelling, and tenderness. Some people also experience pain during urination or an increase in urination frequency.

In contrast, blue balls won’t result in painful or increased urination. Additionally, blue balls pain will resolve with ejaculation, but pain from epididymitis won’t.  

Testicular torsion: This occurs when the spermatic cord that supplies blood to the testicle twists or rotates around it, cutting off its blood flow. Symptoms include sudden, severe pain in the affected testicle, a red or dark-colored scrotum, a swollen (enlarged) scrotum, nausea, and vomiting. 

Testicular torsion is a medical emergency that requires prompt treatment to save the testicle. So if you’re in doubt, you are better off seeking emergency medical attention. 

Blue balls should not result in nausea, vomiting, or sudden severe pain. If you are experiencing these symptoms, that should raise your suspicion for another cause of testicular pain.

Inguinal hernia: Also known as a groin hernia, an inguinal hernia develops when part of the abdominal contents, such as the intestine, pushes through a weak spot in the lower abdominal wall. 

With an inguinal hernia, you may notice a bulge in the area between your lower abdomen and thigh, a bulge in your scrotum, pain in your scrotum, heaviness, or other sensations in the groin area. A hernia can be an emergency if the intestinal contents get stuck, causing that part of the intestines to lose its blood supply.

While blue balls can cause pain and heaviness in your scrotum, the phenomenon won’t cause a bulge.

Kidney stones: A kidney stone is a hard deposit of minerals that forms in the kidney. When passing through or stuck in the urinary tract, a kidney stone can cause pain that radiates to the scrotum and groin. 

Other symptoms include difficulty urinating, nausea, and vomiting. 

Blue balls can cause scrotal pain, but not the other symptoms.

Priapism: Priapism, a prolonged and often painful erection lasting over four hours, is considered an emergency and needs evaluation by a healthcare provider. 

Unlike blue balls, priapism causes pain that’s primarily in the penis, not the testicles.

TL;DR: There are some key differences between blue balls and other causes of testicular pain. Still, it’s important to seek emergency medical attention or go to an emergency room if you experience sudden, severe testicular pain, pain that lasts longer than a couple of hours or pain that’s accompanied by:

• Fever

• Nausea or vomiting

• Swelling of the scrotum

• Abdominal pain

• Frequent or bloody urination

If you are unsure about the cause of your testicular pain, it’s better to get evaluated than not.

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Blue balls is the nickname for a real phenomenon known as epididymal hypertension. Although it may be uncomfortable and painful, it generally isn’t dangerous.

• Blue balls typically subside on their own within a few minutes to a few hours. 

• The phenomenon is caused when excess blood stays in the genitals for a long time, leading to increased blood pressure in the area.

• Ejaculation is the best way to relieve the discomfort, but if that isn’t an option, try distraction, relaxation techniques, or taking a cool shower. 

• If you’re having testicular pain that is severe or persists after a few hours, it may be something other than blue balls, and you should seek emergency medical attention.