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Nov 11, 2021
4 min read

What is blue balls (epididymal hypertension)?

Epididymal hypertension (also known as “blue balls”) is a condition caused by excess blood remaining in the penis and testicles during erection for a prolonged time without sexual release. There is little research into blue balls, but it isn’t believed to be dangerous. Luckily, there are simple remedies you can use to treat blue balls and feel better.

Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

Have you ever been so aroused and for such a long time that, well, it actually hurts? If so, you may have experienced blue balls.

“Blue balls” has been used as slang to indicate frustration so often that it now has an abstract, almost mythical status. But blue balls is a genuine medical condition called epididymal hypertension. Luckily, while it can be pretty uncomfortable, it’s a safe and temporary experience. Plus, there are fairly easy ways to get rid of blue balls and feel better.

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What is blue balls?

“Blue balls,” also known as epididymal hypertension, is an uncomfortable condition that results 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 (also called edging), or during a prolonged period of mental or emotional arousal.

While blue balls is a very real phenomenon, there has been little written about it in medical journals. A literature review reveals only one journal article, a case report published in October 2000. The researchers suggested that the mechanism described above is what causes blue balls (Chalett, 2000). Additional research would undoubtedly be beneficial to help understand more about this common phenomenon. 

What causes blue balls?

During an erection, dozens of blood vessels in the penis fill with blood, causing the penis to elongate and harden. Not many people realize it, but something similar happens in the testicles during an erection, too. As blood flow increases, they increase slightly in size. After orgasm (or a decline in arousal if orgasm doesn’t occur), the blood flows from the penis and testicles back into the body (Panchatsharam, 2021). 

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 penis and testicles can get painful, leading to an ache in the testicles not so fondly known as blue balls. 

Can women get blue balls?

People with vaginas may not have a penis or testicles, but they certainly can experience blue balls. Of course, it’s not usually called blue balls in this case—common slang nicknames include pink pelvis, blue vulva, or blue bean.

The clitoris is built similarly to the penis, meaning that it is packed with blood vessels that cause it to swell with sexual arousal. As occurs with the testicles, the vulva may also experience a small amount of engorgement with sexual arousal. If there is no orgasm to relieve the engorgement of the clitoris or vulva, then you might feel symptoms similar to blue balls.

What does blue balls feel like?

The symptoms of blue balls can include:

  • A feeling of heaviness in the scrotum
  • An aching sensation
  • Testicular pain or mild discomfort

In people with vaginas, the symptoms may include a feeling of heaviness or achiness in the vulva or clitoris.

Aside from epididymal hypertension, other conditions can cause testicular pain, some of which can be serious and require immediate emergency care. Contact your healthcare provider immediately if you experience severe testicular pain, keeps coming back over time, lasts for several hours, or is accompanied by (Schick, 2021):

  • Fever
  • Nausea or vomiting
  • Swelling of the scrotum
  • Abdominal pain
  • Frequent or bloody urination

How long does blue balls last?

There are no published studies documenting exactly how long blue balls lasts. Some men may experience discomfort for only a few minutes, while others—as documented in the case report published in 2000—may experience symptoms up to three hours. 

However, if you experience discomfort or pain that lasts hours, you should contact a healthcare professional to make sure that you’re not dealing with a more serious condition. Some causes of testicular pain are medical emergencies and require prompt care. 

How to get rid of blue balls?

Without much scientific research into the experience of blue balls, there are few officially documented treatments for blue balls. 

However, because the condition is thought to result from prolonged erection and sexual arousal, approaches that decrease arousal and erection are typically believed to help treat blue balls. Such treatments include:

  • Orgasm and ejaculation, with a consenting partner or by masturbating
  • Cold shower or cool bath
  • Mental distraction, such as reading a book, watching television, or working on a project
  • Physical exercise

Fortunately, as you can see, the treatments for blue balls are pretty straightforward, and most people with testicles shouldn’t experience it regularly. If you find that you experience discomfort on a routine basis or have other concerns about your sexual health, contact your healthcare provider, urologist, or sexual health professional.

References

  1. Chalett, J. M., Nerenberg, L. T. (2000). “Blue Balls”: A Diagnostic Consideration in Testiculoscrotal Pain in Young Adults: A Case Report and Discussion. Pediatrics, 106(4), 843–843. doi: 10.1542/peds.106.4.843. Retrieved from https://pubmed.ncbi.nlm.nih.gov/11015532/
  2. Panchatsharam, P. K., Durland, J., Zito, P. M. (2021). Physiology, erection. [Updated May 9 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513278/
  3. Schick, M. A., Sternard, B. T. (2021) Testicular torsion. [Updated Aug 2 2021]. In StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK448199/