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Are Blue Balls Real?

Kelly Brown MD, MBA

Reviewed by Kelly Brown, MD

Written by Erica Garza

Published 05/30/2024

If you’ve ever gotten so turned on that your balls ached, there’s a good chance you’ve experienced blue balls. But what is blue balls, exactly? Are blue balls real?

Contrary to the name, blue balls don’t turn your testicles blue. Medically known as epididymal hypertension, blue balls is the reported pain or discomfort felt in the scrotum after a prolonged build-up of sexual arousal without release.

Though epididymal hypertension may feel uncomfortable, it’s usually not considered a serious condition. Below, we’ll break down what causes blue balls, what they feel like, and how you can relieve discomfort in your testes without guilt-tripping someone into having sex.

“Blue balls” is a slang term for epididymal hypertension. This temporary medical condition is characterized by pain or discomfort in the testicles resulting from having prolonged sexual arousal without ejaculation.

In some cases, people use the term “blue balls” to describe sexual frustration. But epididymal hypertension specifically refers to the physical symptoms of having excess blood in the genitals for a prolonged period. These symptoms can include pain, heaviness, throbbing, and other uncomfortable sensations.

Research in the journal Pediatrics shows that blue balls are more common among young male adults, with symptoms ranging from brief, mild discomfort to severe pain.

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Some of the most common symptoms of blue balls (or epididymal hypertension) include:

  • Pain

  • Heaviness

  • Throbbing

  • Aching

  • Discomfort

Some guys may just feel sexually frustrated, but again, that’s technically not ​​epididymal hypertension.

When sexually aroused through mental or physical stimulation, your brain signals your blood vessels to dilate for increased blood flow to the penis. When enough blood pools, the once spongy tissue of your penis (corpora cavernosa) is now rigid and stiff, resulting in an erection.

To help you maintain this extra blood in your penis (and your erection), a fibrous membrane wrapping around your penile compresses veins and prevents the outflow of blood. In most men, blood pressure in the corpora cavernosa rises to an average of around 100 mmHg (millimeters of mercury).

When you ejaculate, the whole process reverses. The compression of the fibrous membrane decreases, excess blood flows back out, pressure releases, and you return to your regularly scheduled programming.

There’s still a lot we don’t know about blue balls, but epididymal hypertension is thought to happen because of slow blood drainage.

Ejaculation prompts the reversal of an erection and all the processes that led to it. So without this release, your tissues will stay engorged with blood for an extended period, leading to discomfort or pain.

Blue balls can last a few minutes or a few hours, depending on how quickly you find relief.

Most people don’t go to the emergency room for blue balls. They either masturbate, have sex, take a cold shower, or think about their taxes. We’ll go into more detail about what you can do later.

But other serious health conditions can also cause testicular pain:

  • Testicular torsion. Testicular torsion is a medical emergency where the spermatic cord gets twisted. Without prompt medical attention (within a four- to eight-hour window), permanent damage can occur, including fertility issues. While both testicular torsion and blue balls can cause scrotal pain, testicular torsion is often associated with other symptoms like nausea and vomiting.

  • Epididymitis. Epididymitis is when the epididymis becomes inflamed and swells — that’s the tube connecting the testicles with the vas deferens, where sperm is carried out from the testes. It can sometimes cause testicular tenderness.

  • Urinary tract infections. When you have a UTI, bacteria can sometimes spread from the infected site to the epididymis or even the testicle, resulting in pain.

  • Kidney stones. When kidney stones block urine from exiting the body, they can cause pain in the belly area, back, groin area, or testicles.

  • Testicular cancer. Testicular cancer may cause pain and swelling in the groin area, along with abdominal pain, back pain, and fatigue.

  • Varicocele. Enlarged veins in the scrotum may cause mild to severe pain and swelling.

Contact your healthcare provider for medical advice if your pain or discomfort is severe or accompanied by other symptoms to rule out more serious medical conditions.

Choose your chew

The most obvious solution to blue balls is to have an orgasm.

If masturbation or consensual sex aren’t options at the moment, you can try:

  • The classic cold shower

  • Exercise

  • Distracting yourself with unsexy thoughts

  • Slow breathing

  • Urinating

Pressuring or guilt-tripping another person into sexual acts is absolutely not okay. More on this below.

You should never use blue balls as an excuse to pressure somebody to have sex with you. Remember, this is no emergency situation. If you have a working hand, a sex toy, and some privacy, you can sort yourself out.

A 2023 study of 2,621 men and women explored the link between blue balls and sexual coercion. It found that significantly more women than men reported being pressured into a sexual act due to their partner’s fear of experiencing pain without orgasm (aka blue balls).

According to researchers, while it’s true some men have reported severe pain, it can be sufficiently relieved with solo sex and nonsexual activities. Guilting someone into having sex to avoid mild pain has major costs.

Coerced sexual activity has been shown to negatively impact mental wellness and increase the risk of anxiety, depression, and low self-esteem.

What is blue balls in women? Does it exist?

There are many similarities between the sexual arousal process for men and women. Like in a man, when a woman is sexually aroused, her brain signals the blood vessels leading to the vagina to dilate. The clitoris — made of the same spongy tissue as the penis — fills up with blood, creating an erection of sorts.

After orgasm, the process reverses, blood flows out, and the clitoris and vagina return to their normal sizes.

The same 2023 study cited above noted that women may also experience discomfort without sexual release. Terms used to describe this condition include “blue vulva,” “blue bean,” “blue clit,” and “pink pelvis.”

What If a Woman Doesn’t Orgasm After Getting Blue Vulva?

Despite the physiological similarities between men and women, they seem to view the discomfort of blue balls and blue vulva differently.

The 2023 study found that pain was more frequently self-reported in men and more frequently described as severe. And men didn’t report being coerced into sex as often as women.

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Is blue balls real? While there’s still a lot we don’t know about blue balls, lots of men report pain or discomfort after a prolonged state of arousal if they haven’t had an orgasm. While uncomfortable, epididymal hypertension isn’t the end of the world.

Remember these takeaways:

  • Blue balls usually aren’t serious. Dealing with the build-up of excess blood and pressure can be frustrating and uncomfortable, but the condition is temporary and solvable.

  • You can treat blue balls. DO: Masturbate, use a sex toy, have a cold shower, or exercise. DON’T: Pressure someone into having sex.

  • Rule out other men’s health conditions. Other conditions more serious than blue balls can cause testicular pain, including testicular torsion, kidney stones, and testicular cancer. If your pain is severe or comes with other symptoms, ask a board-certified urologist or another medical professional specializing in sexual medicine.

  • Women get blue balls too — it’s called blue vulva. Many of the physical mechanisms behind sexual arousal are the same in men and women. This means women can also experience discomfort if they don’t have an orgasm. However, they’re less likely to rate their pain as severe or coerce someone into having sex as a remedy.

Want to learn more about maximizing your sexual health? Check out our full guide to men’s sexual health and explore these sexual trends for better sex.

4 Sources

  1. Chalett JO, et al. (2000). “Blue Balls”: A Diagnostic Consideration in Testiculoscrotal Pain in Young Adults: A Case Report and Discussion. https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=6c08bfd8c5321c8ae3fe5dee6cd97429780e738e
  2. Levang SA, 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://academic.oup.com/smoa/article/11/2/qfad016/7148610?login=false
  3. Panchatsharam PR, et al. (2023). Physiology, Erection. https://www.ncbi.nlm.nih.gov/books/NBK513278/
  4. Sharp VI, et al. (2013). Testicular Torsion: Diagnosis, Evaluation, and Management. https://www.aafp.org/pubs/afp/issues/2013/1215/p835.html
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kelly Brown MD, MBA
Kelly Brown, MD

Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown is a founding member of Posterity Health where she is Medical Director and leads strategy and design of their Digital Health Platform, an innovative education and telehealth model for delivering expert male fertility care.

She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.

Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.

Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.

Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.

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