Are ‘Blue Balls’ Real?

Have you ever wondered if “blue balls” is a real phenomenon — if testicles everywhere are in constant danger of turning blue? It’s a fair question, given how often the term’s thrown around.

Sure, blue balls can happen, says urologist Petar Bajic, MD. But it’s not medically concerning and doesn’t have any lasting effects. And it’s never a reason to pressure someone to be intimate.

What are blue balls?

“Blue balls” (or “epididymal hypertension,” as medical providers put it) is a feeling of pressure or discomfort that you may feel in your testicles if you become sexually aroused and don’t reach orgasm.

It isn’t a medical condition, despite the fancy name. And healthcare professionals don’t consider blue balls a problem.

“There can be an uncomfortable sensation associated with not ejaculating after a period of sexual arousal,” Dr. Bajic says. “But it’s not something that’s been researched because it’s not a threat to your health.”

Despite the colorful phrasing, your nether regions don’t turn blue if you don’t ejaculate. So, be sure to contact your healthcare provider if you notice skin discoloration. It could be a sign of a more serious medical concern.

Symptoms

Prolonged arousal may not turn your privates blue, but it can cause other symptoms, like:

• Swollen testicles
• Aching
• Throbbing
• Heaviness or pressure
• Mild pain

We all have different thresholds for pain. Some people find blue balls uncomfortable, while others don’t notice them at all. But an erection without ejaculation should never cause severe or debilitating pain. If you have genital pain, consult a healthcare provider.

What causes them?

Blue balls can happen because, as your body prepares for sex, it sends a rush of blood to your genitals. The pressure builds in your epididymis, the tube-like structures above your testicles that sperm passes through. If you reach orgasm, that pressure drops and things start going back to normal.

If you don’t orgasm, it can be like a pressure valve that builds up without release. The excess blood (and the pressure it causes) stays a little longer in your genitals. This can lead to a short-lived feeling of discomfort or heaviness until the blood flow returns to normal.

Is there an equivalent for women?

Anyone can have discomfort if they’re sexually aroused for a period of time without reaching orgasm, including women. There’s a phenomenon similar to blue balls that happens with blood flow to the vulva and clitoris. It’s called “blue vulva” or “blue bean” (a reference to the clitoris).

When blood rushes to the vulva (the collective name for the labia, clitoris and vaginal opening), the area becomes engorged and lubricated in preparation for sex. If that pressure builds up but isn’t released through orgasm, the blood flow can lead to feelings of heaviness or pressure in the vulva.

Like blue balls, blue bean doesn’t actually involve turning blue, isn’t a danger to your health and isn’t a reason to pressure others into sexual activity.

How long does the discomfort last?

The fleeting, temporary discomfort of blue balls can usually be measured in minutes. In rare cases, the sensation lingers for a few hours. If the sensation isn’t going away or is bad enough to interfere with your daily life, visit your primary care provider. Something else could be causing your symptoms.

If you have an erection (not blue balls) that lasts longer than four hours and doesn’t go away after you ejaculate, that’s another story. Unlike blue balls, a long-lasting erection (priapism) is a medical emergency that can do permanent damage to your penis. Go to the emergency room immediately.

How to get rid of blue balls

There are plenty of ways to banish blue balls without coercing others into sex. Dr. Bajic recommends trying:

• Masturbation: If your personal beliefs allow for masturbation, you can reach orgasm without a partner to relieve the discomfort.
• Distraction: Focusing on less-arousing thoughts and activities can help.
• Exercise: Doing some light exercise won’t just get your mind off your crotch. It’ll also divert blood flow away from your genitals and toward the muscles you’re using.
• Taking a warm shower: Have you ever noticed that you turn slightly pink after a hot shower? In addition to relieving muscle tension, warm water expands the blood vessels in your skin. You’re redirecting blood flow away from your groin and toward a much larger organ.
• Taking a cold shower: Cold showers aren’t as pleasant as warm ones, but they’re blue balls’ mortal enemy. The cold water makes your blood vessels constrict and reduces the inflammation in your groin.

How to prevent them

Blue balls can’t be prevented, but you can reduce the risk by having open, honest talks with your sexual partner. Together, you may decide to:

• Avoid “quickies” that could end without an orgasm.
• Restrict sex to times when you’re less likely to be interrupted.
• Make masturbation part of your routine.
• Limit the number of breaks or position changes during an encounter.

Is it blue balls or something else?

If you’re dealing with genital pain or discomfort outside the bedroom, it may be a sign of something more concerning.

“If the uncomfortable sensation in the testicles only occurs after a period of sexual arousal without ejaculation, that’s probably not anything serious,” Dr. Bajic says. “However, if you’re having genital pain under other circumstances, it merits further investigation by a urologist or primary care doctor.”

It can be nerve-wracking to talk about your body, but healthcare providers discuss these issues every day. They’re here to support you and answer questions about your reproductive health, not judge.