The condition itself—also known as epididymal hypertension—is uncomfortable, but not dangerous. It is common in newly pubescent boys, but it can also affect adult males.
This article discusses what blue balls mean, what happens in the body to cause them, and how you can get relief.
What Do Blue Balls Mean?
Blue balls is not a diagnosis, per se, but rather a way to characterize pain in the scrotum associated with prolonged sexual arousal without ejaculation.
Of course, the term is one you’re more likely to hear in casual settings, rather than a healthcare provider’s office. While most males will never need to see a healthcare provider about blue balls, as they are acutely aware of their cause, scrotal pain that is chronic or occurs independently of sex should be evaluated.
Medical providers will more often use the term acute scrotal pain. Prolonged sexual arousal is a very likely cause, but there are many other possible reasons for pain in the scrotum, testicles, epididymis (the tubes behind the testes that transport sperm), and spermatic cord.
Whatever blue balls are called, the term acts as a placeholder until the doctor investigates the cause and ensures that a more serious condition is not involved.
Symptoms of Blue Balls
Symptoms of blue balls can include:
Aching discomfort in the scrotumDull or sharp pain that can extend from the groin to the lower abdomenA sensation of fullness in one or both testicles (although usually without any overt swelling)
What Causes Blue Balls?
Blue balls is thought to be caused by the excessive accumulation of fluid in the epididymis during prolonged arousal. Without ejaculation, the “back up” of fluid can cause the epididymis to expand, causing discomfort or pain.
Blue balls may be also the consequence of:
Delayed ejaculation (an extended lag between sexual arousal and climax)Semen retention (intentionally avoiding ejaculation)
Because the symptoms are non-specific, doctors investigating blue balls will almost always investigate other possible causes of acute scrotal pain. These include:
Epididymitis Inguinal hernia Nerve entrapment in the spermatic cord Testicular hematoma Testicular torsion Urethral stone
Blue balls may be differentiated from other types of acute scrotal pain in that the discomfort doesn’t prevent sex. By contrast, scrotal pain caused by trauma will often interfere with the ability to have sex.
How to Get Rid of Blue Balls
If you truly have blue balls, the symptoms will typically resolve on their own. If you can’t tolerate the discomfort, there are a few remedies that may help:
Over-the-counter analgesics like Tylenol (acetaminophen) can help relieve pain caused by blue balls. Nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) may also help reduce inflammation and epididymal swelling. Exercise, especially strength training, is advocated by some. The idea is that exercise diverts blood to major muscle groups instead of the genitalia. Cold showers have been recommended for generations to temper sexual arousal. The cold may also reduce swelling, much as it does with injuries. Applying a cold compress to blue balls may be a more practical approach. Masturbation has long been a go-to remedy for blue balls; it’s also a strategy endorsed in some journal articles.
A Word From Verywell
Blue balls is a phenomenon that definitely affects some people. It can be temporarily painful or uncomfortable, but it is serious or a threat to your health. It typically resolves on its own with some time.
However, if your symptoms recur, are chronic, or impact sexual activity, contact your healthcare provider. This may be a sign of another, more potentially serious problem.
If the pain is severe and accompanied by fever, nausea, vomiting, scrotal swelling, abdominal pain, and frequent urination, call 911 or go to your nearest emergency room.
