The male scrotum contains the testes (or testicles) which are oval in shape, just like ball used in the sport, rugby, known in the United States as football. This perhaps explains why Americans colloquially refer to them as balls, and you would find one man challenging another by saying, “Try it if you’ve got balls.”

As with other tissues and organs in the body, the testes can get infected or exhibit other medical conditions. One of such conditions is commonly known as “blue balls” which refers to the achy feeling a man might get in the scrotum when he gets sexually aroused but does not have an orgasm. In strict medical terms, doctors refer to blue balls as epididymal hypertension. However, it is not considered a medical problem. While it can be uncomfortable, it doesn’t last long and isn’t harmful to a man’s health. 

Some people also use the term “blue balls” to describe a feeling of sexual frustration. However you define it, it’s never a reason to try to pressure someone to have sex. Nor should you ever feel obligated to have sex with someone because they feel physically or emotionally frustrated.

What causes blue balls

When a man gets sexually aroused, more blood flows into the genitals. That causes the penis the engorge with blood. (become erect) and the testicles to swell up to prepare for sex. Veins in the area get narrower to help keep this extra blood in place and not flow out.

After an orgasm in the course of the sex act, these veins relax and the excess blood – along with the pressure it causes – gets released. But if you don’t orgasm, the blood stays around for a little while longer. For some people, this feeling of pressure causes discomfort.

“I think of a pressure cooker,” says Caroline Pukall, PhD, director of the Sexual Health Research Laboratory at Queen’s University in Ontario, Canada. “As the pressure is building, an orgasm is like a release valve that allows that pressure to balance again. But if you build and build and you don’t release that valve, it can take some time for that pressure to go away on its own.” 

It’s more likely to happen when you stay sexually aroused for a long time, she says. You might get blue balls, for example, when you make out with someone, have phone sex, or watch pornography. 

Blue balls effect is not caused by a buildup of sperm. People with female anatomy can have a similar experience, sometimes called blue vulva, blue bean, or blue clit. 

Epididymal hypertension vs epididymitis

Epididymal hypertension (blue balls) isn’t related to epididymitis, which is an inflammation that can cause intense pain in testicle testicles. It happens when you have swelling in your epididymis, a coiled tube at the back of each testicle. It’s not linked to sexual arousal and is usually caused by a bacterial infection, such as Escherichia coli, or a sexually transmitted infection (STI). If you have symptoms like pain in your scrotum, swelling and redness in your testicles, blood in your semen, or pain when you pee, see a doctor right away.

Symptoms of blue balls

Blue balls might cause these sensations in or around the testicles: a heavy feeling, mild pain and achiness.

The term “blue balls” comes from the belief that the extra blood in your testicles can cause them to take on a faint bluish hue. But doctors disagree about whether that’s true. 

There’s no need to see a doctor for blue balls. But if you have pain in your testicles without being sexually aroused, especially if it’s serious or lasts a long time, you probably have a medical condition like kidney stones, an injury, or an infection instead of blue balls. See a doctor if this happens to you.

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If your testicles look slightly blue and you have sudden, intense pain, you might have a serious condition called testicular torsion. This happens when one of your testicles gets twisted, cutting off its blood supply. It’s a medical emergency that may require surgery right away.

How long does blue balls last?

Most people say the uncomfortable sensation of blue balls passes on its own within a few minutes to a few hours, though a few people have reported discomfort that lasts days. “The amount of time it takes for the body to return to its non-aroused, resting state can vary from person to person and from situation to situation,” Pukall says. 

How to get Rlrid of blue balls

The simplest way to get rid of blue balls is often just to wait it out. Once you’re no longer aroused, the uncomfortable feeling will fade. For some people, a cold shower or bath speeds up this process. Others find relief by: urinating, exercising and doing deep breathing techniques to help slow the heart rate. It may also help to distract yourself with things like reading or sleep.

Of course, having an orgasm through masturbation or sex with a willing partner will also do the trick. But keep in mind that it’s nobody else’s responsibility to relieve your sexual tension.

Prevention of blue balls

Since orgasm is never guaranteed, the only sure way to prevent blue balls is to avoid getting sexually excited. Limit the time you spend doing arousing things like watching pornography, whether with a partner or alone. If you want to avoid blue balls while you’re with a partner, communicate clearly with them ahead of time about what kinds of activities you want to avoid.

One study found that as you get older, you’re less likely to get blue balls. 


In summary, “blue balls,” or epididymal hypertension, is an uncomfortable feeling in your testicles that may happen when you get sexually aroused and don’t have an orgasm. It’s caused by increased blood pressure in your genitals. It doesn’t cause any harm, and it usually goes away quickly on its own. It’s never an excuse to pressure someone for sex. 

Are blue balls real?

For some people, the uncomfortable feeling that comes with blue balls is real. But doctors don’t consider its to be a medical condition, and it doesn’t require any treatment. Doctors disagree over whether it really causes your testicles to have a slight blue tint.

How serious is epididymal hypertension?

Although it can be uncomfortable, epididymal hypertension isn’t medically serious. If you have pain in your testicles that’s not liked to sexual arousal, especially if it’s intense or sudden, see a doctor.

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