Blue Balls

Epididymal Hypertension: Myth or True Blue Medical Condition?

blue plasma sphere
Is "blue balls" really a thing?. Adam Homfray/EyeEm/Getty Images

Millions of teenage boys are not delusional; prolonged sexual arousal without an orgasm can lead to pain in the testicles. Indeed, women can be afflicted with a similar pain in the genitalia from long arousal without sexual release as well.

The colloquial terminology is blue balls, and some people actually claim the scrotum (commonly known as the sack) can become cyanotic from trapped venous blood. I'm not so sure I buy the blue as true, but then again, I don't know anyone who has looked.

True Blue Condition

One article in the journal Pediatrics, published in 2000, discussed "epididymal hypertension" as a potential diagnosis in young adult males. With the exception of a follow-up letter to the editor in the same journal bringing up both real and comical concerns about the condition and a response to that letter, I couldn't find any other legitimate clinical discussion of the condition.

The medical community hasn't spent a ton of time on this particular phenomenon. For one thing, it is absolutely non-life-threatening, despite the belief otherwise by many a first-time sufferer. Plus, any topic even suggesting sexuality among the sub voting aged crowd is politically charged and uncomfortable for many healthcare providers to broach with either their patients or their patients' parents (especially the moms).

Pain Release

Worse yet, the immediate relief of the pain is most efficiently handled by the immediate release of the arousal. The easiest way to do this, of course, is through orgasm.

And there's the rub (sorry, couldn't resist).

No one wants to suggest that a young man is entitled to have his every erection tended to, especially by a sexual partner. That kind of thinking can lead to him pressuring his partner (or partners) into continuing down a path that she or he is not willing to go. No means no, even if it means he's going home with an aching disappointment.

In some households, it's even worse to suggest he handle his own destiny. The idea that a healthcare provider would even consider discussing masturbation with a teenager makes some folks decidedly squeamish, and others downright angry.


The hard truth is that some tales just don't have a happy ending. If you are—or have been recently—experiencing this condition, it will subside. It will most likely stop affecting you after a time or two. If you just can't tolerate the discomfort, besides masturbation there are a couple of home remedies that will probably help.

  • Exercise, especially strength training, is advocated by some. The idea is that exercise diverts blood to major muscle groups instead of the genitalia.
  • Vagal stimulation, often accomplished by bearing down as if having a bowel movement, may relieve the pressure by dilating blood vessels throughout the body. This is known in the medical community as the Valsalva Maneuver.
  • For generations, the most common word of advice has been to take a cold shower. Presumably, the cold will have the effect of reducing swelling, much like it does in injuries.

I doubt we will ever see any comprehensive clinical study of this particular phenomenon. It isn't harmful and it goes away without treatment, which means it will never need pharmaceutical relief. And since it doesn't need drugs, it will never have money to fund research.

View Article Sources
  • Sources:
  • Chalett JM, Nerenberg LT. "'Blue balls': A diagnostic consideration in testiculoscrotal pain in young adults: A case report and discussion." Pediatrics. 2000 Oct;106(4):843. PubMed PMID: 11015532
  • Rockney R, Alario AJ. "Blue balls." Pediatrics. 2001 Nov;108(5):1233-4. PubMed PMID: 11694711