Are Blue Balls Serious?

4 Ways to Get Relief

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Blue balls is the colloquial term for pain or a heavy feeling in the testicles caused by prolonged sexual arousal without orgasm in males. Blood vessels swell during arousal, and that subsides after ejaculation. If ejaculation is withheld or delayed (impaired), fluids build up, resulting in blue balls.

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.

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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 scrotum
  • Dull or sharp pain that can extend from the groin to the lower abdomen
  • A sensation of fullness in one or both testicles (although usually without any overt swelling)

Are Blue Balls Really Blue?

Despite its name, blue balls doesn't cause the scrotum or testicles to turn blue. If bluish or purplish discoloration occurs with acute pain and swelling, this may be a sign of a medical emergency known as testicular torsion.

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:

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.

People with blue balls should never pressure their partners to engage in any sexual activity without full consent or engage in any form of coercion.

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.

Frequently Asked Questions

  • How long does blue balls last?

    Typically, blue balls resolve on their own within one or several hours. The condition generally doesn't require medical attention.

  • Where does blue balls get its name?

    Blue balls is a term that was coined as far back as 1916. Despite its name, it rarely causes blue testicles.

  • How do you get rid of blue balls?

    cold compress applied to the testicles may alleviate pain due to blue balls. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may also help. Masturbation has been described as a remedy for blue balls in some older medical journals, although few doctors today would recommend masturbation as a medical treatment.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. 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.

  2. Velasquez J, Boniface MP, Mohseni M. Acute scrotum pain. In: StatPearls [Internet].

  3. Schick MA, Sternard BT. Testicular torsion. In: StatPearls [Internet].

  4. Parnham A, Serefoglu EC. Retrograde ejaculation, painful ejaculation and hematospermia. Transl Androl Urol. 2016;5(4):592-601. doi:10.21037/tau.2016.06.05

  5. Ayad BM, Van der Horst G, S Du Plessis S. Revisiting the relationship between the ejaculatory abstinence period and semen characteristics. Int J Fertil Steril. 2018;11(4). doi:10.22074/ijfs.2018.5192

  6. Rockney R, Alario AJ. Blue balls. Pediatrics. 2001;108(5):1233-4.

  7. Leslie SW, Sajjad H, Siref LE. Chronic testicular pain. In: StatPearls [Internet].

  8. Dalzell T, Victor T. Sex Slang. London: Routledge; 2008. doi:10.4000/lexis.1889

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.