‘Blue Balls’: Facts and Fiction

Maybe you’ve felt it. Maybe you’ve heard of it. Maybe you’re wondering if it’s real.

The “it”?

The oh-so-descriptive condition we call “blue balls,” and what medical professionals call “epididymal hypertension.” (Hypertension, as in high blood pressure, and epididymal, as in the structure above the testicles through which sperm pass).

It’s common enough slang to make you think that blue balls are running rampant. That testicles everywhere are in a state of threat, constantly in danger of turning blue.

In reality? Sure, blue balls can happen, says urologist Petar Bajic, MD. But it’s not as concerning as you may have imagined. It’s not going to cause any lasting effects and it’s absolutely not a reason to feel pressured into sexual acts.

We talked with Dr. Bajic to separate fact from fiction.

Are blue balls real?

“Blue balls” isn’t a medically recognized condition. (Even giving it a fancy medical name like epididymal hypertension doesn’t mean it’s something that healthcare professionals consider an actual medical problem.)

But it’s understood that for some people, becoming sexually aroused without reaching orgasm can lead to a feeling of pressure or discomfort in their nether regions. That phenomenon is what we’ve come to know as blue balls.

“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 really researched because it’s not a threat to your health.”

Why does it happen?

Blue balls can happen because, as your body prepares for sex, it sends a rush of blood to your genitals. The pressure builds. It then releases if you reach orgasm, and things start to go back to normal.

But if you don’t orgasm, it can be like a pressure valve that builds up without release. The increased blood stays a little longer in your genitals. And it can lead to a short-lived feeling of discomfort or pressure until the blood flow returns to normal.

Myth-busting blue balls

There are a number of misconceptions out there about the supposed dangers of blue balls, so let’s set the record straight.

False: Blue balls is harmful

Some people question whether failure to ejaculate can lower their testosterone, or affect their prostate health or fertility.

The answer? Dr. Bajic says it’s a resounding “nope.”

“There is no risk or harm to experiencing blue balls,” he states. “It isn’t going to cause any kind of damage or problem to the testicles or the reproductive tract.”

Blue balls is not a disease. It’s not a threatening condition. And it isn’t necessarily going to be uncomfortable in many cases.

Blue balls should never (ever, ever, ever) be used as a reason to be pressured into a sexual interaction.

“At worst, blue balls may be inconvenient or uncomfortable for a short time,” Dr. Bajic notes. “But it definitely should not be used as a means to coerce anybody into having sex.”

False: The pain is excruciating

We all have different thresholds for pain. Some people may find blue balls to be more uncomfortable, while others may not even feel any troubling sensation. But any pressure associated with not ejaculating shouldn’t be severe or debilitating. Uncomfortable, perhaps. But not much more than that.

If you’re experiencing pain in your genitals, contact a healthcare provider to rule out possible medical conditions.

False: Your balls literally turn blue

“Blue balls” is a colorful but not-so-accurate name for the experience of prolonged sexual arousal. In reality, your testicles will not turn blue from lack of ejaculation.

False: It’s a ‘guy thing’

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

That’s because sexual arousal leads to increased blood flow to your genitals. 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 sexual intercourse. When that pressure builds 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 isn’t a danger to your health and shouldn’t be used as a reason to pressure anyone into sexual activity. (And, no, your anatomy won’t actually turn blue!)

False: Sex is the only remedy for blue balls

Again, worry about blue balls (or blue bean) isn’t a reason to engage in sex. If you’re experiencing discomfort, sex isn’t the only solution.

If your personal beliefs allow for masturbation, you can reach orgasm without a partner to relieve the discomfort. You may also find that distracting yourself with less-arousing thoughts and activities can help. Or taking a shower may help decrease the blood flow and relieve any symptoms.

Blue balls or something else?

Blue balls can be associated with a fleeting, temporary discomfort associated with sexual arousal. If you’re experiencing genital pain or discomfort at other times, 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, I think it’s safe to say that that’s probably not anything serious,” Dr. Bajic says. “However, if you’re having genital pain under other circumstances, it would merit further investigation by a urologist or a primary care doctor. It’s always worth getting checked out.”

If you’re concerned or have questions about your reproductive health, healthcare providers are available to help. And while it can be nerve-wracking to talk about the intimate details of your body, know that healthcare providers discuss these issues every day and are here to help.