"BLUE BALLS" IS a term that sexually frustrated men have been using for ages—and if you’ve ever been aroused for an extended period without finishing, you know firsthand how unpleasant it can be. But if you’ve ever wondered, “is this all in my head?” or “what’s actually happening here?” let’s start by confirming that blue balls is, in fact, a legit thing. There’s even a medical term for it: epididymal hypertension.
According to James Elist, M.D., a urologist in private practice and inventor of the Penuma penile implant, blue balls is thought to be caused by a build-up of blood in the testicles and surrounding areas when you get aroused but don’t finish the job.
Fun fact: People with a vagina are not necessarily immune to this condition. When there’s a surge of blood flow to the vulva and clitoris—and no orgasm to relieve that pressure—that can also result in what’s often referred to as “blue vulva,” which comes with similar symptoms of aching, tenderness, and discomfort.
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So, are blue balls anything to be concerned about? And how can you get relief—or better yet, prevent this pesky issue altogether?
Here’s what to know.
What actually causes epididymal hypertension?
When you get turned on, arteries that carry blood to your penis expand, allowing more blood flow—which enables you to get an erection. According to Elist, that excess blood sticks around if you never orgasm, causing pressure that can be painful or uncomfortable.
There’s also some evidence that prolonged sexual attraction, leading to a stiffy that won’t go down, can cause some of the oxygen in your blood to be absorbed by the tissue in your genitals. This can leave the blood with a blue-ish hue, says urologist Richard K. Lee, M.D., of Weill Cornell Medical College.
But Lee says this usually only happens when there’s some type of blockage. “Erectile dysfunction drugs or blood flow-constricting devices like a penis ring could cause this, but it’s not likely to occur naturally,” he adds. So unless you've been using Cialis or a new sex toy in the bedroom, your balls likely won't actually become blue—you might just experience some mild discomfort.
Is blue balls dangerous?
Let's get one thing clear right off the bat: While “blue balls” is a relatively common phenomenon, that fleeting testicular pain is not going to do any long-term damage. If you're having sex and your orgasm is interrupted, you might be uncomfortable for a few minutes (or even hours), but that's pretty much the whole extent of it.
"The myth that blue balls is somehow dangerous or super painful is born out of the idea that men need to release their ejaculate, which is a myth designed to pressure women into sex,” says Gigi Engle, ACS, certified sexologist and author of All The F*cking Mistakes: a guide to sex, love, and life.
Historically, society has talked about blue balls in a problematic way.
You might have heard it in a movie or from a buddy at some point: "She gave me blue balls!"
Pepper Schwartz, PhD, a sexologist, relationship expert on Married at First Sight, and author of 50 Great Myths of Human Sexuality, points out that men have long complained about blue balls as a means of pressuring women into sex—and this is never OK. It’s not your partner’s responsibility to relieve your blue balls, no matter what kind of foreplay or other fun you were getting into.
"A guy will pretend he's in pain and appeal to a woman's sympathy in order to get what they want," Engle adds. "It's manipulative, wrong, and it's definitely a form of coercive assault to use blue balls to pressure someone to perform a sexual act they don't want to do."
Remember, you need enthusiastic consent—i.e., a "HELL YES!"—to proceed with any sexual interaction. Guilting someone into a hookup by telling them you have blue balls, as though it's some kind of dangerous medical condition? Nope. Not gonna cut it.
As Schwartz puts it, “You can handle this”—and, assuming you have one working hand, you definitely can.
Should I ever see a doctor about blue balls?
So if you’re fooling around and don’t get to finish, odds are it’s blue balls and nothing to worry about.
But if the pain is severe, prolonged, or accompanied by other symptoms, Elist says that may signal a more serious condition like:
- Varicocele, an abnormal dilation of the veins in the testicles
- Testicular torsion, when one of your testicles gets twisted, impeding blood flow
So, if your symptoms last more than a few hours, set in during non-sexual situations, or are accompanied by redness, swelling, or a fever, Elist and Schwartz say it’s time to pay your doctor or urologist a visit. That way, you can rule out any other underlying health conditions.
Is there a cure for blue balls?
There’s no research-based treatment for blue balls—and according to Elist, your best bet is just to ejaculate, whether with a consenting partner or by yourself with some porn, lube, and a Kleenex.
If that’s not possible for whatever reason, though, Schwartz suggests taking a cold shower—and although there isn’t any research to support this specific strategy, she notes that cold therapy tends to help with inflammation, which is why it might relieve swelling in your testicles.
“Applying a cold compress to the affected area can help constrict the blood vessels and reduce the discomfort associated with blue balls,” Elist adds.
Sony Sherpa, M.D., a board-certified doctor at Shahid Hospital and Research Center and Nature’s Rise medical writer, says you can also just distract yourself until the discomfort subsides. After all, blue balls rarely lasts more than an hour or two.
Better yet, Schwartz and Elist suggest exercising. Whether you hop on a treadmill or crank out a strength training sesh, Elist says physical activity can help to move the blood out of the genitals to help relieve discomfort.
And if the pain is just too much to bear, Elist recommends taking an over-the-counter pain reliever, like ibuprofen.
Can blue balls be prevented?
Blue balls can’t really be entirely prevented—since the only way to ensure it doesn’t happen is to ejaculate every time you get turned on, and obviously that’s impossible to guarantee in life. Things happen.
That said, Sherpa says that taking extended breaks during sex or changing positions too many times before finishing may increase your risk of experiencing this dreaded condition. Elist also recommends avoiding sexual activities when you know you may not have time to finish. (In other words, be careful when trying to squeeze in a quickie—or potentially pay the price.)
“Always communicate with your partner about your sexual needs and desires,” Elist adds. “This can help ensure that both partners are on the same page and can prevent disappointment or frustration.”
Rebecca Strong is a Boston-based freelance writer currently writing about Sex & Relationships at Men's Health. In her free time, she enjoys generous pours of Marlborough sauvignon blanc, true crime podcasts, and writing music (under her stage name, BEX). Rebecca is a graduate of Emerson College (BA) and The Boston Conservatory at Berklee (MFA). She has also covered health and wellness, fitness, travel, and lifestyle for Insider, AskMen, Healthline, Health.com, Clean Plates, StyleCaster, Eat This Not That, Best Life, and Bustle.
