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Blue Balls (Epididymal Hypertension): Know the Facts

Kristin Hall, FNP

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 7/26/2020

“His price for such an unselfish evening is to spend several succeeding hours in stiff-legged waddling pain we call blue balls.” 

References to blue balls are everywhere, including this quote from a 1974 issue of Playboy, according to Merriam Webster. 

You and your friends may joke about it, and a quick Google search will show it on numerous message boards and non-academic websites. 

But where you won’t find references to blue balls is in the medical literature. 

Despite the fact that nearly every male over the age of 13 likely knows what blue balls is, it isn’t widely recognized in medical textbooks or journals. 

So, you probably won’t have much luck when looking for scientific sources to explain the aching in your nuts.

There are few websites out there that discuss blue balls in a meaningful and serious way. 

Luckily, we’re one of them. 

While there isn’t a ton of information on the topic available, we’ve drummed it up and put it together to answer your questions about this age-old men’s health problem. 

What Is Epididymal Hypertension? 

When you’re sexually aroused, the vessels in your penis open wide and allow a rush of blood to enter, causing your erection. 

Your testicles also fill with more blood than usual, causing them to grow larger 

Once you reach orgasm and ejaculation, everything goes back to normal fairly quickly. 

But if you don’t experience that release of pressure, your genitals may ache and be uncomfortable, due to something called vasocongestion. 

This aching and heaviness, my friends, is blue balls (also known by the medical term epididymal hypertension).

Blue balls is definitely a “thing.” You and your male friends all know it well. But the scientific literature doesn’t seem to acknowledge it. 

One case study published in the medical journal Pediatrics says, “it is remarkable that the medical literature completely lacks acknowledgement of this condition.” 

As a matter of fact, for the study, three medical librarians at different institutions combed existing research for mention of blue balls and found only one — an article that mentioned information on the topic comes from common knowledge and experience. 

So, if you’ve been online looking for a scientific explanation of your aching balls, there’s little surprise you’ve come up mostly empty-handed. 

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Why Is It Called “Blue Balls”?

Sometimes, your testicles may actually appear to have a bluish tint with epididymal hypertension. 

This is because of the unoxygenated blood hanging out in your testes. Hence, the term “blue balls.” Also, it’s easier to say than epididymal hypertension. 

How to Relieve the Pressure of Blue Balls 

There is no medical treatment for blue balls. Not surprising considering there is no medical research on the condition.

Fortunately, it doesn’t last long and the discomfort is generally mild. The only surefire way to relieve the pressure of epididymal hypertension — the cure, if you will — is by orgasm and ejaculation. 

The University of California suggests masturbation as often the “most viable way” to achieve this end. 

It’s not a stretch to think that you ended up with blue balls because you were hot and heavy with someone, but didn’t get all the way to the goal line (your body’s physiological one). 

However, it’s ill advised to cure yourself like an exhibitionist and definitely inappropriate, under any circumstances, to pressure a partner who already signaled they were finished to provide you with some “relief”. 

If you don’t have an out, you may just have to suck it up and deal with the pain until you’re alone. 

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Blue Balls and Mental Health 

The case study published in Pediatrics is of a 14-year old boy who presented to the emergency room with a case of blue balls. 

He had been making out with his girlfriend and was in a high state of sexual arousal like a normal, healthy teenage boy. But he didn’t have an orgasm. 

He didn’t understand what was happening, and even after reviewing the literature, doctors could only give him an explanation based on common knowledge, and definitely not medical training. 

His pain was likely compounded by embarrassment. 

The University of California suggests the embarrassment and frustration associated with blue balls can make the pain even worse by causing psychological stress. 

Of course, researchers say having established medical literature and protocol on the topic would alleviate some of this. But blue balls isn’t going anywhere, so in the meantime it helps just to know that the condition is real and the pain legitimate.

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Blue Vulva? 

It may also help to know that women can experience a similar condition, nicknamed “blue vulva” or pelvic congestion. 

Just like you, her genitals experience increased blood flow when she’s turned on, and when she fails to achieve orgasm, that blood doesn’t dissipate as quickly.

Like men, women experiencing the pain and pressure of this condition can get some relief by having an orgasm. And if that’s not possible, waiting for the pain to just go away with time.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.