Are blue balls real? We asked an expert

You’ve probably heard the phrase thrown around in jest. But what does it actually mean and are men around the world experiencing blue balls? We asked our lead GP, Dr Luke Pratsides, to spill the truth on the condition.

Colloquially, “blue balls” is used as a term to describe a man experiencing extreme sexual frustration. It’s suggestive of a build-up of ejaculation with no opportunity to release.

But in medical terms, are blue balls really a thing? And can they actually go blue?

Dr Luke explains that yes, blue balls are completely real. But the medical term doesn’t roll off the tongue quite so nicely: epididymal hypertension. 

“Epididymal hypertension is more commonly known as blue balls,” he explains. “It’s caused by the increased blood flow to the genitals during sexual arousal. This increased blood flow is normal and important for achieving and sustaining an erection. However, if sexual arousal is prolonged without ejaculation, the blood vessels around the testicles remain enlarged and cause too much blood flow to the genitals. In turn, the genitals increase in size and become heavy. This can be very uncomfortable.”

It’s clear. Prolonged sexual arousal without ejaculation is a medical condition. But why use the term ‘blue’? Dr Luke explains, “The collection of blood around the testicles can give a blueish colour which gives the condition its slang name of ‘blue balls’.”

If you’re experiencing blue balls, there are various methods of treatment. 

Dr Luke explains a few of the most simple and effective courses of action:

• Ejaculate through consensual sexual acts with a partner or masturbation

• Become unaroused through distraction

• Take a cold shower (cold temperatures cause smooth muscles in blood vessels to contract leading to vasoconstriction, which results in less blood flow to the genitals, relieving epididymal hypertension)

Epididymal hypertension, or blue balls, can cause pain, discomfort and ache without treatment. “Once ejaculation has occurred or arousal has diminished, the pain or discomfort should go away within minutes or hours,” says Dr Luke. “If the pain is persistent or worsening it’s important to seek medical advice from your primary care doctor. If you experience severe, persistent pain and swelling in the testicle then seek urgent medical care through your local emergency department as this is likely a sign of something more serious than epididymal hypertension. For instance, it could be testicular torsion.”

So, it’s clear where the slang phrase comes from and what you can do to treat it. But what’s the science behind the condition? Let’s get down to the nitty-gritty details.

Dr Luke explains, “Hypertension relates to the increased blood flow around the genitals including the epididymis. There is no particular role of the epididymis in epididymal hypertension. The epididymis is a coiled tube adjacent to the testes where sperm is stored and matures. Sexual arousal is driven through the parasympathetic nervous system and stimulation of the parasympathetic nervous system results in vasodilation, where blood vessels increase in diameter, causing an increase in blood flow. Ejaculation is driven by stimulation of the sympathetic nervous system which also causes vasoconstriction, where blood vessels narrow, reducing blood flow. Hence why, after ejaculation, blood flow to the genitals returns to normal.” 

The numan take

Epididymal hypertension is the medical term for the slang, ‘blue balls’. It refers to a build-up of blood around the testicles as a result of prolonged sexual arousal without ejaculation. This can be very uncomfortable and give the genitals a blueish tint, hence the phrase ‘blue balls’. The condition can be treated through ejaculation, distraction, or a cold shower. If the pain persists and is severe, you must seek medical treatment immediately.