Recently, a much-maligned TikTok user got everyone’s panties in a wad by asserting that the phenomenon of blue balls was just a myth perpetuated by horny dudes trying to get laid. In case you’re not in possession of a set of testicles, the term “blue balls” is used to describe the painful sensation in the testicles of a male who is sexually aroused but unable to experience the sexual release that comes with ejaculation. And yes, blue balls are very real.
The medical term for blue balls is epididymal hypertension (EH). When men become sexually aroused, blood flow to the penis and testicles increases. This is what facilitates an erection and it also causes an increase in the size of the testicles as well. If the aroused man doesn’t have an orgasm, the penis and testicles stay in the engorged state and the increased pressure can cause discomfort. The unpleasant feeling is generally described as an achy or throbbing pain.
Anyone with testicles can experience EH, but it’s more common in younger men. However, not everyone equipped with male plumbing will experience EH and even those without a penis and testicles can experience this type of discomfort. That’s right, when women become aroused, blood rushes to their sex organs, too, causing a similar sensation called “blue vulva” or pelvic vasocongestion. Similar to blue balls, blue vulva can cause feelings of achiness or heaviness in the clitoris and vulva.
Most people would prefer to alleviate epididymal hypertension with an orgasm, but sometimes that’s just not possible. Don’t worry. You will not die from blue balls. In fact, if you’re not able to ejaculate, you will experience no damage or long-term side effects whatsoever. EH will generally resolve itself. The caveat to this is if you routinely practice what’s called “edging,” which is an intentional withholding of orgasm to make an eventual orgasm more intense. Constant edging can make the instance of blue balls worse and lead to prostatitis.
The best way to take care of blue balls is to ejaculate. It’s actually good for your prostate to release these juices on a regular basis. In fact, I recommend that men get in 2 to 3 orgasms per week to avoid blue balls and to keep the prostate healthy. This does NOT mean that you should pressure or guilt-trip your partner into helping you finish. You’re a big boy and you’re perfectly able to take care of that yourself. No one should feel obligated or be forced to engage in any sexual act, ever. Period.
If you’re experiencing EH and ejaculating is not helping, then try taking an over-the-counter medication like Advil or Motrin. Usually, the pain and sensitivity will subside in 3 to 5 days with regular masturbation and anti-inflammatory drugs. However, if the pain worsens, you feel a lump or you’re consistently having pain with erections or orgasms, then you should see a doctor, stat. A urologist like myself can do a thorough examination to make sure that there’s nothing more serious at play.
A doctor’s visit is also in order if you have pain, heaviness, sensitivity and discomfort in the testicles when you’re not aroused. This could be a sign of other problems like epididymitis, orchitis, prostatitis or kidney stones. Also, even though EH is called “blue” balls, your testicles don’t actually turn blue. If you do notice that your testicles are turning blue or purple, it could be a sign of testicular torsion, a condition where the testicles are rapidly twisted causing pain, swelling and discoloration. This is an emergency situation that merits a quick trip to the ER.
The guy on TikTok who set the world of male/female relations on fire with his assumption that blue balls were just a made-up excuse that men use to get laid is wrong. EH is a very real condition. Do men use it to guilt their partners into getting them across the finish line? Yes. Should they? Absolutely not. Taking care of your sexual health is your job, not your partner’s. If you need to take a minute alone to alleviate a case of blue balls, do it. As you disappear into the bathroom, you can tell your partner it’s doctor’s orders.