Is Blue Balls Serious?

Epididymal hypertension is the clinical name for what many people call "blue balls." This occurs when prolonged sexual arousal without ejaculation causes fluid to build up in the testicles.

While blue balls can cause pain and discomfort, it is not dangerous and will gradually resolve on its own without treatment. Ice application, over-the-counter painkillers, and masturbation can help in the meantime.

In this article, learn more about what it means to have blue balls and how you can get relief.

What Does "Blue Balls" Mean?

Blue balls is a slang term used to describe pain in the scrotum ("ball sack") that occurs with prolonged sexual arousal without ejaculation.

There is no hard-and-fast definition of blue balls given that post-arousal pain can occur for many different reasons. Because of this, some providers prefer to call it sexual arousal orchialgia or acute testicular pain.

Regardless, "blue balls" and these other terms are meant to describe the symptoms you are experiencing.

A healthcare provider can conduct an investigation and confirm if your discomfort is, in fact, due to a lack of ejaculation or a medical condition.

Symptoms of Blue Balls

Symptoms of blue balls may include:

• Aching discomfort in the scrotum
• Dull or sharp pain that can extend from the groin to the lower abdomen
• A sensation of fullness in one or both testicles
• Pain usually affecting both testicles rather than just one

Generally speaking, blue balls doesn't cause extreme swelling of the testicles or epididymis. There are conditions like epididymitis that can do this, which typically require medical treatment.

Causes and Diagnosis of Blue Balls

Blue balls is thought to be caused by the excessive accumulation of fluid in the epididymis, the tubes that transport sperm from the testicles, during prolonged arousal.

Without ejaculation, the back-up of fluid can cause congestion in the epididymis, causing discomfort or pain.

Blue balls may be also the consequence of:

• Delayed ejaculation (difficulty ejaculating)
• Anejaculation (the inability to ejaculate despite arousal)
• Semen retention (intentionally avoiding ejaculation)

Because the symptoms of blue balls could also have other causes, healthcare providers will work to confidently rule them out.

This may involve:

• Physical examination of the testicles and scrotum
• Blood tests
• Urine tests
• Imaging studies, like ultrasound

Differential Diagnoses

Some serious conditions can cause symptoms of blue balls. Blue balls can be differentiated from other types of acute testicle pain in that the discomfort doesn't prevent sex.

Your healthcare provider will consider these as part of the differential diagnosis process:

• Epididymitis: Inflammation of the epididymis, usually caused by an infection
• Inguinal hernia: The bulging of the intestine through a weak spot in the groin
  
• Prostatic stone: A hardened crystal that can block the duct from the prostate gland
• Testicular hematoma: A pool of clotted blood in or on the testicles
• Testicular torsion: A medical emergency where a testicle is abnormally twisted

How to Get Rid of Blue Balls

If you truly have blue balls, the symptoms will usually resolve on their own within one or several hours without treatment.

If the pain is significant and aggravating, there are a few remedies that may help:

• Over-the-counter painkillers like Tylenol (acetaminophen) can reduce pain, while nonsteroidal anti-inflammatory drugs (NSAIDs) like Advil (ibuprofen) can also help reduce inflammation.
• Exercise, especially strength training, is thought by some to divert the flow of blood from the testicles to other major muscle groups.
• Cold showers may help reduce sexual arousal and swelling. Applying a cold compress to the scrotum may also ease the pain.
• Masturbation has long been a go-to remedy for blue balls and one that has been endorsed by some health experts.

When to See a Healthcare Provider

There are certain signs that acute testicular pain is more than blue balls. See your doctor immediately if testicular pain is accompanied by:

• A pus-like discharge
• Pain with urination
• Blood in your urine
• Swollen lymph nodes in the groin
• A swollen epididymis (which would feel like a hardened cord behind the testicle)

These could be signs of a more serious condition, like a sexually transmitted infection or a passing prostatic stone.

When to Call 911

Call 911 or seek emergency care if sudden, severe testicular pain is accompanied by other symptoms of testicular torsion, including:

• Swelling of the scrotum
• Abdominal pain
• Nausea and vomiting
• A testicle that rides higher than normal
• Frequent urination
• Fever