WHAT IS BLUE BALLS?
If you have ever experienced a heavy, achy, uncomfortable feeling in your testicles after prolonged sexual arousal, you have probably heard it called blue balls. Despite how commonly the term is used, there is a lot of confusion, exaggeration, and misinformation surrounding it. Some people dismiss it as fake. Others treat it like a medical emergency. Neither is accurate.
In this article, I’m going to explain what blue balls is, what causes it, what it should and should not feel like, and what helps. This is an anatomy based explanation grounded in pelvic health and sexual physiology.
What Does Blue Balls Mean?
Blue balls is a slang term for a physiological phenomenon called epididymal congestion. It refers to temporary discomfort in the testicles that can occur when sexual arousal is sustained for a long period of time without ejaculation.
It’s not dangerous. It does not cause long term damage. It is not a medical emergency.
It’s also not an excuse to pressure someone into sex.
Blue balls is about blood flow, arousal, and pressure.
A Quick Look at Testicular Anatomy
To understand why blue balls happens, it helps to understand the basic anatomy involved.
Each testicle has a coiled tubular structure that sits on top of it called the epididymis. This is where mature sperm are stored.
Attached to the testicle is the spermatic cord. This bundle contains the vas deferens, which carries sperm, as well as arteries, veins, lymphatic vessels, and nerves that support and nourish the testicles.
All of these structures respond to sexual arousal.
What Happens During Sexual Arousal
When you become sexually aroused, blood flow increases throughout the genital region. This includes the penis, the epididymis, the testicles, and the surrounding tissues of the scrotum and pelvis.
Blood vessels dilate. Veins fill. Pressure increases. Tissue temperature rises. Pelvic floor muscles often increase in tone and tension.
This is normal.
When ejaculation occurs, muscle contractions and changes in blood flow help relieve that pressure. Blood gradually redistributes away from the genitals. Tension decreases.
When ejaculation does not happen, especially after prolonged arousal, that congestion can linger.
That lingering congestion is what people describe as blue balls.
What Blue Balls Can Feel Like
Blue balls does not feel the same for everyone, but common descriptions include:
A dull ache in the testicles
A sense of heaviness or fullness
Pressure in the scrotum or penis
Increased sensitivity
A vague discomfort rather than sharp pain
The sensation may last a few minutes or longer, depending on how intense the arousal was and how long it was sustained. Practices like edging can increase the likelihood of feeling this discomfort simply because arousal is intentionally prolonged.
Why It Is Called Blue Balls
The term blue balls comes from the idea that blood pooling in the veins can sometimes create a bluish tint in the scrotum, although this is not common.
Most people with blue balls do not notice any visible color change.
If you ever notice deep purple discoloration, sudden swelling on one side, or severe pain, that is not blue balls and should be evaluated by a medical doctor right away.
When Testicular Pain Is Not Blue Balls
It is important to know when testicular discomfort should not be brushed off.
Seek medical care if you experience:
Sudden, severe testicular pain
Pain that is sharp rather than dull
Swelling or redness in one testicle
Fever, nausea, or vomiting with testicular pain
Pain following trauma
Persistent pain that does not resolve
Conditions like testicular torsion, infection, hernia, or other urologic issues can present with testicular pain and require prompt evaluation.
Blue balls should improve, not worsen.
How to Relieve Blue Balls
Because blue balls is related to congestion and nervous system arousal, relief strategies focus on reducing arousal, redistributing blood flow, and calming pelvic floor tension.
Ejaculation
Masturbation to ejaculation is one effective way to relieve blue balls. Ejaculation triggers muscle contractions and neurochemical changes that help reduce congestion and tension.
It also releases endorphins, which can reduce discomfort.
This is an option, not a requirement.
Letting Arousal Fade
You can also wait it out. As arousal decreases, blood flow naturally redistributes away from the genitals.
This takes time and patience, but it works.
Breathing and Nervous System Regulation
Slow, gentle breathing into the belly and pelvic region helps activate the parasympathetic nervous system, often referred to as rest and digest.
This can reduce pelvic floor muscle tone and help blood flow normalize.
You do not need to force relaxation. Just slow the breath and let the body settle.
Gentle Movement
Walking or gentle lower body movement helps circulate blood out of the pelvis and genitals.
A short walk around the block or light stretching can help ease discomfort.
Warmth
A warm shower or bath can help relax the scrotal tissues and pelvic floor muscles. Warmth encourages vasodilation and muscle relaxation, which can ease discomfort.
Mental Distraction
Shifting your focus away from sexual stimulation helps your nervous system downshift. Watching something neutral, doing a simple task, or changing environments can help arousal fade more quickly.
Often, a combination of these strategies works best.
What If Testicular Pain Keeps Happening?
If you experience frequent or persistent testicular pain that does not seem related to arousal, a medical emergency or condition, or does not resolve with the strategies above, there may be other factors involved.
Pelvic floor muscle tension, nerve sensitivity, referred pain from the lower back, movement patterns, stress, and past pain experiences can all contribute to ongoing genital discomfort.
This is where pelvic floor physical therapy can be helpful.
How Pelvic Floor Therapy Can Help
Pelvic floor therapists are trained to assess and treat the muscles, nerves, and connective tissues of the pelvis. For people with testicular pain, therapy may involve:
Evaluating pelvic floor muscle tone and coordination
Addressing breathing and pressure management
Improving blood flow and tissue mobility
Calming an protective nervous system
Gradual exposure and exercise strategies for pain related to arousal
Not all testicular pain is urologic. Sometimes the issue is muscular, neural, or related to how the body processes sensation.
Final Thoughts
Blue balls is real. It is temporary. It is not dangerous.
Understanding what is happening in your body can reduce fear, shame, and unnecessary worry. It can also help you respond with practical strategies rather than panic or pressure.
If you want deeper education on pelvic and sexual pain, anatomy, and evidence-based strategies for relief, I share additional resources, tutorials, and live discussions on my Patreon.
This information is not intended to substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a healthcare professional with any questions you may have regarding treatment, medications/supplements, or any medical diagnoses. This information is intended for educational purposes only and is in no way to substitute the advice of a licensed healthcare professional.
