Blue Balls (Epididymal Hypertension): Causes, Symptoms, & Treatment

What Are Blue Balls (Epididymal Hypertension)?

Epididymal hypertension, or commonly called blue balls, is a condition that affects males. The condition causes discomfort, mild pain, aching, swelling, and heaviness in the testis. This occurs after a prolonged sexual arousal, without ejaculation and orgasm.

The name blue balls is derived from the bluish color of the testes, which results from the increase in blood volume in the area and engorgement of blood vessels. The swelling in the blood vessels is eliminated after ejaculation.

This condition is not dangerous. Symptoms may resolve on their own, by masturbating, or with a decrease in sexual arousal. The condition is more common in young men (14 to 35 years old).

What Is the Difference Between Blue Balls and Blue Vulva?

Basically, blue balls and blue vulva are the same, but occur in different anatomies.

• Blue balls is the uncomfortable feeling in the scrotum due to a prolonged state of sexual arousal. Whereas, females may also experience symptoms similar to this (discomfort and aching in genital areas), and it is referred to as blue vulva (also called blue cit or blue bean).

• Both occur due to engorgement of blood vessels in the genital area.

• Blue vulva does not turn blue; it's just a slang comparison to blue balls. In contrast, in blue balls, the scrotum may have a blue tint because of increased blood flow.

What Are the Causes and Risk Factors of Blue Balls?

Various factors can lead to blue balls:

• Stress: Stress and physical discomfort are the common factors leading to the condition.

• Prolonged sexual arousal: Being sexually aroused for a long time. This causes fluid accumulation in the testicles. Also, there is increased blood flow, which makes the veins become narrower to keep the extra blood. After ejaculation, the pressure gets released, and the veins relax.

• Delayed or avoided ejaculation: Blue balls can also be due to delayed ejaculation and people intentionally avoiding ejaculation.

• No orgasm: Not achieving orgasm during arousal may cause the condition.

Factors that can increase the risk are:

• Delayed ejaculation: A condition that causes difficulty in ejaculation even after sexual stimulation.

• Anejaculation: Inability to ejaculate.

• Coitus reservatus: Deliberately avoiding ejaculation.

What Are the Symptoms of Blue Balls?

The symptoms of blue balls usually occur after sexual arousal and before ejaculation. Symptoms include:

• Pain. The pain may be sharp or dull, extending from the groin to the lower abdomen.

• Swelling.

• Discomfort.

• Heaviness.

• Bluish discoloration of the scrotum.

• Sensitive to touch.

• In addition, a person may feel a sensation of fullness in the testicles.

It is not necessary to see a doctor for blue balls; the symptoms usually resolve on their own (a few minutes to a few hours) or after ejaculation.

But if there is pain without being sexually aroused, like in cases that are mentioned below, it is important to see a doctor.

• Epididymitis (inflammation of the tube called the epididymis, which stores and transports sperm).

• Kidney stones.

• Orchitis (inflammation of the testicle).

• Testicular torsion (an emergency situation where the spermatic cord that supplies blood to the testes is twisted or cut off).

• Testicular cancer.

• Prostatitis (an inflamed prostate gland).

• Mumps (a viral infection).

• Diabetic neuropathy (nerve damage) in the groin area.

How Are Blue Balls Diagnosed?

The diagnosis of blue balls is usually based on its symptoms, physical examination, and tests to rule out other conditions.

• The doctor will assess the symptoms.

• A visual inspection and palpation will be conducted by the doctor.

• To rule out other conditions, ultrasounds, urine tests, and blood tests may be carried out.

What Is the Treatment and Management of Blue Balls?

The symptoms of blue balls resolve on their own. However, if the pain and discomfort persist, the person needs medical treatment. The remedies are as follows:

• Ejaculate: This is the most effective way to relieve the condition.

• Urinating: Urinating can reduce the pressure in the testes.

• Heavy lifting: Lifting and pushing heavy objects may flex the internal muscles, release the pressure on the testicles, and relieve pain.

• Exercise: The doctor may advise the person to practice exercise that relieves the pressure from the swollen testicles. Using a treadmill and push-ups may help the blood supply to the other body parts and away from the scrotum.

• Natural remedies: The condition is due to an alteration in the blood supply to the testis, leading to pain and discomfort. The problem can be solved by taking garlic to lower blood pressure.

• Divert the mood: The person may divert the mood by ignoring the thoughts and masturbation, which may lead to sexual arousal. It helps release pressure and provides relaxation to the scrotum. These include deep breathing exercises, reading, and sleeping.

• Cold showers: The cold compress, like an ice pack, may reduce the swelling.

• Over-the-counter analgesics: The doctor may advise Paracetamol, which helps with pain, and Ibuprofen, which helps reduce inflammation and swelling.

How Can Blue Balls Be Prevented?

To prevent blue balls, here are a few approaches:

• Avoid prolonged sexual arousal without release.

• Engaging in distracting activities like taking a cold shower, exercising, etc.

• Managing sexual activity with a partner or masturbation. If possible, communicate with the partner about arousals. But remember, it's nobody else's responsibility to relieve your sexual tension.

What Are the Potential Complications of Blue Balls?

Blue balls are something that can happen to males for a short time. It’s not dangerous and usually goes away by itself. However, complications are minimal, such as:

• Pressure in the pelvis.

• Dull, persistent pain in the groin area.

• Psychological distress (anxiety and irritability).

Conclusion:

Blue balls can happen to men after prolonged arousal. It can cause mild discomfort. The good news is, the feeling usually fades on its own within minutes or hours.

If it happens a lot, it’s a good idea to talk to a doctor. The doctor might suggest simple things you can do at home, like a cold shower, or other activities, to keep you distracted.

Blue balls do not cause any harm, but if the pain is strong or keeps coming back, it’s important to get it checked to make sure the pain is not caused by something else.

Note From iCliniq:

• Blue balls or epididymal hypertension is a condition that can cause an uncomfortable feeling in the testes due to prolonged sexual arousal.

• This condition is harmless and can be resolved on its own or after ejaculation.

• This condition is more common among young men.

• Having this condition does not require you to go to the doctor, because it can go away on its own. But if there is persistent pain with other symptoms, you need to see a doctor who can rule out other conditions.

If you have pain, heaviness in the testes, or other symptoms, talk to our iCliniq sexologist, who can help manage it and also improve your sex life.