Blue balls: is it real?

Blue balls is a familiar phrase with very little science behind it. When researchers at Queen's University in Canada reviewed the literature for a 2023 survey, they found only one interview-based study and one case report on it, and a 2025 history in Sexual Medicine Reviews says it has little coverage in the sexual medicine literature.

What is blue balls?

Blue balls is slang for pain or aching in the testicles after heightened sexual arousal that doesn't end in orgasm. The 2023 study in Sexual Medicine calls it epididymal hypertension and describes it as "scrotal pain following heightened sexual arousal that did not result in orgasm".

The term was reportedly first used in America around 1916 and is still widely used in American popular culture. Almost everyone in the survey had heard of it: only 2.8% of people with a penis had never heard of blue balls.

Is blue balls real?

Blue balls is a real thing for plenty of people who report it, but it has barely been studied. In the 2023 survey, 56% of 1,483 people with a penis said their testicles or the area around them had hurt or ached when they approached orgasm but didn't ejaculate.

The survey was developed by the team behind the Science Vs podcast and ran online in September 2021 through the podcast's social media. Levang and colleagues at Queen's University in Canada then analysed and published the data. Of the 2,621 people who took part, 1,483 had a penis and 1,138 a vagina. Among those with a penis, 41.5% believed blue balls is real, 27.6% didn't, and 28.2% weren't sure.

Its limits: the people who answered had seen the podcast's adverts, the survey didn't ask basic details such as age, and some of the pain described might be better explained by another genital pain condition or intense sexual activity.

The 2000 case report, as the 2023 paper describes it, was of a 14-year-old boy with sharp pain in the scrotum after sexual activity without orgasm. He had no other symptoms, and the pain went away without treatment after a few hours.

What causes blue balls?

Nobody has proved what causes it. One theory is about blood flow. During an erection, blood fills the genitals, and after orgasm the veins quickly empty again. Without orgasm, the theory goes, blood drains from the testicles more slowly, and the longer congestion causes discomfort and pain.

People in the survey named causes such as long foreplay or making out without intercourse, and not ejaculating. More on both in our pieces on foreplay and the male orgasm.

What does blue balls feel like?

Most people described a mild ache or pressure. People described pain, aching or throbbing, pressure or tension, and discomfort, felt in the testicles or the groin. Of the 851 people with a penis who rated it, 57.8% called the pain mild, 35.5% moderate and 6.7% severe.

Those with moderate pain described swollen testicles, and some with severe pain described sharp pains, trouble walking and hospitalisation. Most found it rare: of 901 who answered, 45.5% said it happened very rarely and 35.0% rarely, while 2.1% said it happened every time they didn't ejaculate.

How long does blue balls last?

Usually from a few minutes to a few hours. The 2023 study says it appears to resolve on its own, usually over a few minutes to hours, or with orgasm. Many respondents said it lasted from a few minutes to under an hour, others several hours, and some with a penis described it lasting days.

Testicle pain that lasts more than an hour is one of the NHS's reasons to go to A&E, so don't assume a long-lasting pain is blue balls (see below).

How to get rid of blue balls

Blue balls appears to resolve on its own. The authors of the 2023 study say options outside partnered sexual activity exist as a remedy, and list masturbating to orgasm alone, waiting it out, a non-sexual distraction, exercise, breathing slowly to bring the heart rate down, peeing, and a cold shower or bath.

The 2023 paper describes no trial of any of these. In an earlier interview study the authors cite, people said sleep, studying, other activities and time helped, and for some, orgasm didn't ease the pain.

Do balls actually turn blue?

The name comes from the blood-flow theory: its supporters link "blue" to blood low in oxygen looking blue under the skin of the scrotum. The 2023 paper presents this as a theory and reports no measurement of colour.

The complaint is older than the name, which dates from around 1916. The 2025 history, which calls blue balls a mundane complaint, found doctors describing similar scrotal pain from the 1820s to the 1920s, under names such as "testicular neuralgia", "spermatic colic" and "stone-ache".

Can women get blue balls?

Something similar is reported. In the 2023 survey by Levang and colleagues, 42.1% of 1,134 people with a vagina said their vulva or clitoris had hurt when they approached orgasm without having one, and 83.9% of those who rated it called the pain mild.

The popular press has called it "blue vulva", "blue clit", "blue bean" and "pink pelvis". The ways of easing it that the study lists apply to both.

Is blue balls a reason to keep going?

No. The 2023 survey study concludes that the pain of blue balls is not a valid reason to continue unwanted sexual activity, and points out that it can be eased without a partner. The authors note that earlier research describes blue balls being used "as an instrument of persuasion to coerce women into engaging in sex on compassionate grounds".

Even so, 40.1% of the people with a vagina who answered the survey said a partner had pressured them sexually because of a fear of blue balls, against 3.7% of people with a penis.

If someone has made you do something sexual you didn't agree to, the NHS lists places to get help, including sexual assault referral centres (SARCs), a GP, a sexual health clinic and NHS 111.

When is testicle pain an emergency?

The NHS says to go to A&E immediately or call 999 if you have:

• sudden, severe pain in a testicle
• testicle pain along with feeling sick, being sick or pain in your tummy
• testicle pain that has lasted more than an hour or continues when you're resting

Sudden, severe pain can be caused by the testicle twisting (testicular torsion), which can lead to losing the testicle if it isn't treated quickly.

Pain with a tender, warm and swollen scrotum can be epididymitis, where a tube behind the testicles becomes swollen and painful. The NHS says it's often caused by an infection: in men under 35 a sexually transmitted infection such as chlamydia or gonorrhoea is more likely, and over 35 the main cause is usually a urine infection. It's usually treated with antibiotics, from a GP or a sexual health clinic.

Ask for an urgent GP appointment or get help from NHS 111 if you have aching or discomfort in your testicles that you're worried about, a lump, swelling, or a change in their shape or feel, or one testicle has become bigger than the other.

The NHS says not to try to self-diagnose testicle pain: get medical help if you're worried. For more answers like this one, see our men's sex questions hub.