The Science of Blue Balls
/The topic of blue balls has recently come up for me in conversations—you know, as just a thing young adults talk about. What is it? Does it actually exist? What does the medical world say about it? Is it “real”? As a sex educator, of course I wanted to dig deeper and find out more.
For those who aren’t familiar with the term, “blue balls” refers to the phenomenon in which a person’s testicles allegedly turn blue because of unreleased pressure during sexual arousal. Basically, during arousal, blood flows to the penis to allow it to become hard, or erect, and sperm readies itself to exit the penis through ejaculation. The idea is that when the sperm are not released through ejaculation, it creates an aching, painful sensation or pressure that has been termed “blue balls.” In other words, it’s the pain and discomfort caused from not getting off.
Before I dove into medical research on the subject, I wanted to explore the language we use to describe blue balls. I googled “blue balls” and perused the top hits.
From an article on dudeproducts.com, we get language such as this:
“But seriously, blue balls is totally a thing—and it can be agonizing. So, what exactly is this scrotal suffering? How does it happen? Is there hope for the afflicted?”
An article on askmen.com adds:
“The more easily you're aroused, the more likely you'll suffer the wrath of blue balls.”
A Men’s Health article states, “For centuries, men have bemoaned the scourge of blue balls.”
Urban dictionary describes blue balls as “a ridiculously painful condition” and one user wrote, “It felt so brutal. I held my balls in pain but it was like they were replaced by sad blue bags of disappointment.”
“Sad blue bags of disappointment”?? For real?
What does this language suggest?
It paints the condition of blue balls to be one of agonizing pain and suffering. It insinuates that this suffering should be avoided at all costs—why would anyone want to feel that amount of pain and discomfort? It touches on the “disappointment” men feel when they’re not given the orgasm they expect. It calls upon the traditional gender norms that women should please their men and that men should not have to suffer any denial of sexual pleasure.
Indeed, it was presumed by myself and my female peers growing up that blue balls was a condition to be avoided at all costs and one that women were expected to prevent and alleviate during sexual interactions. The blue balls excuse was used both externally by male partners pressuring women to finish them off and internally by women feeling they needed to follow sexual acts to completion for their male partners in order to avoid hurting them.
The excuse of blue balls has been used to perpetuate the patriarchal “norms” that privilege male pleasure and sexual experience over anyone else’s.
But are blue balls real? Or has the condition been made up and/or exaggerated to support the patriarchy?
I turned to medical literature.
I did some basic google searches and found that blue balls has also been called epididymal hypertension or vasocongestion, or I even found it being called DBS, or deadly sperm buildup. So, besides the last one, these terms made it seem like it could be a “legit” medical condition.
Yet, even using those search terms, I found little to no information in the (albeit limited) medical journals I have access to on the concept of blue balls. I even reached out to my mother, a family physician, and my graduate school professor, a pediatrician who teaches our Reproductive Biology class, and they couldn’t find any additional literature either.
My searches only came up with one article in Pediatrics and two associated Letters to the Editor commenting on that article.
The original article, published in Pediatrics in 2000, detailed a 14-year-old male who showed up at the ER with 1.5 hours of prolonged scrotal pain. After an hour of observation, the pain receded and he left the ER. The article detailed that “Telephone follow-up several weeks later revealed that the patient had begun to have sexual intercourse with his girlfriend, and no further episodes of testiculoscrotal pain had occurred.”
Of course, I couldn’t help but wonder if the patient used his pain as an excuse to get his girlfriend to have sex with him…. But, who knows.
The rest of the one-page article described the complete lack of any reference to blue balls in medical literature as of 2000 and physicians’ lack of medical understanding of the phenomenon. It then went on to suggest that the treatment was sexual release or perhaps lifting something heavy like a car bumper. (LOL—what??)
The letters to the editor, also from 2000, disputed the treatment option of lifting car bumpers as the first choice when masturbation is such a clear solution (thank you). Yet, another letter expressed concern of unilaterally advocating for such a controversial solution like masturbation, claiming the adverse effect of blindness. (The only source of this was “personal communication” from “our mothers” so….)
When I reached out to my professor regarding this lack of literature, he reminded me of the danger of using only the medical establishment to confirm or reject possible real-life experiences. I had definitely heard stories from male friends of their very real experiences of blue ball pain—why would they make that up?
I was reminded of the history of the medical field—doctors and researchers alike—discounting the very real pain of black folks in particular: for example, the incredibly painful experiments without anesthesia on female slaves by the doctor heralded as the man who devised effective treatment for vesicovaginal fistulas. Or the experiments conducted on black prisoners by the world-famous dermatologist that left them with painful sores and lifelong medical complications. I’ve heard stories even today of black women being denied pain relief when they turn to medical professionals for help. There is a history of Western medicine discounting folks’ pain that deserves attention.
And also, I think about how the experience of blue balls has been used by privileged men, not just wealthy, white men but by men generally who inherently have privilege through their gender, to coerce and force women (probably womyn* too, I’m just less familiar) into having various forms of sex against their will.
Regardless of the discomfort in someone’s genitals, no one should ever feel they need to have sex to relieve someone’s pain.
So, here’s what I can leave you with:
1) No medical research can confirm that the testicles actually turn blue from a lack of sexual release—that piece might be a myth. If they are turning blue, it could be indicative of a more serious problem, like testicular torsion, that requires immediate medical attention.
2) It was also pretty clear in my search that the condition is not a dangerous one. There is no risk of rupture, permanent damage, or death (of sperm or patient).
3) Masturbation is great. Jerk off, yank one out, beat the bishop…. Masturbation is a safe, risk free way to embrace pleasure and release sexual tension (regardless of anatomy!). It will not make you blind or cause your hands to get hairy, despite what those doctors’ moms say.
4) Folks with vulvas get sexually frustrated, too! I kept thinking in my research, why aren’t blue vulvas being talked about?? How many times have I had to suffer the “excruciating pain” of my male partner getting off while leaving me with not even an inkling of attention for my lady parts? Male pleasure is expected and prioritized; female pleasure is ignored and devalued.
5) And the key message I hope you all leave with: no one should ever feel coerced, pressured, or forced to have any kind of sex they don’t want. Blue balls, or literally anything else, should not be a reason to finish someone off. Everyone is responsible for their own pleasure—as Men’s Health says, “go be a man” [or a woman, or a person!] “…and take care of yourself.”
*womyn: Many folks identify as women but don’t have vulvas or uteruses. The spelling of women as “womyn” accounts for the fact that womynhood can be defined in so many ways and all are great.
