What is Epididymal Hypertension? (The infamous term Blue Balls)

The term blue balls occurs when an erection lasts for an extended period of time without achieving an orgasm. The medical term is epididymal hypertension. It is not a serious condition, but at times it can be very uncomfortable.

What are the main symptoms of blue balls?

Epididymal hypertension symptoms affect the testicles which cause:

  • Pain
  • Discomfort
  • Heaviness
  • Aching

Despite the term “blue balls,” they typically won’t turn blue. A bluish or purplish hue on the testicles may be a sign of a serious condition known as testicular torsion which would require immediate medical attention.

Why do blue balls occur?

When a male person is aroused, the blood vessels to the penis and testicles dilate to allow an increased volume of blood flow.  The increased blood flow causes the penis to expand and stiffen, resulting in an erection.

Typically, this blood is released after orgasm or as a result of decreased physical arousal. Sometimes an increased volume of blood may stay in the genital area of those who become aroused for an extended period of time without a release or decrease of arousal. This could cause pain and discomfort.

When should you see a doctor?

You would not need to see a doctor or clinician about EH usually as it is not serious. If it’s causing you intense pain regularly or impeding your sexual performance, talking with your primary care doctor, urologist, or a sexual therapist would be beneficial.

If you experience strong, persistent testicular pain not associated with sexual activity, see your doctor so they can rule out other conditions that may be causing your pain.

You should also see your doctor if you have the following symptoms in addition to pain:

  • A lump or enlargement in either testicle
  • Dull aching in the groin area
  • Pain in the lower back
  • These symptoms may indicate a more serious problem, like testicular cancer.

Take home message regarding “Blue balls”

Blue balls refers to the pain or heaviness sensation caused by a delayed orgasm. Not all males will experience this and most of the time it is not serious or would need medical attention. If it concerns you, it would be advised to talk with your doctor or a sex therapist if epididymal hypertension causes you significant pain or affects the quality of your sex life. Consistent pain in the testicles, especially if it’s unrelated to sexual stimulation, may indicate a more serious problem that would need a detailed history and examination. 

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