Sex & Dating

The Truth About Blue Balls

Published On 10/05/2015 Published On 10/05/2015

You’ve probably heard (or used) the complaint. Maybe you’ve wondered if there’s any actual, real-life medical science to back up the complaint. Either way, you’re probably familiar with that anguished cry, so common in lust-stricken adolescent boys, in response to practically any interaction that could, maybe, potentially have evolved into a sexual encounter, but didn’t.

That’s right. We’re talking about blue balls.

Whether the term “blue” refers to the color or the mood of the testicles is unclear. But thanks to the faithful hard work of a few diligent medical researchers, we have reason to believe that maybe these tender testes aren’t just a metaphor for frustration after all.


A peculiar case review

In the year 2000, two epic events occurred: First, Outkast came out with Stankonia. Then the brave Drs. Chalett and Nerenberg published a case review in the journal Pediatrics on the topic of blue balls.

They chronicle the trials and tribulations of a 14-year-old boy who was brought to the emergency room (undoubtedly at the behest of a nervous mother) after he had a new onset of severe bilateral testicular pain for an hour and a half. His pain was sharp, stabbing, and constant, but he had no other symptoms.

A physical exam was positive only for diffuse scrotal tenderness...

He denied having any trauma or sexual interactions prior to the onset of his pain. In the hospital, a physical exam was positive only for diffuse scrotal tenderness that was the most intense at his epididymides (the body’s storage facilities for mature sperm).

I’m sure anyone who’s ever seen a medical drama on TV knows that every patient lies. We all do. Well, at least some of us do. A 2010 survey of patients found that 28% admitted to lying or omitting information from their doctors (and the other 72% were probably lying about not lying).

History has ignored a medical condition that’s been sitting in our laps practically forever.

This patient’s omission was an extremely common one. It finally came out (hah!) that he’d had several of these episodes prior to his emergency room visit, each of which was after brief episodes of kissing and heavy petting with his first girlfriend. He was left with these terrible testicular pangs.  

Finding relief

Fortunately, there’s a happy ending to our poor teen’s journey. A follow-up phone call found that his episodes of ball pain went away when the boy’s first relationship intensified to the level of sexual intercourse. Or, as we physicians call it, “doing the nasty.”  

The authors then chronicled their exhaustive search of the annals of modern and ancient medicine for more information about the orbs of azure. They unfortunately came up short. Except for a few anecdotal cases in the literature, and a sworn-by cure which involves attempting to lift up a car by the bumper, they found that history has ignored a medical condition that’s been sitting in our laps practically forever. 

Flickr/Valerie Everett

Where does that leave us?  

With our tails between our legs, I suppose. Dissatisfaction with unfruitful romantic outcomes is a part of life, and may continue to result in phantom genital pains. There’s certainly no place for unwanted sexual satisfaction just to relieve this condition. Perhaps we can find other ways of dealing with such situations… like self-treatment.

If you choose the latter route, be forewarned by the cautionary “Letter to the Editor” response to the blue ball case review, penned by Drs. Weinzimer and Thornton, in which they remind us of the ever-present risks of self-treatment, including developing blindness and palmar hypertrichosis (Google it, bro).


A medical perspective

Medical inside jokes aside, I’ve seen numerous patients in clinic for complaints of testicular pain. In fact, studies have suggested that the number of patients with testicular pain of unknown origin (or, as we call it, idiopathic pain) has been increasing. Patients coming to see urologists for idiopathic testicular pain typically are in their mid-to-late-30s and have normal physical exams. The pain can be exacerbated by exercise, heavy lifting, and sexual activity.

Have I ever given someone the diagnosis of “blue balls”? No. Have I wanted to? Absolutely. So maybe we’re really just putting a fancy term on “blue balls” by calling it “idiopathic testicular pain.”

The future of blue balls

Despite the efforts of the few brave researchers mentioned previously, more studies are needed if we want to better understand this condition. Does trying to lift a car up help relieve blue balls? I hope someone out there convinces the National Institutes of Health to fund that study. Who knows? Maybe one day we can finally eradicate the world of blue balls.

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Dr. Cameron Hill is a urologist in Washington, DC, who is no longer invited to family gatherings due to his propensity for telling tales of phallic disasters.



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