Blue Balls Unpacked: Sex, Science, and Social Myths
Blue Balls Unpacked: Sex, Science, and Social Myths
You might have heard the term “blue balls” thrown around over the course of your life, whether it was in a locker room, a comedy movie, or even a doctor’s office. The term has a lot of baggage attached and little science to back it up, but a new ISSM article “Blue balls: a brief history” by Dr. Diederik F. Janssen is trying to change that.
Studying the history of the term blue balls from its earliest recordings in the 1800s to the present day, Janssen documents how society’s ideas have changed over time and how those changes are informed by other ideas about sex, behavior, and health.
How do “blue balls” figure in myths about sexual entitlement? Jansen explains that men use the term to complain that a usually female sexual partner is “leading them on.” The term refers to testicular pain as a consequence of arousal without orgasm. It has been used as a justification for pressuring a partner into having sex.
Around the 1950s, blue balls came into use as a slang term but mentions of it are seen earlier in medical references. Eighteenth-century people (particularly in the Western, white world) were concerned with semen retention: they thought that blue balls occurred because the person was either too chaste or engaged too frequently in masturbation rather than partnered sex within marriage — a seemingly bizarre contradiction. The pain indicated the danger of semen being created but not excreted. Often marriage was seen as the only “cure.” However, occasionally, some doctors resorted to castration if their patients were in acute distress. It’s interesting that it’s been used to both demonize and support masturbation as well.
Particularly, it’s worth looking at the idea of sexual entitlement that Janssen refers to in the abstract of this paper. Modern connotations often connect blue balls with a failure on women’s part to meet the “biological needs” of men, using the self-reported pain and discomfort of the condition to guilt-trip female partners by emphasizing the “victimhood” of the afflicted man. In fact, another version of the term is the act of “blue balling” which puts the onus on the other person as a torturer and antagonist.
Over time, science refuted the idea that semen was a valuable biological resource that the body couldn’t afford to “waste.” As fears about “semen retention” lessened, along with the advent of oral contraception and increased acceptance of premarital sex, so did medical concern. Because of this, it’s possible that rather than changing our mindsets about blue balls, we just stopped needing to think about it as much.
These days, blue balls isn’t really seen as a serious medical issue-it’s more of a punchline or a way to blame women for men’s sexual frustration. This shift says a lot about how our attitudes around sex and gender have changed. It also connects to things like the “incel” (involuntary celibate) phenomenon, where mostly men feel angry or resentful because they can’t find romantic or sexual partners. These men blame women or society for their situation, and there’s a similar vibe to how blue balls gets used — to guilt-trip or pressure partners by making male discomfort someone else’s fault.
In both cases, the idea is to push the narrative that men are owed something-whether it’s sex or sympathy. Blue balls used to be talked about like it was a big biological emergency, but now it’s mostly an excuse or a way to point fingers. At the end of the day, both ideas keep old-fashioned, sexist attitudes alive, showing how these myths stick around and adapt to whatever’s going on in society.
Janssen DF. Blue balls: a brief history. Sex Med Rev. 2025 Apr 10:qeaf015. doi: 10.1093/sxmrev/qeaf015. Epub ahead of print. PMID: 40207903.
