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Are Your Balls Sore After Ejaculation? We Can Help!

Dr. Joe Pazona

When men hurt in the private region it’s an emergency. Even if it’s not really a medical emergency, we consider it one. This is a VERY SENSITIVE area and we put a lot (let’s be honest, MOST) of our self worth in our frank and beans.

So when it hurts down there, we freak out. The problem is that men don’t like doctors (myself included, and I’m a urologist!). We also don’t know who to trust on the internet. This is not the time to get advice from some random bro on Quora or Reddit.

If your balls are sore after ejaculation, and this is causing you distress, then you’ve come to the right place. VirtuCare was founded by a board-certified urologist (me) to make certain everyone had affordable access to medical experts.

Let’s review the possible causes of achy balls after ejaculation so you can quickly figure out what’s going on.

But first let’s provide some reassurance and state . . .

If your balls are sore ONLY after ejaculation then there’s PROBABLY nothing bad going on.

Let’s be clear. We cannot provide you with a definitive medical diagnosis just by reading a blog article. This is not a substitute for an evaluation with a board-certified urologist. With that medico-legal disclaimer aside, it’s unlikely something serious is the cause of your sore balls after ejaculation if:

  • You are only “sore” and not in extreme pain.
  • The ball soreness alternates sides.
  • The pain is not associated with any other activities or at rest.
  • There is no associated swelling, bruising, lumps or bumps.


If this sounds like you then take a deep sigh of relief and keep reading. On the other hand, you should seek immediate medical attention if you have:

  • Severe testicular pain on one side that is constant.
  • Swelling of the scrotum.
  • A hard mass of the testicle.


Testicular torsion, epididymitis, inguinal hernias and testicular cancer will typically present with one or many of the above symptoms. They are usually not subtle. When in doubt, go see a doctor immediately for an evaluation.

Now that we’ve split the crowd into the “reassured nothing is wrong” vs. “you need to see a urologist ASAP”, we can review the different non-serious causes of sore balls after ejaculation.



Are you surprised that after you bounced your door knockers repeatedly against your partner that they are now sore? Your sore balls after ejaculation may simply have been caused by you beating up your buddies a little too much in the bedroom. If your ball sack is on the droopier side, then they can swing like a pendulum during sexual intercourse.

Our advice . . . take it easy. You may think the jack hammer technique is preferred by most partners, but it is not (well, sometimes it is).

Don’t worry, the likelihood of a testicular rupture or real injury is slim to none unless you took an actual hammer to the junk.


Varicoceles are swollen veins leading to the left testicle. They are seen in up to 15% of men. Sometimes they are visible as a “bag of worms” inside the scrotum. Other times, a varicocele can present as sore balls after ejaculation.

Not only will your ball bag hurt after ejaculation, but it may feel achy at the end of a long day or exercise. Wearing tight underwear can help provide the support necessary. When the pain is bothersome enough, then there’s a surgery to fix the problem.

Don’t worry, the veins won’t burst if you decide to deal with the discomfort.

Epididymal congestion

Most men think of “blue balls” as a build of semen from not ejaculating. Not true. Your semen is made by the prostate and seminal vesicles deep in your pelvis. Very little fluid is produced by your balls.

The primary cause of “blue balls” is epididymal congestion or an increase in blood flow to the testicle and epididymis (squishy hockey stick sitting on top of and behind the testicle). This happens to guys more often during the teenage years when erections are as common as a burp.

During sexual arousal, blood flow to the whole pelvic area increases. If a sexual encounter is prolonged (e.g. “edging” or intentionally delaying orgasm), then it may take a while for the blood to leave the balls. Congestion of blood equals balls that are sore even after ejaculating.

Muscle spasms

The primary cause of sore balls after ejaculation is a musculoskeletal issue. Just like most headaches aren’t caused by brain cancer, most sore balls are not caused by testicular cancer or an infection. You probably just strained a muscle.

There are a series of muscles lining the perineum (taint) in both men and women. These muscles contract both before and during orgasm. The contraction of pelvic floor muscles is responsible for the pleasurable feeling of an orgasm.

Every man who’s ever come out of a cold pool, only to find his balls up by his throat, knows that the testicles have muscles attached to them as well. The cremaster muscles run alongside the blood vessels and vas deferens heading to the testicles. These structures together are known as the spermatic cord.

During ejaculation the pelvic floor muscles and cremaster muscles contract. If this is very intense, then the muscle can spasm leading to pain. For many men, this means the balls are sore after ejaculation. Other men may experience pain in the penis, taint or anal regions.

Aside from an intense orgasm, pre-existing muscle tension of the lower abdomen and pelvis can also lead to sore balls after ejaculation. While some men hold their stress in their neck or lower backs, others hold their stress below the belt. A tight pelvic floor is the issue.

Some men may hold tension in their private area because of a previous negative sexual encounter or relationship trauma. A bad breakup, concern over a sexually transmitted disease, or an episode of poor performance in the bedroom, can all lead to chronic pains “down there”. Don’t worry, you’re not alone and you’re not crazy. We all manifest stress in different ways.

How can I treat sore balls after ejaculation?

You should approach the treatment of sore balls after ejaculation in a similar fashion to how you’d treat any musculoskeletal discomfort.

  • Rest
  • Heat/ice packs
  • Over-the-counter pain medications (e.g. acetaminophen, ibuprofen)


Again we are assuming there is no severe swelling of your scrotum, fevers, or nausea/vomiting.  If you’re truly “sore” then then treat it like any other sports injury with a little “R&R” (that’s rest and relaxation for the type A folks reading this article).

You may also find that changes in underwear help with sore balls after ejaculation. Some men like letting them hang with loose fitting clothes. Others may find relief with “tighty whities”. In fact, compression shorts like these high quality ones on Amazon, can help relieve sore balls.

How can I prevent sore balls after ejaculation?

Assuming you’ve rested your boys and you’re ready to go at it again, there may be some ways to prevent ball soreness before it starts.

First, you can take an occasional Tylenol or Ibuprofen ahead of time. Just as you’d take some OTC pain medication for back pain before hitting the gym. Of course, follow the directions on the bottle and check with your primary care doctor to make certain there are no contraindications to either of these options.

Second, don’t try and keep with your Porn Hub idols. Beating up your buddies for 45 minutes is not always the best idea. Take it easy.

Lastly, take a deep breath and relax. Anxiety isn’t going to help the situation. Focus on your pelvic muscles (AKA “taint”). Are they tighter than your skinny jeans? If so, this tension is going to worsen the situation.

My balls are STILL sore after ejaculation! What should I do?

Still having trouble? Now it’s time to meet with the expert. Urologists specialize in all things related to your balls (it’s a glorious job that is my calling . . . don’t judge).

A good history and physical exam should be the mainstay of an evaluation. This will often rule out anything serious. At times, a urologist will also order a scrotal ultrasound to dot the “i’s” and cross the “t’s”. Usually the ultrasound will be normal but a little reassurance never hurt anyone.

One of the more effective treatments for ball soreness is pelvic physical therapy. They are experts at relieving muscle tension in the pelvis. Through a series of exercises, pelvic therapists can help you get on the road to recovery.

Just as a trainer will help you achieve more optimal results in the gym, a quality physical therapist can help speed along your recovery. This is not a quick fix however. It may take several months to improve the situation.

Lastly, it’s important that you practice self-care. It’s amazing how often pain improves with improvements in diet, exercise routines, sleep habits and mindfulness. If you’re not caring for your mind and body, then it often manifests as lingering pain.

Listen, no one is doubting that your balls are sore. But most of the time, there is nothing anatomically wrong that can be fixed. Shifting your mindset from “there’s something wrong!” to “this sucks, I’m going to do everything I can to feel better!” is a powerful Jedi mind trick that can make a world of difference.

If you need a little more guidance on your sore balls, then maybe a telemedicine consultation with a VirtuCare urologist is what you need. We will listen to your concerns, and if necessary, help you find an in-person urologist for a thorough exam.

Don’t let sore balls keep you from getting busy in the bedroom. We can help!


Dr. Joe Pazona

Dr. Joseph Pazona is the founder and President of VirtuCare, a telemedicine solution for connecting patients with physician experts.

We’re here to help.

At VirtuCare, we believe that patients deserve direct access to the experts. There should be no gatekeeper standing between you and a healthcare specialist. VirtuCare puts you in control.

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