Epididymal hypertension

For an animal with literally blue testicles, see Chlorocebus.

Blue balls is the slang term for a congested prostate or vasocongestion, the condition of temporary fluid congestion in the testicles and prostate region caused by prolonged sexual arousal in the human male. It is often accompanied by a cramp-like ache of prostatic congestion and pain/tenderness or edema of the testes, and is misconceptionally believed to have the symptom of a blue tinged scrotum (from the notion that blue equals pain, as in a bruise or black eye, which can also appear blue). Weinzimer and Thornton suggested calling it "epididymal hypertension".

Lack of orgasm

The cause is sexual activity of the erect penis (intentional or unintentional), that does not result in orgasm and ejaculation. This can, in some circumstances, be a consensual sexual act as part of erotic sexual denial.

During sexual arousal in a male, the parasympathetic nervous system increases its inputs to the genital tissues, resulting in decreased blood flow to the testicles and prostate areas. As this happens, other fluid outflow muscles loosen, causing less bodily fluid to leave the area than enters, ensuring a high enough regional blood pressure to allow a sustained erection for penetration during sexual intercourse. Erection occurs with the parasympathetic nervous system's local release of nitrous oxide, causing relaxation of the smooth muscles in the arteries of the corpus cavernosum and resulting in blood engorgement.

If orgasm is not achieved, blood and lymphatic fluid tend to pool, and the blood becomes oxygen-deprived. The technical term for this is vasocongestion.

Some men may deprive themselves of an orgasm purposely to prolong sexual activity. Their sexual partner may also request that they refrain from ejaculation for a longer period to increase their duration of sex. If this is the case, massaging the testicles or using a vibrator on the testicles during the prolonged sexual activity may prevent the blood from pooling and actually prevent or decrease the severity of blue balls.

Men with priapism or orchialgia may experience an extreme, prolonged pain that requires medical attention.

Other side effects

Some men may also experience other side effects. These can vary from a minor headache that generally wears off after a couple of minutes, or muscle cramps.

Sexually transmitted infection

Some men who are infected with sexually transmitted lymphogranuloma venereum may experience enlarged lymph nodes in the groin that become fluctuant and unable to flush lymphatic fluid correctly, resulting in edema (swelling) of the affected area.

Treatment

The easiest way to relieve the symptoms of blue balls is ejaculating. The resultant ejaculation jump-starts the sympathetic nervous system, which increases blood flow through the penis area, dissipating the fluid buildup. Even without orgasm, the symptoms of blue balls usually subside within an hour of onset, but they can also last much longer, up to 12 hours or longer in men older than 40. While well known in folklore, there was scant information in the medical literature until an article by Chalett and Nerenberg in Pediatrics 2000 which found little formal data regarding the condition but concluded that "the treatment is sexual release, or perhaps straining to move a very heavy object—in essence doing a Valsalva maneuver." Simply lying down can also sometimes help the pain associated with blue balls.

One folk remedy for blue balls is the cold shower. Putting cold substances on the crotch supposedly helps. Coolnurse.com states that "the cool water of the shower would stimulate new warm blood to the scrotum," but local cooling might instead work by causing arterioles in the scrotal skin to constrict, thus decreasing blood flow to those tissues and allowing fluid to leave the congested areas. Sometimes pseudoephedrine can help quicken the process.

Homologous condition in women

Women can also experience discomfort due to unrelieved vasocongestion as their pelvic area also becomes engorged with blood during sexual arousal. They can experience pelvic heaviness (aka blue walls, blue labia, blue box, or blue curtains) and aching if they do not reach orgasm. The general term pelvic congestion refers to such pain as it occurs in either sex.

See also

• Vasocongestion
• Erotic sexual denial
• Orgasm control

External links

• Understanding Male Sexuality
• CoolNurse.com Blue Balls article
• Discovery Health: Blue Balls
• AltPenis.com Vasocongestion