Blue balls

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Epididymal hypertension
Other namesSexual arousal orchialgia[1]
The phenomenon manifests itself in the form of mild discomfort around the genitals or in the lower abdomen.

Epididymal hypertension, informally referred to as blue balls for men or blue vulva for women, is a harmless but uncomfortable sensation in the genital regions during a prolonged state of sexual arousal.[2][3] It usually resolves within hours unless relieved through an orgasm.[4]

In women, it occurs in the erectile tissue and clitoris of the vulva.[3][4] In men, the phenomenon results in an uncomfortable testicular sensation.[5] Most often it describes a temporary fluid congestion in the testicles, caused by prolonged sexual arousal without ejaculation.[6][7]

The term "blue balls" is thought to have originated in the United States, first appearing in 1916.[8] Though lesser known, the equivalent of this phenomenon in women is informally referred to as "blue vulva", among other names.[4] It is not to be confused with the inability to orgasm or the practice of edging.


The phenomenon is sometimes associated with men who are experiencing and practicing delayed, multiple,[9] or inhibited ejaculation.[10] There is scant information on the phenomenon in scientific literature.[11] Little formal data exists regarding the condition. The treatment is sexual release, or perhaps straining to move a very heavy object—in essence doing a Valsalva maneuver.[12]


The cause of epididymal hypertension is a large amount of blood circulation to the genital area. In specifically the penis and testicles, without the release of tension associated with orgasm and ejaculation. When a large amount of blood flows to the genital region, the penis becomes erect and the testicles also experience increased blood flow and swelling.[3] In the vulva the erecticle tissue increases in blood flow, causing them to expand. When a person reaches orgasm, the tissue shrinks back to its initial size, as most of the blood leaves. When this does not occur it can cause mild discomfort.[4]


The following indications and symptoms may be experienced by both sexes:[4]

  • heaviness
  • aching
  • discomfort or mild pain

See also[edit]


  1. ^ Wiener, SL (1990). "Testicular Pain". In Walker, HK; Hall, WD; Hurst, JW (eds.). Clinical Methods: The History, Physical, and Laboratory Examinations (3rd ed.). Boston: Butterworths. PMID 21250139.
  2. ^ Fergusson, Rosalind; Eric Partridge; Paul Beale (December 1993). Shorter Slang Dictionary. Routledge. p. 21. ISBN 978-0-415-08866-4.
  3. ^ a b c "Is Blue Balls Real?". Cleveland Clinic. 18 January 2023. Retrieved 28 November 2023.
  4. ^ a b c d e Bhattacharya, Mallika. "What Is Blue Vulva Syndrome?". WebMD. Retrieved 28 November 2023.
  5. ^ Byrne, Lauren N.; Meacham, Randall B. (2006). "Management of Post-Ejaculatory Perineal Pain". Journal of Andrology. 27 (6): 710–711. doi:10.2164/jandrol.106.001370. ISSN 1939-4640. PMID 17079745.
  6. ^ Yazmajian, Richard V. (1967). "The Influence of Testicular Sensory Stimuli on the Dream". Journal of the American Psychoanalytic Association. 15 (1): 83–98. doi:10.1177/000306516701500103. PMID 6032147. S2CID 7093435.
  7. ^ Glenn, Jules (1969). "Testicular and Scrotal Masturbation". International Journal of Psycho-Analysis. 50 (3): 353–362. PMID 5387383.
  8. ^ Dalzell, Tom; Victor, Terry (December 2007). Sex Slang. Routledge. p. 16. ISBN 978-0-415-37180-3.
  9. ^ Parnham, Arie; Serefoglu, Ege Can (August 2016). "Retrograde ejaculation, painful ejaculation and hematospermia". Translational Andrology and Urology. 5 (4): 592–601. doi:10.21037/tau.2016.06.05. ISSN 2223-4691. PMC 5002007. PMID 27652230.
  10. ^ Perelman, Michael A. (2001). "Integrating Sildenafil and Sex Therapy: Unconsummated Marriage Secondary to Erectile Dysfunction and Retarded Ejaculation". Journal of Sex Education and Therapy. 26 (1): 13–21. doi:10.1080/01614576.2001.11074377. S2CID 141603559.
  11. ^ Komisaruk, Barry R.; Beverly Whipple; Sara Nasserzadeh; Carlos Beyer-Flores (November 2009). The Orgasm Answer Guide. The Johns Hopkins University Press. p. 70. ISBN 978-0-8018-9396-4.
  12. ^ Chalett, J.M.; Nerenberg, L.T. (2000). "'Blue Balls': A Diagnostic Consideration in Testiculoscrotal Pain in Young Adults: A Case Report and Discussion". Pediatrics. 106 (4): 843. doi:10.1542/peds.106.4.843. PMID 11015532. S2CID 36966128.

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