Blue balls is the slang term for a congested prostate or vasocongestion. This is a 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 oedema of the testes.
While the term "Blue balls" is usually applied to men, the female homologue is usually referred to by the more general term "pelvic congestion," or "pink ovaries."
Two primary causes identified for blue balls are sexually transmitted disease and lack of orgasm in a sexually stimulated male.
Sexually transmitted disease
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 oedema (swelling) of the affected area.
Lack of orgasm
The cause is the prolonged sexual stimulation of the erect penis (intentional or unintentional), either by direct or indirect contact, 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 arousal in a human male, the parasympathetic nervous system increases its inputs to the genital tissues, resulting in increased blood flow to the testicles and prostate areas. As this happens, other fluid outflow muscles constrict, causing less bodily fluid to leave the area than enter, ensuring a high enough regional blood pressure to allow a sustained erection for penetration during sexual intercourse.
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 orchalgia may experience an extreme, prolonged form of blue balls, which may require medical attention.
The easiest way to relieve the symptoms of blue balls is through ejaculation. 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. 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 region 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; however, analgesics do not generally help as they do not involve prostaglandins.
Homologous condition in women
Women can also experience discomfort due to unrelieved vasocongestion as their pelvic area also become engorged with blood during sexual arousal. They can experience pelvic heaviness and aching if they do not reach orgasm. The general term pelvic congestion refers to such pain as it occurs in either sex.
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