A Urologist Explains the Medical Phenomenon of Blue Balls

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Urologist and sex educator Rena Malik, MD uses her YouTube channel to dispel medical misinformation and bust myths around sexual health. In a new video, she addresses the sensation of pressure, heaviness, or discomfort that can be felt following sexual arousal when there has been no release. Despite “blue balls,” or epididymal hypertension, being a widely used term in popular culture, Malik says that there is a surprisingly small amount of medical literature on the phenomenon.

“Essentially, what we believe is that the sensation of blue balls is because there’s a buildup of blood in the testicles and pelvic area during sexual arousal,” she explains. “The blood flow to the penis and testicles increases, causing the testicles to get a little bit larger and more firm. If you’re having prolonged arousal, and it’s not getting released through orgasm or ejaculation, the blood does leave the area, but it can leave this uncomfortable heaviness feeling in the genitalia.”

It doesn’t mean they’re actually blue, however the blood that leaves the testicles in the veins is deoxygenated; what this means is that blood has traveled through the body to the testicles and given oxygen to those tissues, and after it leaves it goes back up to the heart and tends to have a little bit of a bluish color.”


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Perhaps even lesser-known, Malik goes on to say, is that blue balls aren’t exclusive to men. Women can experience a similar discomfort when they’re aroused and don’t achieve climax. Malik refers to this as “blue vulva.”

What’s important to remember, though, is that this sensation is temporary, and does not affect your health in any way. While sexual release is the most immediate form of relief for this problem, Malik also advises lying on your back and focusing on non-sexual thoughts, or using a cold compress or taking a cold shower. She adds that heavy lifting can also help to alleviate that blood flow.


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Philip Ellis is a freelance writer and journalist from the United Kingdom covering pop culture, relationships and LGBTQ+ issues. His work has appeared in GQ, Teen Vogue, Man Repeller and MTV.

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