From Wikipedia, the free encyclopedia
Blue balls is a slang term for a temporary fluid congestion in the testicles and prostate region caused by prolonged sexual arousal in the human male. It is most commonly associated with adolescents but can occur in any sexually mature male. It is often accompanied by a cramp-like ache of prostatic congestion and pain/tenderness of the testes.
During arousal in a sexually mature male, the sympathetic nervous system decreases 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 more bodily fluid to enter the area than leave, ensuring a high enough regional blood pressure to allow a sustained erection for penetration during sexual intercourse.
The easiest way to relieve the symptoms of blue balls is through an orgasm either by masturbation or sexual intercourse. The resultant ejaculation jump-starts the sympathetic nervous system, which increases blood flow through the groin area, dissipating the fluid buildup. Even without orgasm, the symptoms of blue balls usually subside within an hour of onset. The symptoms can also last much longer. A review of the medical literature by Chalett and Nerenberg in 2000 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."
One folk remedy for blue balls is the cold shower. Putting cold substances (such as ice) on the crotch region significantly helps. One source  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. Also, physical exercise like walking, climbing stairs etc, can ease the engorgement. Sometimes drugs containing pseudoephedrine can help quicken the process; however, availability of medicine containing pseudoephedrine is limited in some countries. Analgesics do not generally help as they do not involve prostaglandins.
Women can also experience discomfort due to unrelieved vasocongestion as their genitals 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 gender.
A common misconception is that "blue balls" is a myth propagated by young men solely as an excuse to pressure a reluctant partner into sexual activity. While they may use it as an excuse to such an end, the blue balls phenomenon is real.
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, 843. Pubmed unique identifier 11015532.