Advice from the Trenches: Are Blue Balls Real?

Dear C & Dr. B;

Last night my boyfriend called me from the ER. He said that he felt like his penis was falling off and that I was the one who put him there. The ER doctor told him he had blue balls! Is this for real?  Should I feel bad or is he just making this up to try to get me to go all the way? We have only progressed to various forms of foreplay because I don’t really feel ready to give up my virginity.  Am I being selfish?

Moira Less

Dear Moira,

To answer your first question, yes – blue balls is a real condition. When I worked in the ER during  med school, it was the number one thing that brought college-aged boys to seek treatment. Climax is different for men and women. The technique from 50 Shades of Gray, wherein one repeatedly nearly reaches a climax and then backs off, does indeed heighten orgasm for both sexes. However, women can do this multiple times without any problem and men can’t get away with it more than once or twice without needing an orgasm. Both men and women feel a sense of building pressure, but in men the vas deferens  (the duct that carries sperm to the urethra) fill with fluid and if they don’t ejaculate, the fluid has to be reabsorbed. That can be painful.  

Testicular pain can have other causes too – trauma, tight pants or underwear, jogging, or bicycling. Prolonged sexual arousal is not the only culprit.

In answer to your last question – no. You are not being selfish. If you don’t want to go all the way, you never have to. If you don’t want to extend your foreplay and ‘handle’ the situation, all he needs do is excuse himself to the bathroom and finish the job there. That will release the pressure on both of you.

C says: I wish that someone had told me that blue balls wasn’t fatal when I was young and stupid. I remember feeling like I was being a selfish bitch when, after a steamy makeout session, I decided it was time to call a stop to things with my virtue relatively intact. Oh, the guilt trips! Frustrated boys launched accusations ranging from “if you cared about me…” to  insisting that I was crippling them for life. Looking back, all I can think is: if only. It was nothing but a load of hooey.

But pain can also indicate a need for medical attention. Priapism — prolonged erection — might seem like a non-problem to some, but it can cause tissue damage if not treated and set a guy up for a lifetime of erectile dysfunction. Then there is epididymitis, an inflammation of the tube that rests on the backside of each testicle. This can be pretty painful, and since it is generally caused by a bacterial infection of some kind, it’s another condition that requires medical attention. Sometimes, a testicle also becomes inflamed, a condition that a doctor would diagnose as epididymo-orchitis. Sex can exacerbate any of these conditions, so although the guy is probably just jerking your chain, don’t write off the possibility there’s a real problem. You, however, didn’t cause it, so tell your date to get his own ass to the ER and stop blaming you.

I would like to point out that blue balls (medically known as epididymal hypertension) does not just affect those with dicks. Women can experience their own version, called vasocongestion. This can happen when blood flow to the female genitals increases with sexual arousal, causing feelings of aching or heaviness around the clitoris and vulva. The feeling passes when blood flow returns to normal. It isn’t as painful as epididymal hypertension, but it is relieved in the same manner, either after orgasm or when the arousal subsides. BTW – the slang term for vasocongestion is “blue vulva.” Wouldn’t that make a great name for a female rock band? Seriously.

You can visit Dr. B’s blog at drbrilliantcliche.wordpress.com