Let's Talk About "Blue Balls"

By Rachel Zar, LMFT, CST

There are certain sexual myths that sex therapists are all too eager to bust when we see them show up in the therapy space. Blue balls as a reason for on-demand sex is one of them. If you’re a scrotum owner and currently finding yourself wanting to defend your engorged genitals, bear with me for a minute.

Here’s what’s true:

The sensation of discomfort or even pain when blood flows to the penis and testicles is real. The medical term is epididymal hypertension or pelvic vasocongestion, and it’s often described as an aching or throbbing sensation. Most male-bodied people do not experience blue balls frequently (or even every time there’s arousal without release); most male-bodied people describe it as a mild discomfort when it does happen; and it is not at all dangerous. This increased pressure due to excess blood in the genitals is usually resolved with orgasm or with time as the body returns to its unaroused state.

Here’s what’s also true:

The same thing happens to vulvas! Pelvic vasocongestion in female-bodied people occurs for the same reasons: increased blood flow to the labia, which become engorged (just like the testicles), and the clitoris, which becomes erect (just like a penis) when aroused. In female-bodied people, this feeling of pressure, throbbing or heaviness is usually resolved after orgasm or with time as the body returns to its unaroused state (just like blue balls).

Here’s the myth I’d like to bust:

“If you’re partnered with a person who’s experiencing blue balls, it is your responsibility as their partner to relieve them of this discomfort.” You are responsible for the comfort of the genitals attached to your own body. So is your partner. You are no more responsible for relieving that tension in your partner’s body than you are for relieving their hunger or thirst; sure, it’s nice and feels good when a partner cooks for you or gets you a glass of water, but if they don’t feel like it, prefer to do something else, or are not around, you are responsible (and perfectly capable) of feeding yourself and quenching your own thirst. As we’ve discussed, this discomfort or pain will pass on its own with time – and if quicker relief is desired, the human attached to the genitals in question is capable of doing so on their own.

Here’s why this is important:

When the blue balls myth gets too ingrained in a relationship dynamic, it can lead to several patterns that are difficult to get out of. First, you may end up feeling pushed to have sex when you actually don’t want to in order to relieve your partner’s discomfort. This is never OK, and it will lead to resentment and disconnection in any relationship. Secondly, you may find yourself avoiding doing anything that may lead to your partner’s arousal for fear of the “requirement” to have sex if blue balls occur; this may mean that you stop doing things that would otherwise feel good in a relationship—like affection, flirtation, kissing, or touching—because it may lead to a felt obligation to give your partner an orgasm.

So, if you’ve ever cited blue balls as a reason to get your partner to have sex with you, I invite you to start to rewrite this script. Normalize stepping away to relieve your own discomfort if you have to or see how long it takes (or what distractions are helpful) for that discomfort to relieve on its own. If the pain is severe or doesn’t go away with time, see a doctor for medical treatment. But, please, don’t pressure your partner or expect them to feel guilty about the state of your genitals. This behavior is not only decidedly not sexy, it’s manipulative and coercive.