Ask the Sexpert: Nov. 18, 2010

Dear Sexpert,

Sometimes my boyfriend tells me he has to have sex because he’s getting blue balls. What exactly is blue balls, how do you get it and how is it cured?

— Blackballing Blue Balls

Dear Blackballing,

First of all, it is important to distinguish between the medical and social aspects of this disorder.

Medically, what is known as “blue balls” refers to prolonged vasocongestion in the testicles. When a male is sexually aroused, the blood flow to the genitals increases, which causes an erection and also causes the testicles to swell up to 20–25 percent larger than their usual size. If the male ejaculates, blood flows out of the genitals, returning the penis and testicles to their normal states. However, if the male does not ejaculate for an extended period of time, the blood may cause a feeling of heaviness, discomfort and aching, called “blue balls,” perhaps because of an alleged bluish tint in the testicles during this time. This pain is moderate and temporary — it usually lasts no more than a couple hours or until the male ejaculates.

There are also obvious social problems associated with this disorder. It is a common misconception that it is caused by prolonged foreplay and that the treatment is to have sex. A male with this understanding of blue balls may be inclined to try to convince his partner to have sex so that he can ejaculate and end the discomfort. However, there is much more at play here. First of all, the pain associated with this disorder is relatively moderate and temporary and will often pass without the male ejaculating. Also, there may be a social expectation for men to ejaculate during sex. If this does not happen, the physical pain associated with blue balls may be magnified by his frustration.

It is therefore important to note that a male complaining he is suffering from blue balls should not compel you to do anything you do not want to do. This issue also has implications in the stages of consent; the male’s partner may have consented to a sexual act like kissing or heavy petting that arouses the male, but not have consented to an act that is more likely to cause the male to ejaculate. Again, this selective consent is entirely within the partner’s prerogative, and he or she should not feel responsible for the male’s discomfort.

Finally, sexual-health issues are often misdiagnosed. If your partner is habitually experiencing discomfort that he associates with blue balls, it might be a sign of a sexually transmitted infection. In that case, encourage him to make a visit to University Health Services located at McCosh Health Center.

— The Sexpert

The Sexpert is written by a team of peer sexual health educators and fact-checked by University health professionals. You can submit questions to sexpert@dailyprincetonian.com. Don’t be shy!