Scientists have taken a closer look at "blue balls", the supposed feelings of pain and discomfort felt in the genitals after sexual situations that don't lead to an orgasm.
Though "blue balls" is a fairly popular term, and the phrase itself originated way back in 1916 in the USA, there has not been much by way of academic study on the topic. In fact, according to a new paper, there has only ever been one case report and one interview-based study in the scientific literature. The team believes that this lack of study has led to conjecture, as well as people questioning whether it is a real thing, and that people use it as a way to coerce partners into continuing sexual activity to orgasm.
Despite the lack of study, there are a number of theories flying around about the phenomenon and its cause. One theory is that slowed drainage of blood from the testicles could partly explain pain reported anecdotally.
"Following orgasm, the veins quickly decompress, resulting in the emptying of blood from the genitals," the team writes in their paper. "According to this theory, the slowed drainage of blood in the absence of ejaculation may result in prolonged congestion and lead to discomfort and pain. Proponents of this theory ascribe the term 'blue balls' to the phenomenon of deoxygenated blood appearing blue under the scrotal skin."
The team attempted to look into whether people believed in "blue balls" and "blue vulva", whether they have experienced it, and how painful it was, as well as whether it had been used as a way to coerce partners into continuing sexual activity. They recruited 2,621 individuals, 57 percent with a penis and 43 percent with a vagina.
They found that people with penises were much more likely to report believing that "blue balls" is a real phenomenon than people with vaginas. People with penises were also much more likely to report experiencing pain in their genitals (56 percent vs 42 percent) though the orgasm gap may help explain why many men reported not experiencing it.
"Significantly more individuals with a penis endorsed experiencing pain," the team explained. "However, significantly more individuals with a penis reported always ejaculating/orgasming during sexual activity, thus never having experienced blue balls."
People reported experiencing pain in the abdomen/stomach, testicles, groin, vagina, and clitoris, while people with penises were more likely to report feelings of restlessness, and people with vaginas described an "itch". There were differences too in what situations caused the discomfort.
"Prolonged foreplay or making out without penetrative intercourse was a reported cause of blue balls for those with a penis but not for those with a vagina," the team noted. "Causes uniquely endorsed by participants with a penis included a lack of ejaculation and engagement in partnered sexual activity (but not during solitary sexual activity), whereas those uniquely described by participants with a vagina were lack of penetration and lack of vulvar/vaginal stimulation."
According to the study, age has a factor too, with penis-havers saying they had it more frequently when they were younger. As suspected by the team, the phenomenon – which has no evidence suggesting it is harmful – may be used by some to coerce, particularly in the young.
"Participants with a vagina did not remark on age of onset, but some disclosed that their first experience of being coerced into sexual activity due to a partner’s fear of blue balls happened when they were younger."
The pain experienced by most participants was generally an infrequent mild ache, while only a small proportion of people reported severe and frequent pain. The team stresses that the blue ball and blue vulva phenomenon should not be used to coerce partners into sex.
"It is important to note that options outside of partnered sexual activity exist as a remedy for blue balls/vulva," the team wrote in their discussion, "and include solitary masturbation to orgasm, the passage of time, nonsexual activities that involve distraction, exercise, breathing techniques to slow one’s heart rate, urinating, and cold showers or baths."
The study was published in Sexual Medicine.