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| Epididymal hypertension | |
|---|---|
| Other names | Sexual arousal orchialgia[1] |
 | |
| The phenomenon manifests itself in the form of mild discomfort around the genitals or in the lower abdomen. | |
| Specialty | Urology |
Epididymal hypertension (EH), informally referred to asblue balls for males orblue vulva for females, is aharmless but uncomfortable sensation in thegenital regions during a prolonged state ofsexual arousal.[2][3][4] It usually resolves within hours unless relieved through anorgasm.[2]
In females, the discomfort occurs in theerectile tissue andclitoris of thevulva.[4][2] In males, the phenomenon results in anuncomfortable testicular sensation.[5] It most often describes atemporary fluid congestion in thetesticles or vulva, caused by prolongedsexual arousal without orgasm.[6][7]
The termepididymal hypertension is derived from theepididymis, a part of themale reproductive system.[8] The term is also applied to females despite the lack of an epididymis in female anatomy. Professor Caroline Pukall, who co-wrote the first in-depth study on EH, has suggested using the termthrobbing crotch syndrome.[9] The term "blue balls" is thought to have originated in theUnited States, first appearing in 1916.[10] Though lesser known, the equivalent of this phenomenon in females is informally referred to as "blue vulva", among other names.[2] It is not to be confused with theinability to orgasm or the masturbatory practice ofedging.
The phenomenon is sometimes associated with males who are experiencing and practicingdelayed, multiple,[11] or inhibited ejaculation.[12] There is scant information on the phenomenon in scientific literature.[13] Little formal data exists regarding the condition. The treatment is to achieveorgasm, or alternatively strain to move a very heavy object—in essence doing aValsalva maneuver.[14]
The cause of epididymal hypertension is a large amount of blood circulation to the genital area, specifically the penis and testicles, without the release of tension associated with orgasm and ejaculation. When a large amount of blood flows to the genital region, the penis becomes erect and the testicles also experience increased blood flow and swelling.[4] In the vulva, the blood flow increases in erectile tissue, causing it to expand. After orgasm, the tissue shrinks back to its initial size as most of the blood leaves. When this does not occur, it can cause mild discomfort.[2]
The following indications and symptoms may be experienced by both sexes:[2]
