It’s not just for cis dudes, and you don’t have to tolerate it.
The expression “blue balls” has a certain degree of cultural currency. Also known as epididymal hypertension, it’s what happens when people with penises and testicles experience a great volume of blood flow to these organs when they’re sexually aroused. As a result, there’s discomfort – heaviness, pain, and aching, and a blue vein might appear in the scrotum (hence the term). It can be resolved by having an orgasm, taking a cold shower, or distracting oneself until the erection goes away.
People with penises aren’t the only ones capable of feeling uncomfortable when aroused; it can also happen to you if you have a vagina, although it’s somewhat different. “To clarify- the idea of “blue balls” would be pain from not climaxing, not from arousal per se,” says Dr. Ashley Winter, a urologist specializing in male and female sexual dysfunction,and co-host of the sexual health informational comedy podcast The Full Release. “While women can definitely have pain from ‘not climaxing,’ this is less common and may be associated with a condition known as persistent genital arousal disorder (PGAD).” PGAD is a super rare condition in which one experiences constant sexual arousal that has nothing to do with sexual desire.
Uncomfortable sexual arousal in people with vaginas can be caused by a rush of blood to the ovaries, uterus, vagina and clitoris, as well as by hormonal fluctuations that also happen when you’re experiencing sexual desire. According to Dr. Neta Singh Rathod, a GYN with icliniq.com, it’s also not uncommon to experience vaginal secretions, wetness near the vaginal and vulvar region, lower abdominal pain and discomfort, and pain in the pelvic region and perineum (that’s the area between your anus and vulva). Unlike “blue balls,” though, there’s no change in color that occurs in any of the organs in question.
“I experience this all the time,” says Lauren, who lives in New York City. “Sometimes an orgasm helps calms this feeling, but sometimes even after an orgasm I still feel unsatisfied because I’m still aroused. It sucks!”
If the pain you’re feeling is from being aroused, Winter explains that it could be because your clitoris is trapped and can’t expand when it’s being filled with blood, which is called clitoral phimosis. “It’s common,” she says, “and many women don’t even know it’s a problem.” You might feel throbbing towards the opening or back of the vagina, if the glands that facilitate lubrication are inflamed, infected, or clogged. If you normally experience muscle pain in the pelvis, feeling sexual aroused can definitely exacerbate it.
“Blue balls” isn’t a dangerous condition, but when it happens, it’s treated as dire, and it sometimes gets exploited, especially when it’s portrayed on TV or in the movies. It’s a woman’s problem to resolve if a man is sexually aroused – she owes it to him to make sure his blue balls go away, especially if she “caused” it. When this happens to women, though, we don’t talk about it. (Did you know it was a thing before you read this piece?)
“Women often think pain with sex is normal or has to be tolerated,” says Winters. She stresses that just because something is common doesn’t mean it’s normal, and people should know that it can be treated. While she routinely talks to her patients about their clitorises, she says that most doctors don’t. “Not enough doctors are aware of these issues or talking to patients about them.”
To be clear, if you don’t experience uncomfortable sexual arousal, or arousal as described in this piece, there’s nothing wrong with you. There’s not right or wrong way to feel turned on, and no one should be using the way they feel when they’re aroused as an excuse to coerce someone into doing anything they don’t want to do.
Talking about sexual desire in people with vaginas is still seen as taboo, and it’s easy to create all kinds of myths around it, because it’s often uncomfortable to discuss, and so we might not be open about what’s happening to us, even with a health professional. You deserve to feel good and have great sex, so if you’re dealing with a painful situation, definitely bring it up with your doctor – you don’t have to endure it alone, or at all.