Blue balls is a slang term for a temporary fluid congestion in the testicles and prostate region caused by prolonged sexual arousal in the human male. It is most commonly associated with adolescents but can occur in any sexually mature male. It is often accompanied by a cramp-like ache of prostatic congestion and pain/tenderness of the testes.
During arousal in a sexually mature male, the sympathetic nervous system decreases its inputs to the genital tissues, resulting in increased blood flow to the testicles and prostate areas. As this happens, other fluid outflow muscles constrict, causing more bodily fluid to enter the area than leave, ensuring a high enough regional blood pressure to allow a sustained erection for penetration during sexual intercourse.
If orgasm is not achieved, blood and lymphatic fluid tend to pool, and the blood becomes oxygen deprived. In some men, this pooling of oxygen-starved blood may result in a bluish tint to the scrotum.
Men with priapism or orchalgia may experience an extreme, prolonged form of blue balls, which may require medical attention.
One folk remedy for blue balls is the cold shower. Putting cold substances (such as ice) on the crotch region significantly helps. One source * states that "the cool water of the shower would stimulate new warm blood to the scrotum," but local cooling might instead work by causing arterioles in the scrotal skin to constrict, thus decreasing blood flow to those tissues and allowing fluid to leave the congested areas. Also, physical exercise like walking, climbing stairs etc, can ease the engorgement. Sometimes drugs containing pseudoephedrine can help quicken the process; however, availability of medicine containing pseudoephedrine is limited in some countries. Analgesics do not generally help as they do not involve prostaglandins.
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