Dear Alice,

If a woman doesn't come or have an orgasm, can her ovaries hurt just like a man's testicles can hurt if he doesn't come?

Dear Reader,

To paraphrase your question, if men get blue balls, do women get blue ovaries? Blue balls, a wonderfully imagistic bit of slang for the infamous testicular aching that can occur when a male is sexually aroused but doesn't ejaculate, can occur for men and for women. Although ovaries could be considered the female counterpart to testicles, women are more likely to feel pent-up fluids in the labia, clitoris, and the outer third of the vagina. We might call this, blue vulva.

When both men and women become sexually excited, arteries pump blood to the genital area while nearby veins constrict to keep the blood there (technical term: vasocongestion). In men, the entrapment of blood causes the penis to become erect and the testicles to enlarge by about 20 percent. In women, the labia, vagina, and clitoris swell and lubricate, and the breasts and nipples enlarge and heighten in sensitivity. In both genders, heart rate, breathing rate, and muscular tension increase, as sexual tension builds and intensifies. Sounds like a party, right?

These signs of sexual excitement are known as the plateau phase of sexual arousal, which often lead right up to orgasm. When a man orgasms and ejaculates, semen is expelled from the penis by forceful pulsing. Similarly, when a woman orgasms, the uterus and pelvic muscles contract in rhythmic waves, and she sometimes ejaculates fluid. After an orgasm for both men and women, the body quickly returns to a relaxed, non-excited state. Arteries and veins return to their normal size and functioning, and blood quickly drains from the genitals, relieving pressure and reducing their usual size.

However, if there is no orgasm, it takes longer for the physical signs of arousal to subside. People of any gender may experience a feeling of aching or heaviness in the genital and pelvic areas, due to sustained vasocongestion. When blood is trapped in the testicles, they take on a bluish tint, which leads to the term blue balls. A female version of this would be a vagina, vulva, and clitoris that are sensitive, possibly darkened in color, and lubricated.

From a physiological standpoint, this phenomenon can happen to both men and women, although the common vernacular might lead you to believe that men experience it more often. Some might even use the argument of impending blue balls (or vulva) to convince their partner(s) to go farther, sexually, than the partner wants. Remember, blue balls (or vulva) are not fatal, or even harmful: Nobody needs to do anything they aren't comfortable doing in order to stave off a partner's potential blue genitals. Also keep in mind that not all sexual arousal or activity needs to end in orgasm in order to be exciting, fulfilling, and feel really good. 

For both sexes, aching from blue balls or blue vulva is usually short-lived and can be sped along by a self-stimulating session that ends in orgasm, the application of an ice pack or a warm compress to the genitals, or a cold shower. Just not too cold a shower, mind you, or you'll wind up with blue balls or blue vulva for a different reason.


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