WTF is Blue Vulva?

You've probably heard of "blue balls," the slang term sometimes employed to describe a man's overexaggerated pain or discomfort when sexual intercourse is halted just before orgasm. In hookup culture, the term is most commonly used as a euphemism to explain general sexual frustration after a less than satisfying rendezvous. And in more sinister scenarios, the threat of blue balls is even used to guilt unenthusiastic partners into continuing an unwanted sexual experience.

But have you heard of "blue vulva"?

What is a blue vulva?

Despite the alarming proposition of "blue" genitalia, blue vulva (like blue balls) is not a real medical condition, it's merely an uncomfortable sensation some people experience during sexual arousal—and it doesn't actually cause any real physiological damage or pain. You might hear the more fancy term "vulvar varicosity" which is essentially the same thing! But while a failed attempt at reaching orgasm might leave you feeling blue, don't expect your genitals to actually take on a severe Violet Beauregarde-esque hue.

Women who experience blue vulva may experience the following signs and symptoms in the vulvar area:

• Heaviness
• Aching
• Discomfort or mild pain
• A faint blue tint

What causes blue vulva?

During arousal, the arteries in the vulva widen and blood rushes to the genital area like the clitoris and labia in preparation for sexual activity, which results in increased lubrication and heightened sensation—a process that's almost identical to what happens to penises and testicles. Once you climax, that blood returns back to the body and sexual arousal subsides. But when orgasm doesn't occur, that blood pressure remains in the genitals, creating an unpleasant, but temporary, sensation until that state of arousal wears off.

"Think of an orgasm as an extension of arousal: Once you climax, there is a release. If there is no orgasm, the blood will eventually leave the genitals, but it might be uncomfortable until that happens," explained Sameena Rahman, M.D., a sexual medicine specialist, board-certified OB-GYN and educator based in Chicago. "Since venous congestion has always looked blueish, this is how the term 'blue vulva' evolved."

How common is it?

A 2015 survey published in the Journal of Sex & Marital Therapy found that only about 82 percent of female respondents self-reported orgasming during penile-vaginal intercourse alone—a significant difference compared with the 95 percent of heterosexual males who orgasm during sex, according to 2017 research published in the Archives of Sexual Behavior. So why do blue balls get all the hype?

When an orgasm doesn't occur, blood remains in the genitals, creating an unpleasant, but temporary, sensation until that state of arousal wears off.

"The 'orgasm gap' shows how often people with vulvas do not achieve orgasm from sex," said Rachael Rose, a certified sex and relationship coach and educator based in Philadelphia. "As a society, we not only disregard women's pleasure, but we ignore their pain, too—and we don't discuss the pleasure or pain of other vulva owners who are trans or intersex at all. Blue vulva, like blue balls, isn't a dangerous or painful condition, but if it was, it's unlikely it'd be treated as being more noteworthy than it is now."

Coming to the end.. how to treat blue vulva or balls

Whether it's blue vulva or balls, there's no excuse to pressure a partner into continuing physical intimacy if they aren't giving enthusiastic consent. If you're still feeling frustrated or uncomfortable because you haven't achieved an orgasm with a partner, Rahman suggested reaching for your favorite vibrator or toy for some alone time, exercising, or thinking of something that's a turn-off. Some other tips to relieve blue vulva if a woman isn’t able to masturbate:

• Focus on work or solving a math problem. Something that is certain to turn you off!
• Jump into a cold shower. Coldwater is shown to slow down the blood flow to your genitals
• Lay horizontal
• Exercising will help normalize blood flow

However, if you frequently experience extreme discomfort during or after arousal, it may be time to speak to a doctor to rule out any underlying medical conditions.

"Anything that leads to significant distress during your sexual experience—whether it is decreased desire, arousal, orgasm or sexual pain—needs to be addressed, and if it is something that continues, a sexual medicine specialist needs to evaluate you," Rahman said. "There is no shame in seeking help for this."

The occasional case of the blues shouldn't be a cause for concern. Just remember, no matter what you've got downstairs, we're all capable of being in the same predicament.