Painful sex, “blue balls,” and testosterone safety—answered. In this Ask Me Anything episode, Dr. Rena Malik explains why sex should never be painful, how to get properly evaluated, and simple fixes like arousal time, lubrication, pelvic floor therapy, and treating vestibulodynia. She also breaks down epididymal hypertension (“blue balls”), how semen-retention habits can trigger pelvic floor dysfunction, and what an elevated PSA means if you’re on testosterone—plus when it’s safe to resume thera

"Blue balls" medically referred to as epididymal hypertension, is a temporary condition experienced by some males when sexual arousal does not result in ejaculation. The term describes a dull ache or a feeling of fullness in the testicles due to prolonged vasocongestion, or increased blood flow to the genital area. While uncomfortable, it is not dangerous and typically resolves on its own or after ejaculation or a reduction in arousal. The blueish hue some may observe is due to blood vessel engo