Pearly Penile What???

Hi Shawna,

I just started having sex with my new boyfriend and I noticed he had some small bumps around the head of his penis. I asked him about it and he said that his doctor told him it was normal. He said it was called pearly pimples or something like that. What is that and is it something I should worry about it?


Great Question! Does it look something like this???


This is called Pearly Penile Papules, often abbreviated to PPP. They are tiny bumps that form a ring around the head of the penis. PPP is fairly common; about 20%-30% of the male population has them. We don’t know what causes them but we do know that PPP is nothing to worry about. PPP is not a sexually transmitted infection, it is not contagious, and poses no health risks. Although normal and totally not harmful, some men may choose to have them removed for aesthetic reasons (meaning, they don’t know like the way they look).

While PPP are harmless, other lumps or bumps in the genital area may not be. It’s always a good idea to be checked out by a clinician whenever in doubt.

In happiness & health,


Reviewed by Kohar Der Simonian, MD

Blue Balls: True or False?

Hi Shawna,

My boyfriend and I were having a discussion about “blue balls” and I was wondering if it is a slang term for an actual physical ailment or are its symptoms purely psychological. Thanks!



Ah yes! Blue Balls!

Though it doesn’t happen to all men, it is a very real condition that results from a prolonged state of sexual arousal (being turned on for a longer than usual amount of time).  When guys are sexually aroused, blood flows to the penis and testicles causing them to swell (this is what causes an erection).  If he doesn’t ejaculate, there is a buildup of pressure, which can cause discomfort.  The discomfort varies in intensity but is not dangerous.  Ejaculation, whether by sex or masturbation, can relieve the pressure or he can simply wait it out.  The blood will quickly drain, and any discomfort will disappear on its own.  If the erection and/or discomfort lasts longer than 4 hours, he should seek medical attention as this may be a sign of a more serious condition called priapism.

So, if you are messing around with a guy and he tells you he has to have sex/get a blowjob/etc. or he’ll be in major pain, don’t let that pressure you.  If you are not into going any further, he can masturbate or wait it out.  He’ll be fine.

In happiness & health,


Reviewed by Tonya Chaffee, MD