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Varicocele – Causes, Symptoms & Diagnosis

February 23, 2023

The reproductive organs are delicate and prone to infections and complications, in both men and women. Since problems related to the reproductive organs are not widely discussed like the common cold or flu, many are not aware of the possible issues they can face. Varicocele is one such issue, which if not treated in time, can have a lasting effect on the male’s fertility.

What is Varicocele?

Varicocele is the enlargement of the pampiniform plexus – the veins in the scrotum. The scrotum is the loose sac that house the testicles. The scrotum also contains veins that circulate blood and oxygen to and from the testicles

When the blood pools in the veins rather than circulate the testicles, it can result in a bulged vein called a varicocele. This is very similar to the varicose veins one may experience in their leg. It can be equally or even more painful too.

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Varicocele Causes

There are two testicular arteries in the scrotum – one on each side. The testicles receive blood and oxygen through these arteries. The oxygen and the blood are then circulated back to the heart through a network of small veins called the pampiniform plexus. When these veins malfunction and do not deplete the used oxygen and blood from the testicles, it starts pooling in the veins, leading to a painful bulge.

The testicular vein on the left side of the scrotum is slightly different, from the one on the right. This is why varicocele is more likely to occur on the left side of the scrotum. It is also more likely to occur in males around 15 – 25 years of age, just after they reach puberty. Though a varicocele can occur on the right side of the scrotum too, it is very rare.

Varicocele Symptoms

When the blood and oxygen supply to the testicles is not smooth or is blocked, it can impact the development of these testicles. Some of the varicocele symptoms a male might notice are:

  • Pain – When the blood is not drained fully during circulation, it starts pooling around the testicles, thus causing a dull pain, which can get worse while standing. It might decrease when he lies down.
  • Bulge – If the varicocele is big, it will cause a prominent bulge in the scrotum that will be difficult to miss. It may seem like a bag above the testicles. In the case of a small varicocele, the male can feel the bulge by touch.
  • Size Difference – Since varicocele is more common on the left side of the testicles, the left testicles may seem smaller than the right. Similarly, if in a rare case, the varicocele is on the right side, the right testicle may seem smaller than the left. This happens when the development is not equal on both sides due to the block in the veins.
  • Infertility – In some cases, if the varicocele is severe or left untreated, it can cause fertility issues. The male might find it difficult to father a child without addressing or treating the varicocele. However, it is still possible to father a child despite the varicocele.

Impact of Varicocele

So, is varicocele dangerous? No, it is not dangerous but it can affect you in the following ways:

  • Restrict Activity – Since the pain can be more when you are upright or standing, it can interfere with your day-to-day physical activities. It may even make it difficult to run or exercise. Exercises like lunges or squats that put pressure on the testicles can be difficult to perform.
  • Affect Fertility – As varicocele can occur during puberty and affect the development of the testicles, it can have an impact on your fertility. It can result in the underdevelopment of one or both testicles, thus reducing or interfering with sperm production. As a result, one may find it difficult to father a child easily.

Sometimes, it can result in secondary infertility, meaning the male can father a child once but the second time might become difficult.

Varicocele Diagnosis

Since the reproductive organs are not something a doctor checks in a routine exam, especially for a teenager, the diagnosis can happen only if the affected male comes forward to get his testicles checked. Some ways in which the doctor will confirm a varicocele diagnosis are:

  • Examining Physically – Only a big varicocele may cause a visible bulge. When the varicocele is just developing or is small, one can find it only by touch. So, the doctor will physically check the scrotum and testicles. The doctor will check your testicles when you are both standing up and lying down, to see if there is a difference in size or if they can find a bulge.
  • Ultrasound – If there is no visible bulge but the doctor suspects a varicocele, an ultrasound will be required. Only an ultrasound can give a close-up view of the varicocele testicle. It will also help measure the veins and spot the size differences if any.
  • Valsalva Manoeuvre – In this technique, your doctor will ask you to stand upright, take a deep breath and hold it in. As you bear down on your testicles, the doctor will physically examine them to identify smaller varicoceles.

Varicocele Treatment

Can varicocele be cured? Yes, it can. You can opt for Varicocelectomy - a varicocele surgery in which the urologist will surgically cut the enlarged veins to release the blocked blood. If you are looking for a varicocele treatment without surgery, then you can opt for varicocele embolization.

How to Cure Varicocele Naturally?

If you want to ease your varicocele discomfort without going to the doctor, you can avoid activities that increase the pain or discomfort. Alternatively, you can apply ice or cold packs to the bulge for not more than 15 minutes at a time, to ease the pain.

Must Read : Treatments for Men With Low Sperm Count


Varicocele is not a common issue men face but is not unheard of either. With timely treatment, both pain and complications can be reduced without impacting fertility.

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