You may have heard of varicocele previously, the dreadful condition that bloats your testicle(s) and results in pain, infertility, and reduced testosterone.
But do you know the truth about this disorder?
For example, do you know how often it really affects us, men? Some resources affirm that up to 20% is a valid estimate, but the real picture is far more terrifying: the prevalence of this condition goes up by about 10% for each 10 years of life. Here are the specific numbers this study has revealed:
Age Prevalence of varicoceles
30-39 years 18%
40-49 years 24%
50-59 years 33%
60-69 years 42%
All in all, according to modern researches, varicoceles are present in about 15% of the general male population but it’s important to remember the age-related tendency in their prevalence. If you are older than 40 years, your balls may be at a much higher risk, so stay alert.
To help you become aware of the problem and notice any of its manifestations on the earliest stages, let’s start from the very beginning and talk about what the hell are varicoceles anyway.
What are varicoceles?
In very short and simple words, varicocele is like a varicose of your testicle’s veins.
Digging a bit deeper, a varicocele is an unhealthy enlargement and tortuosity a vein or veins in the pampiniform venous plexus in the scrotum, which is a system of vessels that drain blood from the testicles. The result is often visible without any additional diagnostic procedures: soft lumps are formed near the affected testicle, usually above it, and usually on the left side although right-sided and bilateral (on both sides) varicoceles are possible as well.
How can you get varicoceles?
Short answer: the cause of varicoceles is unknown.
Some researches state that congenital abnormalities of the blood vessels in the scrotum contribute to the eventual development of this condition, while others affirm that any damage to the vessels is likely to result in varicoceles at some point.
Common risk factors that are widely mentioned regarding the development of this condition in males include:
- Sedentary lifestyle (sitting too much)
- Lack of physical activity (including sexual)
- Poor dietary habits
The problem here is that there’s no solid scientific evidence to back any of these claims whatsoever. We know the effects of varicocele on a male’s testosterone and fertility (which are BAD), but we don’t know much about what causes this condition in the first place. To a great extent, it seems to be a matter of luck and ageing.
However, as funny as it may sound, overweight and obese men seem to have a lower risk of developing varicocele (and don’t believe any website that tells you otherwise: that’s total BS). According to this study, 43% men with normal weight had varicoceles, while the same rate in the overweight group was 35% and just 22% in the obese group.
One of the possible hypotheses trying to explain this correlation is that overweight men may have some extra adipose (fatty) tissue preventing compression of the renal vein. The veins of the pampiniform plexus eventually open into the renal vein on the left side, so a compression of the latter could lead to a dump of blood in the said plexus, thus resulting in varicoceles.
Although this theory seems valid, the general truth remains unshakeable: we don’t know much about the causes of varicoceles. It seems they are somehow related to the health of your veins in general, but there is no serious correlation between this disorder and, let’s say, varicose veins in the lower extremities, venous insufficiency, or any lifestyle-related factors.
In other words, you just either develop varicoceles or you don’t. And if you DO, it’s essential to notice them as soon as possible, so let’s take a detailed look at the possible signs and symptoms of this condition.
Signs and symptoms of varicoceles
A quick reminder for you, just in case: signs and symptoms are not the same thing. A symptom is something you can notice yourself and visit a doctor to talk about it. A sign, on the other hand, is something your doctor might find during investigation—something you are unable to notice yourself.
That said, common symptoms of varicoceles include:
- Visible soft lumps above the testicle(s), usually above them and on the left side
- Visible veins in the scrotum, usually enlarged and maybe twisted
- A dull pain in the scrotum
- A feeling of heaviness and fullness in the affected side of the sack
Possible signs of varicocele could be:
- Decreased testosterone levels
- Impaired semen quality (volume, concentration, motility and healthy morphology of sperm cells, total sperm count and forward movement of sperm count), often resulting in infertility
- Visible venous deformations on a scrotal ultrasound scan
All in all, varicoceles are usually not hard to detect at all. Their presence is easily confirmed and their magnitude quickly determined by such non-invasive means like ultrasound scanning. The same approach is great as a follow-up method after surgery and/or any other treatment approach.
Because, yes, treatment is required if you want to keep your testosterone levels on a healthy mark. Below you’ll find a bit of solid evidence on how varicoceles affect testosterone, and how severe this impact may be.
How varicoceles affect testosterone
A 2011 study on the relationship between varicoceles, sperm quality and different hormone levels revealed that men affected by this condition had 18% less testosterone on average. And, what’s also important, 87.5% of affected men had some sort of semen quality impairment.
Numbers don’t lie: it is believed that around 35% of infertile males have varicoceles, meaning that this is the leading cause of male infertility worldwide. Luckily, it is quite easily corrected or prevented in most of the cases, but nevertheless. It’s scary stuff, especially when you think about the fact that you could have varicoceles and live without noticing them, the silent testo-killers.
But why does this happen anyway? How varicoceles decrease T levels?
Enlarged and twisted veins are unable to effectively perform their main function: to bring the blood from your peripheral tissues back to your heart, from where it will be pumped to your lungs, oxygenated, turned into arterial blood and used to supply oxygen to other organs and tissues in your body.
Therefore, varicose veins become somewhat similar to a dump of blood. Part of the blood’s liquid fraction “leaks” through the vessel wall due to an increase in hydrostatic pressure, thus causing swelling of the adjacent tissues. In case of varicoceles that’s—you’ve guessed it—your balls. The organ that producec the lion’s share of testosterone in your body. Naturally, when your testicles are swollen, they won’t be able to produce the big T in a healthy amount, nor will they be able to create healthy sperm.
And there you go, the dreadful results: low testosterone and infertility.
Luckily for all of us varicocele is treatable, and in most cases fixing the condition can bring back at least part of your T and increase fertility as well. And the good news is that you don’t have to go straight under the surgeon’s knife to treat this disorder: there are quite a few natural, safe, and fairly effective ways to deal with varicoceles. Let’s get straight to the matter!
How to treat varicoceles: a 3-step approach
The essential question regarding the treatment of varicoceles is: how can you prevent or cure something that has an unknown mechanism of development? Yeah… That’s a seemingly hard one, but it turns out that there are quite a few verified approaches to the matter.
This section is divided into 3 consecutive steps in order to minimize your risk of developing varicoceles, or to safely treat it if you already have one. Ready? Let’s go.
Step 1: Be healthy, be active.
If a certain medical condition does not have a specific cause, it is very likely to be a multifactorial disorder, meaning that it could result from a multitude of different factors. Therefore, the wisest way to avoid such a disorder would be to adopt a healthy lifestyle in general. Which means:
- Adopt a healthy diet devoid of junk food and excess fats. Although veins are not affected by plaques and atherosclerosis (this is an exclusively arterial condition), their walls can still be damaged by oxidants, for example. Damaged blood vessel walls are far more susceptible to deformations, enlargement and twisting, so be sure to get enough antioxidants with your diet (eat fruits, vegetables, seeds and nuts).
- Exercise regularly. When you move, your muscles work as a pump that helps to move the blood from your extremities back to your heart—where the cycle starts over. Similarly, a healthy amount of exercise could prevent your blood from dumping in your testicles and resulting in varicoceles. However, certain studies indicate that physical exercise could be an aggravating factor for those men who already have varicoceles, so it’s important to not overdo it. If unsure, consult a physician to assess the severity of your condition.
- Have enough sleep. Although this isn’t connected to your testicles in any way, sleeping well could make your body more effective in dealing with all kinds of stress imaginable, oxidative stress included. The latter could be a factor damaging your sperm cells and blood vessels, thus worsening vairoceles.
Step 2: Try out some natural supplements.
Although there aren’t many scientifically confirmed options here, certain supplements have shown impressive results in the prevention and treatment of varicoceles. Let’s take a look at the most effective of them.
- Escin (Aescin) is one of the main beneficial components of the horse chestnut, with powerful vasoconstrictor (narrows the blood vessels), vasoprotective (protects the blood vessels from oxidative damage), and anti-inflammatory properties. Studies have confirmed that escin can improve the venous valves’ functions and improve sperm quality in males suffering from varicoceles. In the mentioned study, participants received 30 mg of escin every 12 hours orally during 2 consecutive months.
- A combination of garlic and vitamin C has shown a dramatic two-fold increase in NO and significant lowering of blood pressure in this study. Theoretically, this effect could help to improve the circulation of blood in your testicles, thus alleviating its symptoms and improving the deteriorating effect on your testosterone and fertility.
- Biorutin, or just rutin, is a flavonoid found in many vegetables, fruits, and berries. It has powerful antioxidant properties and is able to protect your blood vessels from oxidative damage, thus increasing NO production and circulatory efficiency. This could be extremely beneficial for the prevention of varicoceles and alleviation of their manifestations.
Step 3: If nothing works, opt for surgery.
Surgical treatment is your “last line of defense.” When all else fails, do not hesitate to consult your physician and discuss the possibility of surgical treatment of your varicocele. All in all, the procedure is quite simple, safe, and extremely effective for your testosterone. Just take a look at the numbers:
- A 2011 study revealed that after microsurgical varicocelectomy (excision of the enlarged veins), total testosterone levels increased by 18.7%
- A 2004 study performed a retrospective analysis of men who underwent internal spermatic vein embolization (a type of surgical procedure) and assessed their total testosterone and free testosterone levels: TT increased by 43%, whereas FT was boosted by 72%. Quite impressive results, don’t you agree?
Although the surgical treatment of varicocele is considered to be exceptionally safe in general, you should still be aware of the most common side effects. According to data from the Cleveland Clinic, the latter include:
- Inability to relieve pain (up to 15% of patients) or insufficient pain relief after varicocelectomy.
- Deep venous thrombosis (less than 5% of patients), also known as blood clots in the legs.
- Pulmonary embolism (less than 1%), a condition which happens when a blood clot travels from the lower extremities to the lungs. This is a rare and dangerous complication.
- Infection after surgery (less than 1%)
- Return of varicocele (less than 5%)
- Shrinking of the operated testicle after surgery (less than 1%)
All in all, this is a matter of weighing the pros and cons, the risks and benefits. Whenever possible, of course, it is better to avoid surgery and getting the most of natural treatments, but if the latter turn out to be ineffective in your case, don’t hesitate to ask a surgeon for assistance.
Varicoceles are enlargements and twists in the veins of the pampiniform venous plexus, a system of vessels in the scrotum that drain the blood from your testicles. The prevalence of varicoceles in the general male population is considered to be as high as 15%, but the risk clearly goes up with the years, reaching about 42% in males aged 60-69 years.
Why should you bother at all? Well, varicoceles are known to be one of the most common causes of male infertility: they drastically lower testosterone levels and severely impair sperm quality. The scariest part of this story is that varicoceles are asymptomatic for quite a long period, meaning that you can have them and be unaware of this fact. Varicoceles are silent testo-killers.
The causes and risk factors of varicoceles are unknown, but certain sources believe that this is, to a great extent, linked to congenital malformations or anatomical peculiarities of the scrotal blood vessels. Contrary to what many websites affirm, excess weight and obesity are actually linked to a lower risk of developing varicoceles.
Common symptoms of varicoceles include soft lumps above the left testicle, a feeling of dull pain, heaviness, and fullness in the scrotum, visible veins in the scrotum (usually enlarged and/or twisted).
Common signs of varicoceles include impaired sperm quality, low testosterone levels, infertility, presence of enlarged and twisted scrotal veins on ultrasound scans.
Luckily, varicoceles are quite easily ad painlessly diagnosed using ultrasound and physical examination. After that, treatment should be initiated without further delay.
Taking into account that varicocele development is likely to be a multifactorial process, it is recommended to start the treatment by adopting a healthy lifestyle. This includes sticking to a healthy diet with lots of antioxidants (eat plenty of fruits, vegetables, seeds and nuts), exercising regularly (but not too much, as this could be an aggravating factor for varicoceles), and having enough sleep each night.
The second step would be to try out some natural supplements that were tested throughout multiple scientific studies. The most popular of them are escin (a major compound of horse chestnut), a combination of garlic and vitamin C, and biorutin (rutin). They have all shown promising results in the treatment of a wide range of blood vessel-related medical conditions and could be beneficial for varicocele as well.
However, if nothing works, be aware that the surgical treatment of varicoceles is also a viable option: it is highly effective, safe, and with minimal side effects. Don’t hesitate to consult a physician, assess the stage of your varicoceles, and pick a surgical approach that would be optimal in your specific case. Multiple scientific studies have confirmed that both testosterone levels and quality of sperm return back to normal (or improve significantly) after surgical repair of varicoceles.