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Understanding Varicocele: Symptoms, Risk Factors, Causes, Treatments, and Prognosis

Dr. Craig Smith, MD

4 Min read

Varicocele, a condition characterized by the enlargement of veins within the scrotum, is one of the most common causes of male infertility. While it may not always present symptoms, varicoceles can lead to discomfort and fertility issues in some cases. Understanding its symptoms, risk factors, causes, treatments, and prognosis is crucial for early detection and effective management.


Varicocele may not always manifest noticeable symptoms, but when they do occur, they typically include:

  • Visible or palpable swelling: Varicoceles often appear as a lump or swelling in the scrotum, usually on the left side, but they can occur on both sides.

  • Dull pain or discomfort: Some individuals may experience a dull ache or pain in the scrotum, which may worsen over the course of the day or after physical exertion.

  • Feeling of heaviness: Varicoceles can cause a sensation of heaviness or dragging in the scrotum.

  • Testicular atrophy: In severe cases or when left untreated, varicoceles may lead to shrinkage (atrophy) of the affected testicle.

Risk Factors:

Several factors may increase the risk of developing varicocele, including:

  • Age: Varicoceles are most commonly diagnosed in young men between the ages of 15 and 25, although they can occur at any age.

  • Family history: Having a family member with varicoceles may increase the likelihood of developing the condition.

  • Height: Taller individuals may have a higher risk of developing varicoceles, possibly due to increased pressure on the veins in the scrotum.

  • Occupation: Jobs or activities that involve prolonged sitting or standing may contribute to the development of varicoceles.


The exact cause of varicocele is not always clear, but several factors may play a role in its development:

  • Faulty valves: Varicoceles occur when the valves within the veins in the scrotum fail to function properly, leading to the pooling of blood and subsequent enlargement of the veins.

  • Anatomical abnormalities: Some individuals may have anatomical variations that predispose them to varicoceles, such as abnormal vein anatomy or compression of the veins.

  • Increased abdominal pressure: Conditions that increase pressure in the abdomen, such as obesity or constipation, can contribute to the development of varicoceles by disrupting blood flow.


Treatment for varicocele may not always be necessary, especially if the condition is asymptomatic or does not affect fertility. However, if treatment is required, several options are available:

  • Observation: In some cases, doctors may recommend a "wait-and-see" approach, especially if the varicocele is small and asymptomatic.

  • Medication: Pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may help alleviate discomfort associated with varicocele.

  • Surgical repair: The most common treatment for varicocele is surgical repair, known as varicocelectomy. During this procedure, the affected veins are either tied off (ligation) or sealed (embolization) to redirect blood flow and reduce swelling.

  • Assisted reproductive techniques: In cases where varicocele leads to infertility, assisted reproductive techniques such as in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) may be recommended to achieve pregnancy.


The prognosis for varicocele is generally favorable, especially with early detection and appropriate treatment. Surgical repair of varicocele can often relieve symptoms and improve fertility outcomes in affected individuals. However, in some cases, varicocele may recur after treatment or lead to complications such as hydrocele (fluid buildup in the scrotum) or infertility. Regular follow-up with a healthcare provider is essential to monitor for any recurrence or complications.

Conclusion: Varicocele is a common condition that can cause discomfort and fertility issues in affected individuals. Understanding its symptoms, risk factors, causes, treatments, and prognosis is essential for timely diagnosis and management. With proper evaluation and treatment, many individuals with varicocele can experience relief from symptoms and achieve successful outcomes, particularly in terms of fertility. However, ongoing monitoring and follow-up are crucial to ensure optimal long-term health and well-being.

About the Author

In 1984, Dr. Craig Smith founded Lifesource. As a coach, he's worked with world-class athletes and guided thousands towards successful weight loss. Driven by a desire to elevate his understanding of the human body, he returned to the rigors of medical school in his 50s, achieving his goal of becoming a physician at 56. Now in his 60s, Dr. Smith leads by personal example, continuing to inspire, educate and empower individuals from all walks of life to achieve their health and fitness goals. If you wish to train and diet online with Dr. Smith, hear his message and schedule a 45-minute consultation on the New You page.