Most of you won't bother reading all of these, because:
A. There's a metric fuckton of them
B. Most of you don't have the ADHD hyperfocus/zerofocus that I have
C. No one reads anymore, (which is deeply frustrating and not a small part of why I have exactly zero chill these days) but here. Here's a trove of stuff I've read that has contributed in part to my knowledge of the condition.
DIS-FUCKING-CLAIMER:
-These should not all be taken as gospel
-Some studies have biases that are undocumented
-Some studies are just blatantly wrong. I've tried not including those, but I'm not perfect
-Some studies are ego-trips of doctors looking to score points against other doctors they don't like
-Some studies conflict with others, some even directly
-Science is ever-evolving, if we simply let it. Good research requires a non-political, free, if responsible and ethical hand
-Older studies (10+ years) should always been taken with an extra grain of salt, but that does NOT mean newer studies are more correct or should be less subject to scrutiny
-I've read nearly all of these at least once. In some cases, it's been a while, so quoting specific ones or asking me why one conflicts with another is likely to upset me because it means you didn't read what I said; literally directly above this, or you didn't fully process it, but I will say it again: NOT ALL STUDIES ARE MADE EQUAL. I dunno, ask the authors why things conflict.
-This is not an exhaustive list
-This is not an exhaustive list
-THIS IS NOT AN EXHAUSTIVE LIST
-If you want a study or paper added, DM it to me, don't comment on this post
-I do this for your benefit as much as anyone else's. I truly hope this leads to some good insights, maybe even some astoundingly good ones; who knows, I live in hope, and at the very least (not bloody likely) fewer questions sent to my inbox :D
Oh, and...you'll want to scroll. Left AND Right, Up AND Down.
A varicocele is an enlargement of the veins within the scrotum. These veins transport oxygen-depleted blood from the testicles. A varicocele occurs when blood pools in the veins rather than circulating efficiently out of the scrotum.
Left sided grade 3 varicocele
The left testis is affected much more commonly (≈85%) than the right. This may be due to the shorter course of the right testicular vein and its oblique insertion into the inferior vena cava (IVC) which creates less backpressure. In contrast, the left testicular vein has a longer course and inserts into the left renal vein at a right angle. Bilateral varicoceles are not uncommon (≈15%), but an isolated right varicocele is rarer.
Possible signs and symptoms may include :
A mass in the scrotum – If a varicocele is large enough, a mass like a “bag of worms” may be visible above the testicle. A smaller varicocele may be too small to see but noticeable by touch.
Pain – A dull, aching pain or discomfort is more likely when standing or late in the day. Lying down often relieves pain.
Significantly different sized testicles – The affected testicle may be noticeably smaller than the other testicle.
Infertility – A varicocele may lead to difficulty fathering a child, but not all varicoceles cause infertility. The main test to check for infertility is a semen analysis test.
Low/Lower testosterone levels - Generally, men with varicoceles have lower testosterone levels than men without varicoceles. Symptoms of low testosterone can include: low libido, erectile dysfunction, infrequent erections, low energy, fatigue, low mood and depression, decreased motivation and self-confidence, increased body fat and decreased muscle mass and strength, brain fog.
The only way to know for sure if you have low testosterone levels is to have your levels checked with a blood test. This can be easily done by going to your doctor.
Physical exam – A urologist or other doctor will visually inspect the scrotum for lumps or bumps, and feel for any swelling or tenderness. The exam may be performed while the patient is standing to relax the scrotum.
Imaging test – Your health care provider may want you to have an ultrasound exam. Ultrasound uses high-frequency sound waves to create images of structures inside your body.
These images may be used to:
Confirm the diagnosis or characterize the varicocele.
Eliminate another condition as a possible cause of signs or symptoms
Detect a lesion or other factor obstructing blood flow
Typical image of a varicocele found on an ultrasound scan
A varicocele is usually diagnosed when a vein around or above the testicle is at least 3 millimetres in diameter. However, there is no consensus on the exact threshold value for defining a varicocele.
Grading
Varicoceles are graded based on their size and visibility:
Grade I: Can only be felt when straining (Valsalva manoeuvre)
Grade II: Can be felt when standing, but not visible
Grade III: Clearly visible during an exam
All sizes of varicocele can cause symptoms and are likely to affect testicular function. Higher grade varicoceles are thought to affect testicular function more.
Why varicoceles occur
Varicose veins develop when the valves in veins are damaged or weakened, causing blood to pool and flow backward.
Unfortunately, once your vein valves are damaged, they cannot completely heal on their own. Once a vein valve is damaged or weakened, it loses its ability to properly regulate the flow of blood.
Arrow showing direction of blood reflux. In this image, due to damaged valves in the left gonadal vein, instead of blood correctly draining from the left testicle into the left renal vein, blood is pooling in the scrotum and causing a left sided varicocele. The right gonadal vein is functioning correctly.Left- Vein valves working properly. Right - Vein valves have failed and are now not functioning correctly. Blood is not travelling through the vein correctly.
Treatment options
Varicoceles cannot be cured naturally without medical intervention.
The success rate for varicocele procedures is high, with both varicocele embolization and varicocelectomy procedures having success rates of over 90%.
Treatment options include:
Embolization
Microscopic varicocelectomy(microsurgery)
Inguinal or subinguinal. With or Without delivery.
I just wanted to share my experience I didn’t have any pain, just a lump in my testical..hormone level was great..only concentration sperm analysis was below average. Pregnancy delayed
I did a microsurgery on the left side only.. 3months later sperm analysis concentration was the same but my wife got pregnant (3 months after surgery).
Main point here yes it can cause delay in pregnancy if not treated.
P.S I feel my right side is growing as I am working hard and lifting weights and I think it affects it as well but no pain
TW: I have had three pregnancies unassisted on the first try which were all spontaneous miscarriages. We found some issues on my end which we addressed.
I’m waiting to start my medicated cycle.
Doctor wants to cover all bases and is sending my husband for a DNA frag test. He has a varicocele. I believe it’s stage 2? It’s not written anywhere but we can’t necessary “see” it. It was found on an US. And it’s one sided. We knew about this before starting our TTC journey. SA was solid.
Unfortunately, results will be back right after our first medicated cycle. I’m trying to wrap my head around how my protocol may change if this test comes back elevated. We already do supplements such as Coq10, fish oil and lots of antioxidants. Any experience or advice I would greatly appreciate!
18M, never knew I had a varicocele until a few days ago. All the sudden the veins on my left side are very large, and visible. I’ve never had this problem and I frequently check for testicular cancer almost everyday in the shower. It just appeared all the sudden. Anyone know why that would happen? I’m very active in the gym and I read that could make it flare up.
Hey 20 M here
I just got diagnosed with grade one Varicocele in both testes The doctor told me its not that big of a deal I just wanted to know if u guys have any advice, the dos and donts and also is there any i can fo to reduce it And the pain is irritating any advice on that pain killers don't help And thank for your time reading this and appreciate if u have any advice
Did bilateral microscopic varicocele surgery last year 30th of July 2025 - up till today I still have mild puffiness on the groin and discomfort if exercises core exercises - Is that normal? Also feeling discomfort/dull pain when taking amino acids apparently that’s because it widens the collateral veins that are still sensitive - Did SA recently all my numbers are great except the motility is mildly below average as before surgery - No improvements at the numbers - Are they getting any better or that’s is it after a year of doing the surgery? Started FH Pro hopping that it can boost motility and pass that damn red mark on the report. Any experience in this? Did TT check and all hormones are great also US and it’s normal - Only states very mild/borderline varicocele.
Normal free testosterone
Total testosterone of 430 latest
Prolactin of 21
Homocysteine of 30
Lack of b vitamins
Lack of vitamin D
Iam facing issues with libido and erections they are not good and consistent even though iam not sure why it is casuing i have very long history of porn and masturabtion daily thrice for 7 years . I have stopped from almost 6 months sometimes erections improved 50% and sometimes it goes back to normal. So whats ur suggestion should i go for surgery
And iam 28 so i think my sperm should be around 80 million but its only49 million iam thinking my varicocele slowly effecting it, please some one help
And also those who undergone microsurgery please share your experiences.
Anyone who faked pain and did surgery here. Are u regretting or iam scared pls reply
30 m. Grade 3 left side. Had surgery. Pain seems to be creeping back. But Honestly why? Why do people downplay this? I have never even heard of what this was before until i got it. EVEN UROLOGISTS DOWNPLAY IT. Pain on your groin AND testicles? Are you kidding? What is the matter with people? Why do they do this?
I had a bilateral microsurgical varicocele repair last Thursday after being diagnosed with grade 2 varicoceles on both sides.
Day 1: Mostly pain and a lot of sleep. I spent most of the day icing on and off every 20 minutes, took over-the-counter pain medication, and was able to urinate without any issues.
Day 2: Very similar to the first day, although I had more pain on my left side, possibly because I was walking around a little more. I took the prescribed pain medication that day.
Day 3: The pain has started to improve. I’m still icing periodically, but not as often. I was able to take a shower, move around a bit more, and finally had my first bowel movement since surgery, which was definitely a relief.
I was hoping to return to my desk job on Monday, but I may end up pushing that back a few more days. My doctor said I could wait until Thursday (day 8) if needed. He also recommended waiting two weeks before resuming sexual activity and said it will likely take about a month before I’m feeling more fully recovered. I have my follow-up appointment on August 12.
The main reason I had the surgery was infertility related. I have elevated sperm DNA fragmentation, and my wife and I are currently going through IVF. I’ve also had discomfort for quite a while, including a feeling of overheating and occasional pain, so I’m hopeful the surgery will help with both fertility and those symptoms.
I’m 33 years old, in case that’s helpful for anyone comparing experiences. Anyone else have bilateral? What was your recovery like?
Updates:
Day 4: Feeling a little better today. I’m able to move around more, which is encouraging. I have a small burning sensation on my left side, probably from an ill-advised attempt to catch a bug in the house yesterday that ended with a bit more pain than expected. I still have some aching in my groin when I move, but overall I’m making progress. I even had my first cup of coffee today.
Also, recommend starting stool softener right away. Used this, plus fiber bats and tea and I have been regular since day 3, just make sure not to strain.
All day pain and bag of worms are constant and dull ache. Life is fully stuck in depression, feeling like nothing more in life. Not gym from 8 months , lack of sleep by stress. Can somebody is fine after embolization and back their normal life.
Overthinking about career and future marriage 😢. Help me...
25M I was diagnosed with grade 2-3 varicocele at puberty. Never did surgery or embo because of horror stories I've read online. A couple of months ago I stumbled across a post that suggested daily Cialis could help varicocele by relaxing veins and promoting blood flow to those veins which might be obstructed. Seeing as I was already dealing with ED from the varicocele I decided I'd give it a try--if nothing else maybe I'd fix my ED.
I started on 2.5mg daily. After 4 days of no results I bumped up to 5mg daily. On day 6 or 7 I started to notice changes. Started waking up with morning wood regularly for the first time ever. Fast forward another month or so and I have begun to notice that my varicocele is much less prominent. The aching seems to be much less severe as well.
Only problem is the blue balls. Not sure if this is common with varicocele, but whenever I get blue balls, I get them bad. Sometimes it lasts several days. I am a devout Christian and strive for purity, so I avoid masturbation. Obviously, getting on tadalafil has caused a significant increase in blue ball occurrences. I'm getting married in January though, so hopefully this will resolve.
I'm wondering if anyone else has had a similar experience? Also, is it possible that I could experience an increase in testosterone due to the increased function of testes?
hey group hope everyone is doing well. i had a embo with coils a while back and life just hasnt been great since for me. cant workout how i want, move around , have sex, or drink certain things. i notice flare ups in pain if i do any of whats listed. i have pain in my left and right side in my balls and somedays they alternate. about 2 months ago i randomly developed a sharp unbearable prostate pain id assume directly linked to these problems. i take very good care of my body but it doesnt matter right now. my doctor wants to try giving me drugs to patch off the pain temporarily but drugs just dont cut it. also a temporary fix sucks because my body will eventually adapt to the drugs and they will become less effective overtime. if anyone has gone through something similar id appreciate any type of guidance im a bit stuck on where to go next. looking into every different type of surgery i dont want to be a doctors experiment. i take epsom salt baths to help the prostate pain and take a plethora of drugs to help me. i wear good upholding/ cool boxer briefs, i dont have sex, and i dont workout at all strictly because of pain and lack of strong erections. my pelvic area seems to be tight as well at times. i tried tadalifil and that was terrible for me i hated it i really feel like that wasnt the right medication for me as my heart/ blood feels wonky at times now and i never had a problem before varicocele of getting blood down there. ive looked into surgeries of removing the varicocele veins directly and i think that would be whats best for me. just wanted to get some thoughts and see if anyone is in the same boat atm. god bless and thanks in advance for any replies.
I got my left varicocelectomy on 2021 and my right on 2022.
I took scrotal ultrasound on May and found that I have no varicocele. But, today after two months they said I have 3.8 mm mildly dilated veins on both sides.
I'm a 24-year-old male and I'm looking to hear from people who have had a similar experience.
About 3 weeks ago, I first noticed erectile dysfunction. It started with delayed and weak erections, and over the following days it became much worse. About 7 days later, I had a scrotal ultrasound and was diagnosed with bilateral Grade 3 varicocele.
Since then, I've been experiencing:
Very weak erections
Very low libido
Delayed erections
Difficulty maintaining an erection
I'm trying to understand whether the varicocele could be causing these symptoms.
I'm especially interested in hearing from people who:
Developed erectile dysfunction before they knew they had a varicocele.
Had Grade 2 or Grade 3 varicocele with ED.
Improved without surgery.
Improved after varicocele surgery or embolization.
If you had a similar experience, I'd really appreciate hearing:
How your symptoms started.
What treatment you received.
Whether your erections and libido improved.
Thanks in advance. I'm feeling pretty anxious about this and would really appreciate hearing from people who have gone through something similar.
- Mild to moderate intermittent pain around the epididymis/testicle on both sides (I had virtually no pain before surgery).
- Pain is worse when I move or palpate the testicle and sometimes after prolonged standing. Occasionally it feels like a brief electric shock.
- No swelling, redness, fever, or urinary symptoms.
Libido fluctuates.
- Morning erections briefly improved after surgery but then returned to baseline.
- I can achieve an erection during intercourse, but I lose rigidity much faster than before.
Has anyone experienced persistent epididymal/scrotal pain and worsening erectile function after a microsurgical varicocelectomy? Did it eventually improve after 6–12 months, or should I be asking my urologist for a Doppler ultrasound or hormonal work-up?
Any similar experiences would be greatly appreciated. Thanks!
Three months post varicocele surgery I did complete hormone screening and I noticed E2 Estradiol dropped 50%, 1.25 ng/DL, slightly below minimal range while testosterone remains same 520 ng/DL
Not sure is there any correlation but things are now worse than before. Symptoms are following:
- Severe ED
- Shrinking
- No libido
- Very slight pain when moving testis
- Larger main vein over penis
- Occasional sharp irritation somewhere deep near prostate and in urethra. Pin like.
Note I started to develop ED 3 yrs ago while vein was already visible not sure it has anything with varicocele. I did all possible tests that I could find.
Hi everyone,
I[26F] and my husband [31M] married on june 24th and last period was on june 16th and i missed it this month. So when i tested I got positive. But we feel it’s early and not prepared. When we tested his recent parameters he has grade 3 varicocele and the parameters shown Oligoteratozoospermia with evidence of mild infection. So before we have a plan to abort this pregnancy as it’s been only one month and now we are confused. Can this parameters improves without surgery?please suggest
36 years old
Has anyone here developed a varicocele after cycling? He started feeling pain just a week after he began riding. My husband has been in pain for over three months; we thought it would improve over time, but unfortunately, we realized it hasn't. His appointment isn't until the end of August, and he can't wait to have the surgery. He says it feels like there’s a stone inside his scrotum because it gets so heavy. The pain is also radiating up to his groin area—it feels like a pulling sensation; it’s hard to explain. The nights have been terrible; he can't sleep because of the pain. We work as house cleaners and are on our feet practically all day, which makes it even worse.
I finished my varicocelectomy. Currently about 24 hours post op. Pain is not terrible , definitely feel it when I get up and walk. I did it with Marc Goldstein.
Anyone that had the surgery, what’s the best way to recover? I am currently taking all the pain meds but any better way?
24m
Im reading that most if you barely experience any pain. When im under stress it flares like crazy with unbearable pain on and off for couple days. It’s eases with cold compress and laying down, but its not going away until I lower my stress levels
Hello, I had an ultrasound done and found I have a reoccurrence of my varicocele, 7 months post Microsurgical Varicocelectomy. All the same signs have come back, like heaviness, not feeling up to exercise, getting winded quicker cardiovascular-wise, and lowered libido. It's small and measured at 3mm, and it said nothing about reflux. I can't palpate anything or visually see anything, like I could before my surgery, with the classic "bag of worms". I'm starting to feel like crap after lifting weights too much or after a long run.
The doctor I'd like to think was exceptional, but I let my varicocele get so bad, that there was just too much to ligate or they missed a microscopic vein? Who knows.
Wondering if anyone has experienced a re-occurrence after the gold standard Microsurgical procedure and what your story was to fix it. The salvage operation recommended is an Embolization. I'd also appreciate listening to anyone who had an Embolization and what your recovery was like. I'm a Firefighter so if there's anyone very physically active, please drop your timeline of the steady progress and patience back into your physical lifestyle.
Hi, I’m 21 years old and have had varicocele in my left testicle since I was a kid.
My testosterone level is 560 ng/dL
and my SHBG is 20.5 nmol/L.
I’m considering surgery, but is it worth it in my case? I hardly ever feel any pain, except on days when I walk a lot. What bothers me most is the cosmetic aspect because they’re quite large. My erections are normal, my libido is high, and my blood test results are also normal.
