Varicocele
Informed by recognized medical guidance
Overview
A varicocele is an enlargement of the veins inside the scrotum (the pouch of skin that holds the testicles). It is similar to varicose veins in the legs. Most of the time, it is harmless, but it can sometimes cause pain or affect fertility (the ability to father a child).
Key facts
- Varicoceles are found in about 10 to 15 out of every 100 men.
- They are the most common cause of low sperm count and poor sperm quality.
- Many men with a varicocele have no symptoms and never need treatment.
Yes, varicoceles are fairly common, especially in teenage boys and young adult men.
Varicoceles usually affect young men between the ages of 15 and 35, but they can occur at any age.
Symptoms
- Sudden, severe pain in the scrotum or testicle
- Swelling or redness of the scrotum that comes on quickly
- Nausea or vomiting along with the pain
- ⚠Pain that keeps you from doing your daily activities
- ⚠A new lump or swelling in the scrotum that was not there before
Common symptoms
- A dull, heavy ache in the scrotum, especially after standing or sitting for a long time
- A feeling of heaviness or dragging in the scrotum
- A soft, painless lump above the testicle that feels like a bag of worms
- Pain that gets better when you lie down
Symptoms in children
- Often there are no symptoms – the varicocele is found during a routine check-up
- If symptoms do occur, they are usually a mild ache or a feeling of fullness
Symptoms in older adults
- Symptoms are similar to those in younger men
- Pain or discomfort may be more bothersome and last longer
Causes
Main causes
- The valves inside the veins of the spermatic cord (the tube that carries blood to and from the testicles) do not work properly, causing blood to pool and veins to enlarge
Risk factors
- Having a family history of varicocele
- Being tall or overweight
- Jobs or activities that involve standing or sitting for long periods
When to see a doctor
See a doctor urgently if:
- If you have sudden, severe pain in your scrotum or testicle, seek emergency care right away – this could be a sign of testicular torsion (a twist in the testicle) which needs immediate treatment
Book a routine appointment if:
- If you notice a lump or swelling in your scrotum
- If you have a dull ache or heavy feeling that does not go away
- If you are trying to start a family and are concerned about fertility
Diagnosis
A doctor can often find a varicocele during a physical exam by feeling the scrotum while you are standing and then while you are lying down. They may also ask you to take a deep breath and hold it (Valsalva maneuver) to make the varicocele more noticeable.
Tests that may be done
- Physical exam of the scrotum
- Ultrasound – a painless scan that uses sound waves to create images of the veins and testicles, and can confirm the diagnosis
- In some cases, a semen analysis (sperm test) may be done if there are fertility concerns
What to expect at your appointment
The exam is quick and usually not painful. You will be asked to undress from the waist down and a doctor or nurse will check your scrotum. If you feel nervous, you can ask for a chaperone or bring a friend or family member for support.
Treatment
Treatment is not always needed. If the varicocele does not cause pain or affect fertility, your doctor may simply recommend watching it over time. If treatment is needed, there are options to block the enlarged veins and reroute blood flow.
Self-care at home
- Wear supportive underwear or a scrotal support (jockstrap) to help with discomfort
- Avoid heavy lifting or straining during bowel movements
- Apply a cool compress to the scrotum for a few minutes to ease pain
- Take over-the-counter pain relievers like paracetamol or ibuprofen (ask your pharmacist for advice)
Medical treatments
If the varicocele causes ongoing pain, affects fertility, or leads to testicle shrinkage, a doctor may suggest a procedure to fix it. Options include: surgery (varicocelectomy) to tie off the affected veins, or a procedure called embolization where a small coil or special liquid is used to block the vein. Both are done by a specialist and are usually effective.
When is surgery considered?
Surgery is typically considered when the varicocele causes significant pain, contributes to infertility, or causes the testicle to shrink (atrophy). Your doctor will discuss the risks and benefits with you.
Living with this condition
Most people with a varicocele live completely normal lives. If you have mild discomfort, simple self-care measures usually help. You do not need to avoid exercise, but you may want to take it easy if heavy lifting worsens your symptoms.
Lifestyle tips
- Wear supportive underwear or a scrotal support during physical activity
- Take breaks if you stand or sit for long periods
- Avoid straining during bowel movements – eat a high-fibre diet to prevent constipation
Diet and exercise
There is no special diet for varicocele, but eating a balanced diet and staying at a healthy weight can support your overall health. Gentle exercise like walking, swimming, or cycling is fine – just listen to your body and stop if you feel pain.
Mental health and emotional wellbeing
Some men worry about the effect a varicocele may have on their fertility or general health. It is normal to feel anxious or stressed. Talking to your partner, a trusted friend, or a healthcare professional can help. If needed, your doctor can refer you to a counsellor who specialises in men's health or fertility issues.
Prevention
There is no known way to prevent a varicocele because it is often due to the way the veins are formed. However, wearing supportive underwear and avoiding prolonged heavy lifting may help reduce discomfort if you already have one.
Vaccines
There are no vaccines to prevent varicocele.
Screening programmes
There is no routine screening for varicocele in the general population. Your doctor may check for it during a routine physical exam, especially if you have symptoms or are concerned about fertility.
Complications
If left untreated
- In some men, the varicocele can lead to a gradual decrease in sperm count and quality, which may contribute to infertility
- It can cause the affected testicle to shrink (atrophy), though this is rare
- Pain may become more frequent or severe over time
Long-term outlook
The outlook for men with varicocele is very good. Most never need treatment and have no long-term problems. For those who do need treatment, surgery or embolization is highly effective at relieving pain and improving fertility. Even without treatment, many men with varicocele father children naturally.
Find support
International organisations
Local organisations
- Your GP or local sexual health clinic · UK
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.
Sources and guidance
This article is educational and is prepared with reference to recognized health information and clinical guidance sources where available. Specific source links may vary by topic.
Last updated: July 16, 2026
Educational note: This information is for education only and is not a diagnosis.
Use it to support, not replace, advice from a licensed clinician.
If symptoms are severe, worsening, or urgent, call your local emergency number or seek emergency care.