Updated:
by
Luis Barajas, MD, RPVI, DABVLM
Medically reviewed by Luis Barajas, MD, RPVI, DABVLM
Most men have never heard the word "varicocele" until a doctor says it out loud. But this condition, which describes enlarged veins inside the scrotum, affects roughly 1 in 6 males and is one of the most common, correctable causes of male infertility, according to the National Library of Medicine (NIH).
Even more surprising than these numbers is that many men with a varicocele have no symptoms. They may go years without realizing something is wrong, while the condition quietly affects sperm production, testosterone levels, or both.
Understanding varicoceles starts with understanding veins. Both varicoceles and the more familiar varicose veins in the legs share a root cause: chronic venous insufficiency, the failure of vein valves to keep blood flowing in the right direction. When those valves stop working properly, blood pools, pressure builds, and veins enlarge. The location differs — legs versus the scrotum — but the underlying mechanism is essentially the same.
This article explains what varicoceles are, how they relate to overall vein health, and when to seek medical attention. If you believe that you may be experiencing varicoceles, contact your primary care physician or urologist.
If leg vein symptoms such as aching, heaviness, or swelling are impacting your daily life, the vein specialists at Center for Vein Restoration (CVR) can help. CVR is the nation’s largest physician-led practice, with more than 130 vein clinic locations from coast to coast, that expertly treats symptoms such as leg swelling, aching, throbbing, visible varicose veins, and restless legs.
Call the helpful Patient Services Representatives at 240-249-8250 or find a CVR location near you HERE.
A varicocele (pronounced VAIR-ih-koh-seel) is an abnormal enlargement of the veins in the scrotum, sometimes called scrotal varices in clinical settings. Specifically, it involves the pampiniform plexus, the network of veins that drain blood away from the testicles, according to the NIH/StatPearls.
Think of it like a varicose vein in the leg. In the leg, damaged or weakened valves allow blood to pool in the superficial veins, causing them to bulge and twist. According to the Cleveland Clinic, in the scrotum, the same type of valve failure causes blood to collect in the testicular veins rather than flow efficiently back toward the heart.
Varicoceles are more common in younger men. They typically develop during puberty, when blood flow to the genitals increases rapidly, and then grow slowly over time, UCLA Health advises. They most often occur on the left side of the scrotum, for the anatomical reasons explained below.
Many varicoceles cause no symptoms at all. This is part of what makes them easy to miss. However, according to Mayo Clinic, when symptoms do appear, they may include:
In more significant cases, varicoceles may also contribute to lower testosterone levels, which can cause fatigue, reduced sex drive, and muscle loss, warns Cleveland Clinic.
If you notice persistent scrotal discomfort, visible changes in the scrotum, or unexplained fertility concerns, it is worth talking to a healthcare provider. These symptoms can overlap with other conditions, so an accurate diagnosis is important.
The root cause is faulty valves in the veins of the spermatic cord. When those valves fail, blood flows backward and pools in the pampiniform plexus instead of draining properly toward the heart, according to UCLA Health. Several factors can increase the risk:
Congenital valve defects. Many varicoceles are thought to result from congenital (present at birth) valve abnormalities, according to UCLA Health.
Puberty and rapid growth. The sudden increase in testicular blood flow during puberty can overwhelm an already marginal venous drainage system.
Anatomy of the left side. The left testicular vein drains into the left renal vein at a sharper angle than the right side does. This makes venous return harder on the left, which is why varicoceles are far more common on that side.
Abdominal pressure. Chronic straining, obesity, or persistent coughing can increase intra-abdominal pressure and impair venous return from the testicles.
Underlying conditions. In rare cases, a varicocele, especially one that appears suddenly in a man over 40, may indicate a kidney tumor or another obstruction blocking venous drainage, warns UCLA Health Interventional Radiology. This warrants prompt medical evaluation.
According to the NIH/NLM, varicoceles are the most commonly identified correctable cause of male infertility (While roughly 15 percent of men in the general population have a varicocele, that number jumps to approximately 40 percent among men evaluated for infertility, says UCLA Health.
The reason comes down to temperature. The testicles function best at a few degrees below core body temperature; that is why they sit outside the body in the first place. Varicoceles disrupt this temperature regulation by pooling warm blood near the testicles. Over time, elevated scrotal temperature can impair sperm production, reduce sperm motility, and affect sperm quality, confirms Mayo Clinic Health System.
It is worth noting that not every varicocele causes infertility, and not every man with fertility problems has a varicocele. The relationship is significant, but it is not a guarantee in either direction.
Both varicoceles and leg varicose veins develop because of venous insufficiency, the same underlying failure of vein valves to keep blood moving in the right direction, according to the Korean Journal of Internal Medicine, 2019, as reported by the National Library of Medicine. Blood pools, pressure increases, and veins stretch and enlarge.
The differences are largely anatomical:
The shared mechanism matters because it suggests that men with one form of vein disease may have an underlying susceptibility to venous valve dysfunction more broadly. If you have been diagnosed with a varicocele and notice symptoms in your legs, such as aching, heaviness, swelling, or visible varicose veins, those leg symptoms also deserve attention.
CVR treats leg vein conditions only. For varicocele concerns, see a urologist, andrologist, interventional radiologist, or your primary care physician.
If you are experiencing leg pain, swelling, and visible changes in your leg veins, do not wait to get help. Center for Vein Restoration's board-certified vein specialists are ready to help at 130+ locations across 23 states.
📍Find a Center for Vein Restoration near you HERE
📞 Call Center for Vein Restoration at 240-249-8250
📅 Book an appointment at CVR online HERE
Center for Vein Restoration does not treat varicoceles. Depending on the severity and whether fertility is a concern, seek advice and treatment from:
Urologists who diagnose and manage varicoceles through physical examination and imaging and can determine whether intervention is needed.
Interventional radiologists who perform varicocele embolization, a minimally invasive procedure that uses imaging guidance to block off the affected vein and redirect blood flow, according to UCLA Health Interventional Radiology.
Vascular surgeons may perform a varicocelectomy, a surgical procedure to tie off the dilated veins, in more complex cases.
Not every varicocele requires treatment. Many men are monitored with regular checkups, especially if the varicocele is not causing pain and fertility is not a concern, says Mayo Clinic.
See a healthcare provider if you notice:
Do not attempt to self-diagnose! Several conditions can produce similar symptoms, and an accurate diagnosis requires a physical exam and often a scrotal ultrasound. A urologist, andrologist, or interventional radiologist is the appropriate specialist for the evaluation and treatment of a varicocele. Center for Vein Restoration does not treat varicoceles or male infertility. CVR specializes exclusively in chronic venous insufficiency and venous disease of the legs.
Men are less likely than women to seek care for vein-related symptoms, even when those symptoms affect quality of life. This holds true for varicoceles and leg vein disease alike.
Chronic venous insufficiency affects a significant portion of the adult population, and leg symptoms such as aching, fatigue, swelling, and visible varicosities are often dismissed as simply getting older or standing too much. They are not.
Venous disease anywhere in the body is a medical condition. It is diagnosable and treatable. And catching it early means better outcomes. For varicocele concerns, the right specialist is a urologist, andrologist, or interventional radiologist. For leg vein symptoms, Center for Vein Restoration's board-certified physicians are ready to help at 130+ locations across 23 states.
Vein health affects more than how your legs look. It affects how you feel, how you function, and for men with varicoceles, potentially your fertility and testosterone as well. Whether your concern is scrotal vein symptoms or leg vein disease, the right step is the same: get evaluated by a specialist.
Center for Vein Restoration is the nation's largest physician-led vein practice, with 130+ locations across 23 states and a 98% patient satisfaction rating. Our board-certified vein physicians diagnose and treat venous insufficiency, varicose veins, spider veins, and related vein conditions using the latest minimally invasive, outpatient procedures.
If you have been ignoring leg heaviness, swelling, or visible changes in your leg veins, do not wait! The vein specialists at Center for Vein Restoration are here to help. Call 240-249-8250 or schedule a consultation online at a CVR near you
Q: Does Center for Vein Restoration treat varicoceles or male infertility?
No. Center for Vein Restoration does not treat varicoceles or male infertility. CVR is the nation's largest physician-led vein practice, specializing exclusively in chronic venous insufficiency and venous disease of the legs, including varicose veins, spider veins, and venous leg ulcers. If you have concerns about a varicocele, consult a urologist, andrologist, interventional radiologist, or your primary care physician.
Q: Can a varicocele go away on its own? Varicoceles do not typically resolve without treatment. Many remain stable for years and require only monitoring. Others may worsen over time and eventually require intervention. A urologist can assess severity and help determine the right approach for your situation.
Q: Is a varicocele the same as a varicose vein? They share the same underlying cause — venous insufficiency, meaning vein valves that fail to keep blood flowing properly. But the location and consequences differ. Varicoceles involve the veins of the scrotum and can affect fertility and testosterone. Varicose veins in the legs can cause pain, swelling, and, if left untreated, more serious conditions like venous ulcers or blood clots.
Q: Does having a varicocele mean I will be infertile? Not necessarily. While varicoceles are found in approximately 40% of men evaluated for infertility, many men with varicoceles father children without difficulty. Whether a varicocele is affecting fertility depends on factors your urologist can assess, including sperm analysis and the grade of the varicocele.
Q: Can leg varicose veins and varicoceles occur in the same person? Yes. Both conditions stem from venous valve dysfunction, and a man who develops one form of vein disease may be more susceptible to the other. If you have been diagnosed with a varicocele and also have leg vein symptoms, it is worth discussing both with the appropriate specialists. If you have concerns about a varicocele, consult a urologist, andrologist, interventional radiologist, or your primary care physician. If you have a concern about varicose veins of the leg, contact Center for Vein Restoration.
Q: What does a vein center treat, and who should I call? Vein centers like Center for Vein Restoration treat venous insufficiency and related conditions in the legs, including varicose veins, spider veins, chronic venous insufficiency, and venous leg ulcers. For varicoceles specifically, you would see a urologist or interventional radiologist. If you have questions about leg vein symptoms, CVR's team is available at 240-249-8250.
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