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Varicocele - ExSeed's go-to guide

Ever heard of varicocele? If you haven’t, don’t worry, you’re not alone. Despite being pretty common, the condition is not often spoken about or understood – until you find yourself in a doctor’s room being told you have one. 

Whilst varicoceles don’t usually call for concern, they can sometimes impact your fertility. That’s why it’s good to know what to look out for and what to expect if you develop one.

Here we’ll run through what varicoceles are, what risks they pose, and what treatments are available. 

So, what is a varicocele? 

The scrotum holds the testes and the epididymis – the tube which transports sperm. If you’ve read our blog “Testicle Temperature: How Heat Impacts Fertility” you’ll know that for optimum sperm production, testes need to have a temperature of 2-4°C lower than body temperature. Part of this is down to the pampiniform plexus – which is a network of veins surrounding the testicles and the epididymis. The pampiniform plexus acts through a “heat exchange” mechanism to cool down the scrotum.

A varicocele is when the pampiniform plexus becomes enlarged. It’s a condition which affects approximately 1 in 6 men (15%). A varicocele will usually be found on the left side of the scrotum, but can be on both sides or, in rare cases, just the right side.

What are the causes?

Varicoceles generally form during puberty when the testicles need a lot of blood flow for rapid maturation.

Experts currently think this is due to a defect in the valves which stops the regular blood flow to and from the testicles. This can then cause the blood to pool or flow backwards and cause a swell. 

Since they usually happen during puberty and are down to a random defect, there’s no sure way to prevent a varicocele. There’s also no link between varicoceles and any specific ethnic group or medical condition, so predicting who will develop varicoceles is near impossible.

That being said, hypertension and being overweight both increase the risk of blood pooling. Varicoceles usually come on between the ages of 15-25, but there’s a chance of developing one later in life. Keeping physically active and following a good diet can limit your chances of developing high blood pressure, which is good for your heart and lungs, as well as your balls!

What are the symptoms? 

The common symptoms of varicoceles:

  • swelling in the scrotum Varicocele
  • visibly twisted and enlarged veins in the scrotum, which can look like a bag of worms.

And less common:

  • a lump in one of the testicles
  • a dull pain in the scrotum

 

While most cases of varicocele happen between ages 15-25, it’s still important to practice regular self-examinations no matter your age. If you do feel changes or swelling of the veins, your doctor can diagnose a varicocele with a physical examination of your testicles, or a scrotal ultrasound. The ultrasound gives the doctor more detailed information about the varicocele, including its size.

Unusual changes in appearance or feel (especially in the testicles!) can’t go ignored and need to be reported to the doctor. 

Can varicoceles impact my fertility? 

The sad truth is yes, they can. While most men with a varicocele do not experience fertility issues, around 1 in 3 infertile men do have a varicocele.

Sperm production is all about balance and keeping the perfect conditions. So when the veins needed to regulate heat are swollen, it can get too hot for proper sperm production. Research shows that men with a varicocele often have lower sperm concentration and sperm quality, and that this gets worse with time as the varicocele increases in size. 

Varicoceles may also impact testosterone production, and lead to lower T levels. This isn’t always a concern for fertility or overall health, but lower testosterone levels can cause erectile dysfunction and fatigue among other issues. You can read more in our blog “Low Testosterone, Symptoms and Impact on Fertility” to learn more.

How can I be sure a varicocele isn’t impacting my fertility?

Since most varicoceles don’t cause serious pain, they go untreated or ignored after a diagnosis. This means if you’re living with a varicocele, you could be subfertile or even infertile without knowing it!

Without treatment, varicoceles won’t go away and can get progressively worse with age. This means it’s really important to keep an eye on your sperm health if you have varicoceles, especially if you’re currently trying to conceive.

An ExSeed home-test kit makes it easier than ever to monitor your sperm health. Not only can you test from the comfort of your home, but you can also receive detailed results of your sperm count and quality. ExSeed provides expert guidance to improve your fertility through lifestyle changes, and also offers support through the difficult journey of infertility.

Is there treatment that can help?

Most of the time, varicoceles aren’t something to worry about. Minor painkillers can usually manage any pain or discomfort. But if varicoceles are causing more serious pain or fertility issues, then there are options available for treatment:

Embolization. The doctor will insert a small needle into the varicocele to temporarily cut off the blood supply. It’s performed under local anaesthesia, so the patient is awake but won’t feel any pain. The procedure has a very easy and quick recovery, usually without much pain other than tenderness.

Embolization has a failure rate of around 3.2% to 18.9%, and is largely dependent on which side the varicocele is on. 

There’s also the option of microsurgery:

Varicocelectomy. Like embolization, a varicocelectomy blocks off the blood supply to the vein. A doctor will put the patient under general anaesthetic. There are just a few days of pain or tenderness during recovery. 

The good thing about surgery is it has a failure rate of less than 5%, and has been successful in increasing fertility for men suffering infertility due to varicocele. 

Conclusion?

Varicoceles are pretty common but almost always start during puberty. So if your squeaky voice and acne phase is a distant memory, developing a varicocele is unlikely. But, it’s not impossible! Take care of your blood pressure by avoiding cigarettes, keeping physically active, and managing your emotional stress. 

If you have a varicocele and are worried about your fertility health, then an ExSeed sperm analysis is just one delivery away. 

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Wearing tight pants and underwear

Studies show that men who wear looser underwear have higher sperm concentration and total sperm count compared to men who wear tighter underwear. So, lose the tight clothes and wear something loose to give your testicles some air.

CONCLUSION: learn more about how heat can affect sperm quality here.

Stress

Besides higher mortality rate and various diseases, stress is associated with low sperm quality. Stress is known to be associated with lower testosterone levels and oxidative stress with both playing an essential role in producing and maintaining healthy sperm cells.

CONCLUSION: If you feel stressed, we recommend you get some help so you can have a balanced mental health. For a stress management guide, download the ExSeed app for free and start your personalized action plan today.

Physical activity

Scientific studies show that men who are physically active have better semen parameters than men who are inactive. Fertility specialists also state that regular physical activity has beneficial impact on sperm fertility parameters and such a lifestyle can enhance the fertility status of men.

Prioritizing exercise can help improve your overall health and result in healthy, fast swimming sperm cells that have good chances of fertilizing an egg.

CONCLUSION: Try incorporating exercise in your weekly schedule to you ensure exercising at least twice weekly. We recommend a combination of cardio training and strength exercise. Read more about exercise and male fertility on our blog.

Nutrition

Fast Food
Processed foods damage the health of sperm-producing cells and cause oxidative stress, which lead to poorer sperm quality. Heavy consumption of junk food (every week) can increase the likelihood of infertility since men who consume vast amounts of unhealthy food are at risk of having poor sperm quality. Besides harming your fertility, junk food enlarges your waistline, harms your cardiovascular system, kidneys, and more.

Vegetables
Eating more fruit and vegetables can increase your sperm concentration and motility. It’s important that you consume a healthy diet filled with antioxidants and that you eat vegetables every day. Foods such as apricots and red bell peppers are high in vitamin A, which improves male fertility by nurturing healthier sperm. Men who are deficient in this vitamin tend to have slow and sluggish sperm.

Sugary snacks/beverages: several times a week Excessive consumption of high sugar items can lead to oxidative stress, which negatively impacts testosterone levels and sperm motility. Sugary snacks and beverages are also highly associated with obesity and low fertility.
CONCLUSION: To boost sperm quality, stay away from fast food, processed food, and sugary snacks or beverages. You need to implement a healthy prudent diet filled with necessary superfoods needed for good sperm production. Check out our guide to Male Fertility Superfoods. For personalized guidance and support on how you can start improving your sperm health, check out the Bootcamp.

Heat

Direct heat can inhibit optimal sperm production and cause Sperm DNA damage. Sperm cells like environments that are a couple of degrees lower than body temperature. Avoid overheating from warm blankets, seat warmers, heat from your laptop, hot showers, and saunas.

Cigarette smoking

The exposure to tobacco smoke has significant negative effects on semen quality. The damage of cigarettes and nicotine of course depends on how many cigarettes you smoke per day and for how long, but even low usage (up to 10 cigarettes / day) can inhibit healthy sperm production.  

CONCLUSION: Stay as far away from cigarette smoking as possible if you care about your general health and your fertility. Read more here.

Cell phone

When you have your cell phone in your front pocket, your testicles are exposed to electromagnetic radiation, which studies have shown to damage the sperm cells. Put your phone in the back pocket of your pants or in your jacket pocket.

BMI

There is a clear association between obesity and reduced sperm quality. At least part of the reason for this is that obese men may have abnormal reproductive hormonal profiles, which can impair sperm production and lead to infertility. 

A BMI higher than 30 can lead to several processes in the body (overheating, increase in oxidative stress in the testes, sperm DNA damage, erectile dysfunction) that can have a negative impact on male fertility. This can result in problems when trying to conceive.  

CONCLUSION: BMI is one of the risk factors that influence semen quality and, for example, sperm motility.  

Alcohol

A beer or glass of wine now and then do not really harm sperm quality. But excess alcohol drinking (more than 20 units per week) can reduce the production of normally formed sperm needed for a successful pregnancy.

CONCLUSION: If you want to stay safe, stay under 14 units of alcohol per week. For more information on how alcohol can affect male fertility, take a look at our blog: “Alcohol and Sperm Quality”.

Age

Studies show that women younger than 35 and men younger than 40 have a better chance of getting pregnant. Men can produce sperm cells almost through their entire life, but the sperm cell DNA is more fragile and prone to damage after the age of 40.

As men age, their testes tend to get smaller and softer resulting in a decline in sperm quality and production. These changes are partly because of an age-related decrease in testosterone level, which plays a very important role in sperm

production. Higher male age (>40 years) is not only associated with a decline in sperm production but also with increased sperm DNA fragmentation and worsened morphology (shape) and motility (movement). These negative effects make the sperm cells less qualified for egg fertilization.

CONCLUSION: with an age under 40, you shouldn’t have to worry much about age as a factor in itself. However, studies have shown a slow decline after the age of 30-35 years

and if you are above 40 years of age, your sperm quality can be affected due to increased sperm DNA damage resulting in a decrease of sperm motility and concentration. Remember that you cannot evaluate the quality of a sperm sample by just looking at it – this requires a sperm analysis.