Varicocele: Impact on Testicular Health and Hormones - Urology

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Thank you for your response, doctor.
However, I would like to ask further.
Isn't it true that varicocele can lead to testicular atrophy? If that's the case, shouldn't male hormone levels decrease? Does it really not affect sexual function?

Wán Tóng, 10~19 year old female. Ask Date: 2018/01/21

Dr. Du Shixi reply Urology


Hello: Male hormone deficiency is primarily produced by the testes.
There is a regulatory mechanism involved, and a malfunction in this mechanism could lead to a decrease in hormone levels.
Therefore, testicular atrophy may contribute to this decline, but it might be too simplistic to attribute it solely to that.
Wishing you good health.

Reply Date: 2018/01/21

More Info


Varicocele is a condition characterized by the enlargement of veins within the scrotum, similar to varicose veins that can occur in the legs. This condition is relatively common and can have significant implications for male reproductive health, particularly concerning testicular function and hormone levels.

One of the primary concerns with varicocele is its potential impact on testicular health. Studies have shown that varicocele can lead to testicular atrophy, which is a reduction in the size of the testicles. This atrophy can occur due to several factors, including increased temperature in the scrotal area caused by the engorged veins, which can impair spermatogenesis (the production of sperm) and lead to hormonal imbalances. The testicles are sensitive to temperature changes, and the elevated temperature associated with varicocele can negatively affect the Leydig cells, which are responsible for testosterone production.

As a result, men with varicocele may experience lower testosterone levels, which can lead to various symptoms, including reduced libido, fatigue, and mood changes. However, the relationship between varicocele and testosterone levels is complex. While some studies indicate that men with varicocele may have lower testosterone levels, others suggest that testosterone levels may remain within the normal range despite the presence of varicocele. This variability can depend on the severity of the varicocele, the individual's overall health, and other underlying factors.

Regarding sexual function, varicocele is often associated with male infertility rather than direct sexual dysfunction. While some men may report issues such as erectile dysfunction or decreased libido, these symptoms are not universally experienced and may be influenced by psychological factors, hormonal imbalances, or other health conditions. It is essential to differentiate between infertility and sexual dysfunction, as they are not the same. Infertility refers to the inability to conceive after a year of unprotected intercourse, while sexual dysfunction encompasses a range of issues related to sexual performance and satisfaction.

If a man is experiencing symptoms related to varicocele, such as testicular pain, swelling, or concerns about fertility, it is advisable to consult a healthcare professional. A urologist can perform a physical examination and may recommend a Doppler ultrasound to assess blood flow and the severity of the varicocele. Treatment options may include lifestyle changes, medication, or surgical intervention, depending on the severity of the condition and the symptoms presented.

In terms of lifestyle modifications, maintaining a healthy weight, avoiding prolonged sitting or standing, and wearing supportive underwear may help alleviate some symptoms associated with varicocele. Additionally, addressing any underlying hormonal imbalances through medical evaluation and treatment can also be beneficial.

In conclusion, while varicocele can lead to testicular atrophy and potentially lower testosterone levels, its impact on sexual function varies among individuals. It is crucial for men experiencing symptoms to seek medical advice to determine the best course of action tailored to their specific situation. Regular monitoring and appropriate treatment can help manage the condition and mitigate its effects on reproductive health.

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