Painful Testicles: Varicocele and Scrotum Swelling

Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2009/07/03 - Updated: 2025/10/03
Publication Type: Informative
Category Topic: Male Health Concerns - Academic Publications

Page Content: Synopsis - Introduction - Main - Insights, Updates

Synopsis: This report outlines how a varicocele — an abnormal swelling of veins in the scrotum akin to varicose veins — develops when faulty one-way valves allow blood to pool and backflow, leading to enlarged, heat-damaged veins around the testicles. Over time this can impair nutrient and hormone exchange, potentially lowering testosterone levels, causing testicular shrinkage, fertility decline, or pain. It notes that varicoceles often begin during adolescence and are more frequent on the left side, sometimes remaining symptomless until later life, but if untreated they may worsen. While many men with varicocele face no overt risk, the article flags that delays in treatment might have subtle systemic effects. The information is helpful because it translates vascular and reproductive pathology into accessible language, giving context and warning to older adults, men with disabilities, or those with limited access to specialist care — who might dismiss scrotal discomfort or hormonal changes as inevitable rather than treatable - Disabled World (DW).

Introduction

Varicocele & Scrotum Swelling: Causes, Risks, Treatment

A varicocele is basically one or more swollen veins in the scrotum. If you have a swelling on one or both sides of your scrotum, you might have a varicocele. So what is a varicocele? I'll start with the pronunciation. Imagine you are on an iceberg with a seal. You shiver as you try to say "Very cold, seal" and it comes out "Very co, seal."

Main Content

What is a Varicocele?

A varicocele is basically one or more swollen veins in the scrotum. When the spermatic veins that lead upward from the testicles toward the heart become abnormally swollen, the one-way valves inside the veins fail and it becomes difficult for blood to be pumped uphill against gravity.

Normally the blood leaving the scrotum is pumped upward when the heart beats. Then the valves close and prevent the blood from falling back down until the next heartbeat. When the vein gets stretched out and becomes too wide for the valves to fully close, then the blood flows back down between beats. The blood backs up in the veins around the testicles, the weight of the blood stretching and enlarging the veins further, like when you pour water into a balloon.

These swollen veins are called a varicocele. You may know someone who has varicose (i.e. swollen) veins in their legs. A varicocele is, essentially, varicose veins of the scrotum. Without proper blood flow, the testicles become undernourished, polluted, and overheated. This may result in infertility or low testosterone levels.

Varicoceles are common. About 15% of all men have a varicocele. Varicoceles usually develop slowly and there may not be any symptoms. Over time, the veins may become quite enlarged and painful.

Varicoceles usually appear on the left side of the scrotum, but can involve both sides, in which case there is an increased possibility that they may contribute to hormone imbalances that cause erectile dysfunction.

Varicoceles develop after puberty, most commonly in men aged 15 to 25.

The sudden appearance of a varicocele in an older man may be caused by a renal tumor that affects the renal vein and impairs the blood flow through the spermatic vein. However, it is common for a varicocele to go undiagnosed until fertility problems become evident or it becomes quite enlarged or painful, so an older man diagnosed with a varicocele may actually have had it for many years.

It is widely believed that varicoceles are the most common cause of infertility, although this is debated. 39% of males who are treated for infertility have a varicocele. Among those who have previously fathered a child but now are unable to do so, 80% have a varicocele. The good news is that fertility can be restored when the varicocele is treated.

The consensus opinion is that varicoceles are not a health risk and do not require treatment. However, while you delay treating your varicocele, your testicle may be shrinking, resulting in lower testosterone levels. This has profound effects, resulting in decreased vitality and a weakened immune system.

Several studies have shown a decrease in testosterone levels in men with varicoceles, however it is often still within the normal range.

Insights, Analysis, and Developments

Author Credentials: Ian is the founder and Editor-in-Chief of Disabled World, a leading resource for news and information on disability issues. With a global perspective shaped by years of travel and lived experience, Ian is a committed proponent of the Social Model of Disability-a transformative framework developed by disabled activists in the 1970s that emphasizes dismantling societal barriers rather than focusing solely on individual impairments. His work reflects a deep commitment to disability rights, accessibility, and social inclusion. To learn more about Ian's background, expertise, and accomplishments, visit his full biography.