Varicocele: A cause of ED? Can Varicocele Surgery (varicocelectomy) Help Erectile Dysfunction?

Varicocele is a condition that affects a lot of men in America and around the world. Erectile Dysfunction (ED), on the other hand, affects the sexual lives of over 30 million men in the U.S.

In this article, we’ll talk about varicocele, the link between varicocele and erectile dysfunction, and whether or not varicocele surgery helps with erectile dysfunction.

What is Varicocele?

Varicocele is a health problem that affects men. It is caused by the enlargement of the veins in the scrotum, which is a loose bag that contains the testicles.

These veins generally carry oxygen-depleted blood back to the heart, and varicocele occurs when there is a problem with the valves of these veins, causing the blood to pool in the veins and cause enlargement of veins.

Varicocele’s Impact on Erections and Can it Cause Erectile Dysfunction?

Before we talk about how Varicocele affects erections and erectile dysfunction, let’s talk about how Varicocele affects a man’s testicles, fertility, and testosterone levels.

Effects of Varicocele on Men

Although Varicocele is an asymptomatic condition in most men, it does have some complications. The most common complications are as follows:

Impaired Fertility

Typically, testicles function at a 3°C lower temperature than the average body temperature. However, Varicocele has an impact on sperm production and quality because it raises the warmth in the testicles. Studies have shown that between 40 and 50 percent of patients with varicocele are also diagnosed with infertility [2]. Hence, it is clear that varicocele has a serious detrimental impact on male fertility and can result in reduced fertility.

Decreased Testosterone Production

Leydig cells are the primary source of testosterone, and when stimulated by a luteinizing hormone, these cells are able to create testosterone ( LH ). Varicoceles almost always result in the deterioration of Leydig cells, which in turn brings about a drop in testosterone levels.

Scrotal Discomfort

As blood pools in the scrotum, the scrotum becomes heavy and causes pain during exercise, activity, or after prolonged standing. This can produce discomfort or pain in the scrotum, which is often described as a dull, aching, or throbbing ache in the testicle, scrotum, or groin, however, it can occasionally be severe, sharp, or stabbing.

Testicular Atrophy ( Shrinking of Testicles )

As blood accumulates in the veins of men with Varicocele, the veins lose flexibility and become brittle. As a result, the accumulated blood exerts pressure on the testis, causing the testicles to shrink ( atrophy ).

Decreased Sperm Motility

Sperm Motility mainly refers to the capacity of sperm to move. According to the World Health Organization, the optimal range for Overall motility is 40 to 81%, although according to research, the motility percentage in varicocele patients ranges from 21.1% to 61.9% [1]. It is obvious from the studies that Varicocele has a deleterious impact on sperm motility in men with Varicocele.

Abnormal Sperm Morphology

The shape of sperm (Sperm Morphology ) in people with varicoceles shows what is called a “stress pattern,” which is when the head gets longer and thinner and the cells get amorphous. The number of spermatozoa that looked normal also went down. Also, the number of abnormal sperm heads and cytoplasmic excesses was much higher in the group with varicoceles.

As previously discussed, varicocele has a variety of effects on men’s fertility, testis, and scrotum. Let’s talk about how Varicocele affects erections and erectile dysfunction.

Effect of Varicocele on Erections and Erectile Dysfunction

Although there are few studies that show a link between Varicocele, Erections, and Erectile Dysfunction. The available studies are also ineffective in clarifying the relationship, as some say Varicocele affects a man’s erections and causes Erectile Dysfunction, while others say they don’t.

However, according to the studies, 38.6% of men with Varicocele had erectile dysfunction, whereas only 26.1% of men without Varicocele had Erectile Dysfunction [3]. This demonstrates that Varicocele can, to some extent, affect a man’s erections, resulting in erectile dysfunction.

With the data presented above, we cannot conclude that Varicocele is a direct cause of erectile dysfunction, but it may be an indirect cause.

Are you wondering what an indirect cause is? Although Varicocele is not a direct cause of Erectile Dysfunction, as we have seen from its complications, it does affect testosterone levels, sperm motility, and fertility in men.

When varicocele impacts testosterone levels, it may cause men to have low libidos, which may affect their ability to erect and result in erectile dysfunction.

Additionally, when Varicocele affects male fertility, males may experience worry and depression due to their infertility or diminished fertility. This stress and depression can negatively impact erections and lead to erectile dysfunction.

So we can say that Varicocele might not be a direct cause of Erectile Dysfunction but it is an indirect cause that affects erections and causes erectile dysfunction.

Can Varicocelectomy (Varicocele Surgery) enhance erections and cure erectile dysfunction?

Varicocelectomy (Varicocele Surgery) is a procedure used to repair varicocele-affected veins in males. As evidenced by the preceding section, Varicocele can affect testosterone and Sprem levels in men.

Hence, several patients have reported an increase in sperm and testosterone levels post-varicocelectomy. After varicocelectomy, the majority of patients experienced a rise in testosterone from 648±156→709±232 ng/dL [4]. This rise in testosterone levels and sperm quality will have an effect on a man’s libido and confidence, hence improving erection quality. So many people who have had Varicocelectomy have experienced a considerable improvement in their sexual life and erection quality.


As we can see from the discussion above, Varicocele indirectly contributes to erectile dysfunction since it lowers testosterone levels and sperm quality in males. Men’s erections, erectile dysfunction, and quality of sex life will all significantly improve as a result of varicocelectomy since it helps patients regain their testosterone levels and sperm quality.

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