You train your body, track your protein, count your reps—and then ignore a dull ache or heaviness in the scrotum.
For many men, especially gym-goers, that is how varicocele symptoms begin: mild, intermittent and easy to dismiss.
A varicocele is an enlargement of veins around the testicle, most commonly on the left side. It is not caused simply by the gym, tight clothing or a sauna. It is usually related to vein-valve anatomy. But repeated heat exposure, smoking and delayed assessment can be important for testicular and fertility health—particularly if a varicocele is already present.
“It used to come and go…”
“Many patients tell me: ‘Doctor, it used to come and go. Of late, it has become more frequent and lasts longer.’
By the time some men seek advice, the pain has become persistent—or they have already received a poor semen-analysis report while planning a pregnancy.”
— Dr Rohit Madhurkar
A dragging, dull aching sensation that worsens after a long day, standing, exercise or heavy lifting should not be ignored—especially if you notice enlarged veins, heaviness, or a difference in testicular size.
Can varicocele be prevented?
Not always. A varicocele cannot be completely prevented because it is often related to the anatomy and function of the scrotal veins.
But you can reduce avoidable stress on your reproductive health and seek help before symptoms or fertility concerns become more significant.
1. Wear supportive, well-fitting underwear
Choose comfortable, well-fitting supportive underwear—especially during workouts or if you experience a dragging sensation.
The goal is support, not excessive tightness. If pain is worse after training, temporary scrotal support may help while you arrange an assessment.
2. Do not push through persistent pain during heavy workouts
Heavy lifting does not automatically cause varicocele. But strenuous workouts and breath-holding during lifts can increase abdominal pressure and may make symptoms from an existing varicocele more noticeable.
Practical tips:
- Use correct lifting technique and avoid repeated straining
- Do not ignore a recurring scrotal ache after workouts
- Reduce intensity temporarily if discomfort persists
- Avoid self-medicating and repeatedly “testing” the pain at the gym
- Get examined if pain is recurring, prolonged or worsening
Fitness is good for overall health. Persistent testicular discomfort is not something to train through.
3. Be sensible about heat exposure
The testicles function best at a temperature slightly lower than core body temperature. Repeated or prolonged heat exposure may temporarily affect sperm production and quality.
If you are trying to conceive, have a known varicocele or have an abnormal semen analysis, consider limiting:
- Frequent sauna or steam-bath sessions
- Prolonged hot baths or very hot showers
- Keeping a laptop directly on the lap for long periods
- Repeated high-heat exposure around the groin
This does not mean that one sauna session causes infertility. The concern is regular, prolonged exposure—particularly when there is an existing fertility issue.
4. Stop smoking—your sperm health matters too
Smoking can adversely affect sperm quality and is a modifiable risk factor for male reproductive health.
If you have varicocele, are planning pregnancy, or have an abnormal semen report, stopping smoking is one of the most useful changes you can make for your overall vascular and fertility health.
5. Do not wait until fertility testing forces the discussion
Many men first discover a varicocele only after a poor semen analysis while trying for pregnancy.
A varicocele does not mean infertility, and not every man with varicocele needs treatment. But early evaluation is sensible if there is:
- Dull, dragging or worsening scrotal pain
- Visible or palpable enlarged scrotal veins
- A feeling of heaviness, especially after standing or exercise
- Difference in testicular size
- Difficulty conceiving
- An abnormal semen analysis
- Pain that is becoming more frequent or prolonged
What does an early assessment involve?
A proper assessment usually includes clinical examination and a scrotal Doppler ultrasound to identify the veins, reflux and testicular size. Semen analysis may be advised when fertility is a concern.
The purpose is not to push every patient toward a procedure. It is to understand whether reassurance, lifestyle changes, pain control, follow-up, or treatment is appropriate.
Protect your testicular, fertility and sexual health
Varicocele is primarily linked to scrotal discomfort and, in some men, impaired sperm parameters. It should not be assumed to be the cause of every sexual-health concern.
The practical message is simple:
Do not ignore a recurrent dull ache. Do not wait until pain becomes severe or a semen report becomes abnormal.
If you have symptoms or fertility concerns, get a timely clinical and Doppler assessment. In selected men with a clinically significant varicocele, persistent pain or abnormal semen parameters, treatment such as image-guided embolisation or surgery may be considered after proper evaluation.
At PinHole Clinic, Bengaluru, we assess varicocele with a focus on symptoms, testicular health, fertility goals and minimally invasive treatment options where appropriate.
This article is for general awareness and does not replace an individual consultation.