If you’ve noticed a dull ache, heaviness, or swelling in your scrotum, you’re not alone. Many men quietly experience these symptoms and wonder if it’s normal — or if it’s something to be concerned about.
Let’s be clear: your comfort, sexual health, and future fertility matter. That heavy, dragging feeling in your scrotum might be caused by something called a varicocele, a condition that’s more common than most people realize, yet too often ignored. The good news? It’s very treatable, and you don’t have to just live with the discomfort or worry.
What Is a Varicocele?
A varicocele is an enlargement of the veins inside your scrotum — similar to varicose veins that some people get in their legs. These veins are part of a network called the pampiniform plexus, which helps cool blood going to the testicles to keep sperm healthy.
When the tiny valves inside these veins stop working properly, blood backs up and the veins stretch out and swell. This can cause that heavy, throbbing, or aching sensation, and sometimes visible twisting or bulging of the veins that people often describe as looking like a “bag of worms.”
Common signs of varicocele include:
- A dull ache or feeling of heaviness in the scrotum, which often gets worse after standing, exercising, or at the end of the day
- Enlarged, twisted veins you can see or feel
- One testicle (often the left) appearing smaller than the other (known as atrophy)
- Concerns about fertility, since varicoceles can affect sperm production and quality over time
It’s important to know that varicoceles are very common, affecting about 15 out of every 100 men, and most often appear between ages 15 and 25. They’re most frequently found on the left side due to the way the veins drain into the body.
Why You Deserve Relief
Many men try to tough it out, telling themselves:
- “It’s probably nothing.”
- “It’s just how my body is built.”
- “I don’t want to make a big deal about it.”
But the truth is, untreated varicoceles can impact more than your comfort. They can lead to testicular shrinkage and are a known cause of male infertility, affecting sperm count and quality. Even if you aren’t planning a family right now, preserving your testicular health is important for your hormones and long-term well-being.
Getting help isn’t overreacting — it’s being proactive about your health, comfort, and future.
First Steps: Recognizing and Seeking Help
If you’ve noticed persistent scrotal heaviness, visible veins, or if you and your partner have been trying to conceive without success, it’s time to see a healthcare provider.
Start by seeing:
- A urologist, a doctor who specializes in male reproductive and urinary health
- Or your primary care doctor, who can examine you and refer you to a specialist if needed
What to expect
Diagnosing a varicocele is usually straightforward. Your doctor will:
- Perform a gentle physical exam, often while you’re standing and asked to take a deep breath and bear down (called the Valsalva maneuver), which makes the veins more noticeable.
- In some cases, they may order a scrotal ultrasound to look at blood flow and rule out other possible causes.
This process is simple, non-invasive, and often gives clear answers right away.
Proven Treatments for Varicocele
Lifestyle and Supportive Measures
For men who have mild symptoms and aren’t trying to conceive, simple measures can sometimes help manage discomfort, such as:
- Wearing supportive underwear (like briefs or athletic supporters) to reduce pulling and heaviness
- Avoiding heavy lifting and prolonged standing
- Applying ice packs occasionally to ease soreness
These strategies won’t correct the underlying vein problem, but they can make daily life more comfortable.
Surgical and Minimally Invasive Treatments
If you have persistent pain, testicular shrinkage, or concerns about fertility, your doctor might recommend a procedure to fix the varicocele.
The two main options are:
Varicocelectomy: A minor surgical procedure where the surgeon ties off the affected veins so blood is redirected through healthier ones.
- Usually done through small incisions under general or local anesthesia.
- Most men go home the same day and return to light activities within a few days.
Percutaneous Embolization: A less invasive option performed by an interventional radiologist.
- A tiny catheter is guided through a vein in your groin or neck to the problem veins, where coils or a special solution block them off.
- No incisions are needed, and recovery is typically very quick.
Both approaches are highly effective and chosen based on your anatomy, symptoms, and preferences.
Protecting Your Fertility
If you’re trying to conceive, treating a varicocele can often improve sperm count and quality, and increase your chances of natural pregnancy. Your doctor might recommend a semen analysis before and after treatment to track progress.
Takeaway
A heavy, aching scrotum isn’t just something you have to put up with — and it doesn’t have to hang over your sex life, self-confidence, or future family plans. With straightforward evaluation and proven treatments, you can protect your comfort, your fertility, and your peace of mind.
If you’ve noticed symptoms or have concerns, reach out to a healthcare provider. You deserve a life where your health and intimacy aren’t clouded by pain or uncertainty. Relief is possible — and it starts with a simple conversation.