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Varicocele - Any Way To Reverse Testicular Atrophy?

Discussion in 'Sexuality' started by Ulysses, Aug 22, 2018.

  1. Ulysses

    Ulysses Member

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    Hi,

    In January I visited a urologist to address an unrelated complaint, and while I was there he diagnosed me with a left varicocele. Not having ever heard of the condition before then, I didn't think much of it until I started noticing some posters discussing it on these forums, and dug a little deeper.

    I began to feel concern about it, sought a second opinion. This urologist ordered a scrotal ultrasound, and I just got the results. My left testicle currently measures 4.2 x 1.4 x 2.3 cm. According to the formula used on this site, that places it in the bottom 1% of testicular volume for men my age (26).

    The other testicle is more or less normal, slightly below the mean volume but nothing significant.

    I haven't had the followup phone appointment with the urologist yet, but this already has me feeling quite depressed and a little anxious, so I would appreciate the thoughts of this forum on my situation. I have been dealing with poor libido, lack of erections, low energy and moodiness for some time, and it seems obvious to me that this is a factor.

    Most importantly, what can I do, if anything, to reverse the testicular atrophy? The varicocele is sizable and I would consider surgical repair. From what I've read, modest increases in testicular volume on the order of 1.5-2.5 mL can be expected from varicocelectomy, but I would like to achieve something more than this if possible.

    I have stopped weightlifting and other vertical-load-bearing activities because they clearly aggravate the varicocele, and replaced them with swimming, which noticeably improves blood flow to both testicles for several hours after my workout, and temporarily stops the dull ache I often feel in my left testicle. I know chlorine exposure is not ideal for the testicles, but my thinking is the circulatory benefits outweigh the downsides.

    The last thing, which has me puzzled, is that as recently as December of last year, I had my reproductive hormones tested and my total testosterone was extremely high (1300 ng/dL). I understand that varicocele has progressive effects on testicular function, so maybe my hormone status is worse now, but my feeling is I've had this for a number of years, and I doubt my testicular function was much better just eight months ago. The other relevant pieces of information were low-ish Free Testosterone (towards the bottom end of the reference range) and high estradiol (61 pg/mL if memory serves). I'll try to dig up the test results, but I guess I should probably have my hormones re-tested anyways.
     
  2. General Orange

    General Orange Member

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    You could suppress prostaglandin E2 and increase E1, with aspirin and borage oil against further inflammation.
    You could increase -deleted- elastin, Hyaluronic Acid with asiaticoside and madecassoside extract of Centella asiatica for accelerated healing. In combination with Tribulus terrestris to increase testicular weight.
     
  3. ImprovingDaily

    ImprovingDaily Member

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    I have a vericocele too. Not as bad as yours but I think it'll still apply. I think they come from high estrogen. When I began taking higher doses of Progesterone, the vericocele goes away, no more pain, no more inflammation. It'll come back a bit if I do too much dhea for example or am too stressed, but the progesterone definitely works for me.
     
  4. General Orange

    General Orange Member

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  5. TheHound

    TheHound Member

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    someone posted this book I believe: https://www.amazon.com/Complete-Gui...514124459/ref=cm_cr_arp_d_product_top?ie=UTF8

    I dont have a varicocele but the methods in it helped for general libido improvement. I think you can find a free pdf of it online
     
  6. vulture

    vulture Member

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  7. General Orange

    General Orange Member

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    When you lift weights, this increase stress hormones norepinephrine and prostaglandin E2 and constricts and inflames the veins. But estrogens via Nitric oxide try to relax the constriction and this decreases vascular tone for blood buildup and can damage the structure and valves. Estrogens also increase collagen buildup further damaging structure of veins.

    Peat:
    Aging, estrogen, and progesterone
    In shock, the blood pressure decreases, mainly because the blood volume decreases. Water is taken up by the tissues, out of the blood. Much of the remaining blood volume is accumulated in the relaxed veins, and little is returned to the heart, yet the increased need for circulation accelerates the heart, causing each stroke to pump only a small amount. The reduced blood pressure caused many people to think that adrenaline would help to improve the circulation, but actually the “resistance arteries,” small arteries that provide blood to the arterioles and capillaries, are constricted in shock, (Lin, et al., 1998,) and adrenaline usually makes the situation worse. When tissue is poorly oxygenated (or is exposed to estrogen) it takes up water, swelling and becoming more rigid, turgid. (It also takes up calcium, especially under the influence of estrogen, causing muscles to contract.) This swelling effect will be much more noticeable in small arteries than in major arteries with very large channels, but when the effect is prolonged, it will affect even the heart, causing it to “stiffen,” weakening its ability to pump. There is some evidence that estrogen can make large arteries stiffen, over a span of a few months. (Giltay, et al., 1999)

    Estrogen, by creating an oxygen deficiency, stimulates first swelling, and then collagen synthesis. Collagen tends to accumulate with aging.

    In shock, the cells are in a very low energy state, and infusions of ATP have been found to be therapeutic, but simple hypertonic solutions of glucose and salt are probably safer, and are very effective. The low energy of cells causes them to take up water, but it also causes the veins (which always receive blood after most of its oxygen and nutrients have been extracted) to lose their tone, allowing blood to pool in them, instead of returning to the heart. (Abel and Longnecker, 1978) This contributes to varicose veins (Ciardullo, et al., 2000), and to orthostatic hypotension, which is seen in women who are exposed to too much estrogen, and very frequently in old people.
     
  8. OP
    Ulysses

    Ulysses Member

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    Thanks for the leads; I'll run them down as soon as I have time.

    I can give you guys a quick update on the varicocele situation; I'm happy to say it has improved significantly since I made this post.

    Almost immediately after receiving the ultrasound results, which did shock me, I woke up to the severity of the situation and spent an afternoon researching a number of lifestyle and supplement changes for varicose veins. It would have been better, theoretically, to implement them one at a time, in order to isolate them and thereby get a better sense of which changes were working and which was doing what, but to be honest I was so distressed that I wasn't willing to wait and see for even a short while, so I implemented them all at once. They were:

    1) Inclined bed therapy -- I have seen many reports online that IBT helps varicose veins in general, and so I thought it is likely to also be effective for varicocele. I was only able to find one or two reports from men stating that they had improved or cured a varicocele, specifically, with IBT. So, I elevated the head of my bed (which has a solid metal frame and thus does not bend in the middle) to give 5 degrees of tilt with respect to the floor. There's already a big thread of people raving about this but I can't recommend it enough. It has improved the quality of my sleep significantly.

    2) Pycnogenol supplementation -- I was persuaded to take this by the study linked below. It is a small study and the only one I could find of its kind, but I think ex vivo analysis is evidence of a very high quality, and the effect size they recorded is huge. I ended up taking a larger dose than the one they used in the study, on the strength of some other research that showed Pycnogenol to have greater efficacy for varicose veins (in general, as opposed to varicocele specifically) at a dose of 360 mg/day. If anyone cares to see that second study, I'll try to find it the next time I log on. I should specify that the supplement I'm taking, from NOW Foods, contains Rutin Powder and Acerola Powder in addition to Pycnogenol.

    3) Pansterone -- thinking that hormone production had been affected negatively by the varicocele, I tried supplementing with 1 drop of Pansterone 3x/day. At first I was applying to the testicles, but started having a weird "spacey" feeling so switched to systemic application (on my wrists) instead. When applied systemically, Pansterone makes me feel better almost instantaneously. I'm using a low dose because at my age (26) I don't want to go overboard on the DHEA. I may go back to direct testicular application, because I tried it again last night and felt fine. I have no idea how to explain this, other than perhaps the testicle is getting healthier and more functional.

    4) Aspirin -- Regarding testicular health, I have some concerns about the long-term safety of daily aspirin. I know plenty of forum users take it without issue, but since I obviously have a testicular problem, I want to be especially careful. @haidut posted a study that persuaded me Aspirin is safe for up to ten days of continuous administration, and since the study used athletes, who actually have a higher incidence of varicocele than controls, I think the results would apply specifically to my case. I am cycling it ten days on and ten days off at 325 mg 2x/day, which is the dose used in the study. I started doing this because of the lab showing high estradiol, which I believe is implicated in both the varicocele and its effects on my testicle.

    5) Oral Vitamin C -- 1,000 mg 2x/day. Just to help reduce oxidative stress in the pampiniform venous plexus.

    6) Swimming -- I first heard about swimming for varicocele from the book someone linked to above. After trying it a few times (easy for me because I was a swimmer throughout my childhood and adolescence), I saw immediate and profound acute improvements in the vein, which would shrink to a normal size every time I swam, and stay that way for several hours after I finished. According to the book, this is because when the body is horizontal to the ground, the heart is not fighting gravity to move blood through the spermatic vein, and so long as that's true, an elevated heart rate is actually good for the vein, whereas other forms of exercise will definitely worsen it (I was into cycling for a couple of years and I think that was one of the worst things I could have done). Wanting to understand this further, I dug through some research databases and found the following: water sports players with varicocele have a lower incidence of varicocele and improved morphology compared to other athletes, and have almost the same testicular volume as controls [2]. For those of you unfamiliar with water polo, the sport itself involves plenty of swimming and water polo teams practice their stroke, just like a swim team, as much as they practice ball handling etc. Another user here posted a study arguing that varicocele is the cause of BPH, an argument which I find convincing, and so I think for varicocele patients, swimming also has the benefit of completely emptying the blood vessels in the groin area.

    If you have a varicocele, I urge you to practice some kind of water-based sport to prevent it from getting worse. I often think that if I'd known I had this condition, I would never have stopped swimming after high school. They typically form at puberty and I have always known that swimming made me feel better than any other kind of exercise, but I never knew why and didn't necessarily trust that feeling. Now I realize I should have just listened to my body, which clearly knew better than I did.

    If you don't like exercise or don't enjoy swimming, I think even just hanging out in a pool helps the vein. The authors talk about this in the study I linked:

    "Conversely, the effect of increased hydrostatic pressure acting outside the body and affecting the external genital organs in water polo players is tantamount to the effect of a suspensory, as has been used in the treatment of varicocele, wherein the external pressure of the water when practicing, playing, or competing in water polo acts to enhance the blood that exits the pampiniform venous plexus and inhibits dilation of the veins."​

    7) Eating smaller, less frequent meals -- I guess this is "Peaty" anyways, but wasn't something I took very seriously until I realized that the vein was getting much worse every night after dinner, which is usually my largest meal of the day. There has been speculation on this forum that endotoxin and the associated inflammation of the gut may compress the spermatic vein, thereby contributing to varicocele. I think this is true, and if so, it stands to reason that larger meals are worse, so I started making a very deliberate effort to eat smaller, more frequent meals throughout the day.

    The results: about a month after making all these changes, I can say there has been incremental and sustained improvement in both the vein and testicle.

    Furthermore, the affected testicle feels larger and firmer than before, especially when I'm laying down.
    It used to be that laying down would reduce my left testicle to a kind of gelatinous, amorphous state where it didn't even really feel like I had a testicle at all. Now it is feeling more like a normal testicle, more like my right one, even when gravity is not forcing blood into the testicle.

    It would be nice to have another ultrasound to confirm this, but obviously that would require talking my doctor into ordering it, and I don't see that happening.

    Recall that there are three "grades" of varicocele: I, II, and III. Grade I is a subclinical varicocele, detectable only when the patient bears down. Grade II is a varicocele can be felt, but not seen through the skin of the scrotum. Grade III varicoceles can be seen through the skin, and present the classical "bag of worms" appearance.

    What happens with my varicocele is that when I wake up, it's quite small, almost normal, and becomes progressively engorged as the day goes on. Before starting all these treatments, I would wake up with a Grade II and go to bed with a Grade III. Now, the vein is often practically a Grade I when I wake up, and only rarely reaches the status of a Grade III. When it does, for instance after I have been sitting for a long period of time, all it takes is a simple inversion or cooling treatment to help the vein recover. And furthermore, once the vein has been emptied and shrunk again, it stays that way, rather than immediately re-engorging after the treatment is over, which is what it did before.

    I think the improved venous tone, the ability of the vein to contract, is primarily from taking Pycnogenol. I found pycnogenol while researching Horse Chestnut, which I had tried earlier in the year but discontinued because I felt it was actually worsening the varicocele, perhaps by increasing Nitric Oxide release in the vein. There is a small body of research showing that HC extract (escin) improves varicoceles and sperm count, but I suppose the condition has multiple causes, with some of them responding positively to HC and others not. In any case, it didn't work for me, and I found another study showing that pycnogenol is more effective for varicose veins: Comparative study of Venostasin and Pycnogenol in chronic venous insufficiency. - PubMed - NCBI

    The research on Pycnogenol had subjects taking it for 60 days, and in my case I haven't even been taking it for a month. I set a calendar reminder to re-assess my supplementation strategy on the 1st of November, so I'll try to write another update then.


    [1] Improvements of Venous Tone with Pycnogenol in Chronic Venous Insufficiency: An Ex Vivo Study on Venous Segments
    [2] Restricting sports activity in reducing the rate of varicocele and related infertility parameters in athletes
     
  9. ecstatichamster

    ecstatichamster Member

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    Always appreciate a detailed follow up post. Thanks @Ulysses
     
  10. churchmouth

    churchmouth Member

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    Interesting update. Actually I have a similar hormonal profile and varicocele. The intensity of the varicocele does vary quite a lot too but I don't think I have had any sustained improvement.
     
  11. Bart1

    Bart1 Member

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    I also have a varicocele. Two years (pre peat) ago after reading a lot about it I decided to have a surgery. At first this seemed to help, but I got another one back and this one is far worse because now I have issues with maintaining an erection while lying down. I’m telling you this because I want to warn people fir the possible consequences. I’m hypothyroid and there seem to be a relationship with that. Vitamin E and cascara really helps, but still it is there some days it’s gone
     
  12. churchmouth

    churchmouth Member

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    Can you be specific on the type of surgery? I haven't had my sperm counted but if I am infertile this might be the option required
     
  13. Bart1

    Bart1 Member

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    I had surgery instead of embolization. I would try other options before doing surgery. For instance in my case, I have gut issues due to hypothyroidism, doing a surgery did not help because the cause (gut/hypo) was not treated. If you are in good health and you don't think your hypo a surgery might help. I had a friend who had a positive experience, but he didn't have any other health issues.
     
  14. CLASH

    CLASH Member

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    Many men have left sided varicoceles. Its an anatomical effect most likely due to the positioning of the left testicular vein to the left renal vein. Its not really a varicose vein I dont think. The testicular veins dont have valves from what I understand. Its a pressure gradient effect. With increased intra-abdominal pressure from bearing down or contracting the pelvic floor, the blood is somewhat constricted higher up, leading to a pooling of blood at the testicular level. I would say it may be more of a postural issue around the pelvis and deep musculature like psoas, TVA, obliques, diaphragm. I can make my varicocele go away completely by relaxing my pelvic floor. If I clench it comes back, its only really on the left side for me.
     
  15. Lokzo

    Lokzo Member

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    Man nice finds!
     
  16. jacob

    jacob Member

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    Any tips for relaxing the pelvic floor?
     
  17. CLASH

    CLASH Member

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    @jacob
    Learn how to kegel, aka stop your stream while peeing. If you can contract the muscle you can learn how to relax it. Once you learn how to kegel you can learn how to reverse kegel as well, where you actually expand your pelvic floor.

    Somewhat tangential but I think interesting is learning how to kegel, or more specifically controling your pelvic floor can teach you how to control your ejaculation, erection strength and penile sensitivty as well. For women learning how to control thier pelvic floor can allow them to have orgasms if they dont know how to yet or multiple orgasms if thier stuck at one (this is assuming your stimulating her the right way). The pelvic floor contraction also stimulates the contraction of the tranverse abdominis aka the corset or the muscle involved in stabilizing your core, you can use this to stabilize your spine during lifting.
     
  18. vulture

    vulture Member

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    Are you saying you can intentionally control erection strength?
     
  19. CLASH

    CLASH Member

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    To some degree, yes. I can make my erection harder or softer depending on the contraction of my pelvic floor, this isnt all hard or all soft tho. Its more of a harder or softer. I can maintain the erection for a long time as well keeping my pelvic floor contracted, especally when sensation decreases. Can also keep an erection for 5-10 minutes after I cum by keeping my pelvic floor contracted. The larger share of control is over sensitivity to stimultion tho.
     
  20. General Orange

    General Orange Member

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    I have only one kind of erection: rock hard LOL

    Sure have fun with that but be warned with regular "kegel exercise" for man, training the PC muscle can lead to pre-mature ejaculation. That stuff ifs better suited for females tot strengthen the vaginal walls and stronger orgasm.
    Asian's say to train your anus instead for more orgasm control.

    my 2 cents

    Have a nice day!
     
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