Testosterone gels and other ways of boosting a man’s testosterone levels are all the rage at the moment. For the right man with the right condition – meaning a verified below-normal testosterone level – these therapies may help. But before jumping onto the hormonal bandwagon, I suggest that guys consider alternatives. For example, clomiphene can boost testosterone levels indirectly and help you avoid some of the side effects of testosterone replacement therapy. In this blog I want to talk about another way that testosterone levels can be raised naturally: by fixing a common problem that can silently sap a guy’s testosterone.

Roughly 1 out of every 5 guys has an abnormality in their scrotums called a varicocele (var-i-ko-seal).  A varicocele is a bundle of enlarged veins that can feel like a bag of worms. The veins are swollen because of defects in the tiny valves that normally keep blood moving forward in the veins that drain from the testicles. In a varicocele, the valves don’t work well, so the blood collects and swells the veins. That extra blood warms the testes unnaturally. This interferes with the cells that manufacture both sperm and testosterone, which are extremely temperature-sensitive.  

Unfortunately, many guys don’t realize they have a varicocele unless it becomes really large and noticeable. A varicocele typically doesn’t hurt and it doesn’t interfere with orgasm or ejaculation. But both animal and human studies show that varicoceles can significantly reduce testosterone levels.

The good news is that fixing a varicocele appears to allow testosterone levels to rebound to their normal levels. The rebound is most pronounced in guys whose T-levels are on the low end of normal. The most recent study to look at this found that after a varicocele was fixed, T-levels increased between 110 and 136 ng/dl over their baseline levels.  

Fortunately, varicoceles are usually relatively easy to detect – you can usually feel them under the skin of the scrotum when it is in a relaxed state, such as after a warm shower. In fact, many men with varicoceles have "low hanging" scrotums. If you’re in doubt, a health care provider or urologist can quickly make the call. If you discover you have a varicocele, there are several simple surgical fixes. They all involve tying off, or blocking, the distended veins in the scrotum. Which method is best depends on such things as the particulars of a man’s anatomy, and the nature and location of the varicocele.

Fixing a varicocele is likely to not only boost your testosterone, but also to improve your sperm count and overall fertility. The moral of the story is that if you’re considering testosterone therapy because you’re feeling the symptoms of “low-T” (i.e. tiredness, low sex drive, muscle weakness), take a moment to check your scrotum and, if you feel anything amiss down there, see your health-care provider or urologist pronto.