Can a Varicocele Be Treated with Tablets? What the Evidence Shows

Ultimo aggiornamento: Agosto 27, 2026

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Men who have been told they have a varicocele reasonably ask whether there is a tablet for it, particularly when the problem is a dull ache rather than a fertility question. The short answer is worth stating before anything else.

No medication corrects a varicocele. The dilated veins remain dilated. What is discussed on this page is whether a drug can ease the symptoms in a man who does not want an operation — a narrower question, and one where the evidence is thinner than it is usually presented.

For what a varicocele is, when it needs treating and when it does not, start with the varicocele overview.

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The reasoning behind trying a tablet

The testicle works best a couple of degrees below core body temperature. A varicocele lets blood at full body temperature pool around it, and that — together with oxidative stress and the pressure of the pooled blood — is how it interferes with sperm production and produces the heavy, aching sensation men describe at the end of a long day standing.

Since the problem is essentially a plumbing one, the drugs that have been tried are venoactive agents — the same class vascular specialists use for varicose veins in the leg. The best studied is micronised purified flavonoid fraction, usually shortened to MPFF, which improves the tone of vein walls and reduces pressure within them.

An earlier version of this article described MPFF as the only scientifically approved oral medication for varicocele. That overstates its status and has been corrected — it is licensed for chronic venous disease of the legs, and its use for varicocele is off-label and supported by small studies rather than by regulatory approval for this purpose.

Reading the trial figures properly

Il study usually cited reported that after six months, 87.5% of men were completely free of testicular discomfort and the remaining 12.5% were significantly improved. Those numbers are quoted widely, including in the earlier version of this article, and they deserve a moment’s attention.

They add up to 100%. Every single man improved and not one failed to. No treatment in medicine performs like that, and a result of that shape tells you what kind of study it was: a small one, without a comparison group.

That matters because varicocele pain is exactly the sort of symptom that improves on its own. It fluctuates, it responds to attention and expectation, and men enrolling in a study for it are usually at their worst when they start. Without a group taking a dummy tablet, there is no way to separate the drug from all of that. The honest reading is that MPFF may help varicocele-related pain, on weak evidence — not that it relieves it in everybody.

And on fertility

The same study reported improved sperm motility, with no improvement in semen volume, concentration or morphology. One parameter moving in a small uncontrolled study is not a fertility treatment, and MPFF should not be taken in place of proper assessment by a couple who are trying to conceive. Where a palpable varicocele sits alongside an abnormal semen analysis, the discussion is about surgery or embolisation — see the overview, e how to read a semen analysis before drawing conclusions from one.

What to try first, if the problem is the ache

These are simple, free or nearly so, and often enough on their own — and the earlier version of this article went straight to medication without mentioning them.

• Supportive underwear rather than loose, particularly on days spent standing.
• Lying down when it aches. A varicocele drains when you are horizontal, which is why the discomfort eases — and why a swelling that does non settle when you lie flat needs looking into rather than tolerating.
• Simple painkillers for bad days, and breaking up long periods of standing where work allows.
• Confirming the varicocele is actually the cause. This is the step most often skipped. Scrotal ache has other explanations, and men with a varicocele found incidentally sometimes have their pain attributed to it and then treated for years without benefit.

Where those fail and the pain is genuinely attributable, a trial of a venoactive drug is a reasonable next step before considering surgery, provided you understand what it is and is not likely to do. If it has not helped after a few months, it is not going to.

Findings that need attention rather than a tablet

In an emergency in Thailand, call 1669.

• A varicocele on the right side only, one that has appeared suddenly, or one that does not drain away when you lie down. These patterns can indicate something in the abdomen pressing on the vein and need imaging rather than treatment for symptoms.
• Sudden severe testicular pain — an emergency the same day, and not a varicocele.
• A firm lump within the testicle itself, as distinct from the soft veins above it.
• One testicle becoming noticeably smaller than the other, particularly in a teenager.

Domande frequenti

Can a varicocele be cured without surgery?

The varicocele itself cannot be corrected by any tablet — the dilated veins remain. What medication may do is ease the pain. An earlier version of this article answered this question with a plain yes, which conflated relieving a symptom with treating the condition.

Does MPFF really relieve pain in nearly everyone?

Those figures come from a small study with no comparison group, and they total 100% — every man improved and none failed to, which no treatment achieves. Varicocele pain fluctuates and improves on its own, so without a placebo group the drug cannot be separated from natural improvement. It may help; the evidence is weak.

Will tablets improve my fertility?

They should not be relied on for that. One study reported improved sperm motility with no change in volume, concentration or morphology, which is not a basis for treating infertility. A couple trying to conceive should be assessed properly rather than taking a venoactive drug and waiting.

What should I try first for the ache?

Supportive underwear, lying down when it aches, simple painkillers on bad days, and breaking up long periods of standing. Also worth confirming that the varicocele is genuinely the cause, since scrotal ache has other explanations and an incidentally found varicocele is often blamed for pain it is not causing.

How long should I give it?

A few months is a fair trial. If the pain has not eased by then, it is not going to, and continuing indefinitely is not the answer — that is the point to discuss surgery or embolisation.

Arranging a consultation

Dr. Soarawee Weerasopone sees andrology and male fertility patients at Ospedale Bangokok Sede Centrale and at Samitivej Sriracha Hospital in Chonburi on 088-022-1445. Bring any semen analysis reports with their dates, and a list of anything you are already taking for the pain.

Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. Samitivej Sriracha is in-person only. Enquiries about cost are answered by the hospital, not by this website.

Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters, and is intended for education only. It is not medical advice, diagnosis or a prescription for any individual, and no advice, diagnosis or prescription is given through personal messaging channels or social media. Dr. Soarawee operates no public social media account; any account offering private consultation in his name is fraudulent. In an emergency in Thailand, call 1669.