Men with scrotum condition have raised heart attack risk

A common condition that affects men’s scrotums has been linked to heart disease and diabetes for the very first time in a study.

Those who suffer symptoms from enlarged veins in the scrotal sack were found to be more likely to go on to develop vascular disease – the most common precursor to coronary heart disease and heart attack.

They were also discovered to be at a raised risk of metabolic syndrome, the medical term for a cluster of conditions — increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol levels — that occur together, increasing your risk of heart disease, stroke and diabetes. 

An estimated 15 per cent of men have these dilated veins, also known as varicoceles but not all suffer symptoms from them.

Similar to varicose veins, the exact cause of varicoceles is unknown. They tend to affect one side – usually the left – and can cause infertility. At present, those who do have symptoms are treated and those without any are often told not to worry. 

A link found with men who suffer symptoms from varicoceles – enlarged veins in scrotal sack – and heart disease and diabetes (stock photo)

But after analysing a large data set from insurance claims, researchers from Stanford University’s Medical School believe there may be reason to be cautious.

‘To millions of men that are diagnosed with this, a lot of them are told, ‘Don’t worry about it,’ said study author, Michael Eisenberg, assistant professor of urology.

Varicoceles are treated for low sperm production and pain, but other risks may be going unchecked. 

‘Varicoceles are associated with low testosterone, and low testosterone in turn is associated with metabolic risks and heart disease,’ said urology resident Nancy Wang. 

‘No one has connected the dots between varicoceles, testosterone and these conditions before now.’

WHAT IS VARICOCELE?

A varicocele is an enlargement of the veins within the loose bag of skin that holds your testicles (scrotum). It is similar to a varicose vein that can occur in your leg.

Varicoceles are a common cause of low sperm production and decreased sperm quality, which can cause infertility. However, not all varicoceles affect sperm production. Varicoceles can also cause testicles to fail to develop normally or shrink.

Most varicoceles develop over time. Fortunately, most varicoceles are easy to diagnose and many don’t need treatment. If a varicocele causes symptoms, it often can be repaired surgically.

Symptoms

A varicocele often produces no signs or symptoms. Rarely, it may cause pain. The pain may:

  • Vary from sharp to dull discomfort
  • Increase with standing or physical exertion, especially over long periods
  • Worsen over the course of a day
  • Be relieved when you lie on your back

With time, varicoceles may enlarge and become more noticeable. In young men, the presence of a varicocele impairs sperm production and can often be improved with treatment.

When to see a doctor

Because a varicocele usually causes no symptoms, it often requires no treatment. Varicoceles may be discovered during a fertility evaluation or a routine physical exam.

However, if you experience pain or swelling in your scrotum, discover a mass on your scrotum, notice that your testicles are different sizes, or develop a varicocele in your youth, or you’re having problems with fertility, contact your doctor. A number of conditions can cause a scrotal mass or testicular pain, some of which require immediate treatment.

Source: Mayo Clinic 

How the research was carried out 

The researchers analyzed a database of insurance claims filed by 77 million men since 1996.

They identified more than 4,400 reproductive-age men diagnosed with varicoceles between 2001 and 2009, to see whether the condition also put them at risk for health problems.

For comparison, the team also looked at men without varicoceles. All were followed for three years.

The study, published in the journal Andrology, found that compared to men without varicoceles, men with the condition had a significantly higher incidence of heart disease, diabetes and had high concentrations of fat in their blood.

Only men with symptoms, especially fertility problems and scrotal pain, showed increased risk of developing these diseases.

Those without symptoms from their varicoceles had no raised incidences.

Key findings

The team believe the enlarged veins are thought to allow more blood to flow through the scrotum and raise its temperature above normal levels. 

The heat can impair testicular function leading to lower sperm and testosterone production. 

The condition also can cause pain or shrinkage of the testicles, but often results in none of these symptoms and is left untreated. 

The study authors suggest that their findings could mean that even men without symptoms should be closely monitored.

Varicoceles often form during puberty and therefore may be an early marker of heart problems and diabetes.

‘If it’s truly asymptomatic, observation remains appropriate,’ said Dr Eisenberg.

The authors said more research is needed to determine if the condition plays a causative role in these conditions and whether treatment could help prevent disease later on.

  



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