Varicocele and the Adrenal/Kidney Connection

I wanted to post this study for anyone dealing with varicocele and going on TRT. For a long time I’ve pondered if my symptoms were from low sex hormones or adrenals/thyroid being out of “whack”. When I initially started getting symptoms directly after getting a varicocele due to injury, they mimicked that of post-finasteride usage, or someone who had been castrated (literally). My labs were coming back in the normal range just my libido disappeared and my testicle atrophied. Around this time I started having weird ED/shrinkage and weight gain around my mid section. Energy/mood wise I had some changes, but nothing major. I’ve always been somewhat “lean”, so it wasn’t overly noticeable. Mood was “okay”.

Because the left testicle is connected to the left adrenal/kidney, it made sense to me that the adrenal gland hormones may also get “messed up” with a varicocele forming, not just impacting the testicle itself. This article explains this does happen and the reasons why:

Essentially, the adrenals over-produce anti-steroid hormones like progesterone (which is always elevated in varicocele sufferers), cortisol, etc and various other hormones that disrupt the actual sex hormones and lead to issues with libido/ED, etc.

I’ve been on TRT for roughly 8 weeks and have seen little improvement, and this seems to be the case for a lot of varicocele sufferers. I don’t have a definitive answer on how to resolve this situation, because it’s pretty complex - one may be taking cortisol in low dosages to suppress adrenal hormone production, though I am still researching this further and don’t have an exact answer.

I am interested to hear from other guys on TRT who have/had varicocele and managed to get improvements from treatment.

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Hi I just had a bilateral varicocele removed grade 3 and grade 2. I am now trying to do a restart. I have been on TRT for 2 years now. Regarding to the varicocele what do you think is best to do?

How did you get on with TRT and what forced the restart?

I got on TRT because I had all the low symptoms of low testosterone and my levels were at 340 and I was only 28 at the time. And I am now doing a restart because I was thinking maybe the varicocele was causing the low T and now that I have it removed maybe I can get my natural T pumping again.

Did TRT solve all your symtoms? Also what were your symtoms pre TRT?


for the most part it did. But still never felt the same as I did before I had any low T problems

What were the symtoms you couldn’t fix?

errections never really came fully back. Libido never came fully back.

That sucks, was there at least a big improvement?

most defiantly

My theory/research still stands that varicocele causes elevated progesterone, which blocks all the improvements and benefits of testosterone. Fixing varicocele “may” bring some slight benefits (it did for me - reduced pain), but it did not correct the libido/ED symptoms and it appears neither does TRT. I have a few thoughts on what “might” work:

  • Low dosages of cortisol may down-regulate that adrenal glands enough to stop the over production of adrenal hormones.
  • DHT Cream - DHT applied directly to the scrotum may circumvent the negative side effects of progesterone, but it’s hard to say. I don’t believe the issue is purely DHT, but also E2 being driven down locally by progesterone.
  • Limit HCG to twice a weekly and TRT to around 100-125mg per week. I know someone with bi-laterial varicoceles that did this with good success in libido/erections. HCG also stimulates the adrenals which could again elevate progesterone and cortisol, leading to further issues.
  • Increasing thyroid function (through NDT or similar drugs) can help take the “load” off the adrenals and may reduce those steroid hormones.

I am still actively researching and trying to find solutions to this!

I have left varicocele. Gonna try to get on TRT soon, have appointments made with private clinic. Hopefully I can get all these symtoms dealt with. Honestly my erections are pretty decent, but my libido is quite low. Along with depression, social anxiety (which I never had issues with prior to varicocele) , poor performance in gym, no assertiveness anymore. I’m just a useless blob at this point. Really hoping I’m offered TRT. Even if half of my issues could be resolved it’d be worth it to me.

So you are currently on TRT rite now?
What is your protocol?
Do you know what made you go on TRT?
So your saying that we need to get our cortisol levels checked out?
and you think that the cream would work better for us then the shots?
So are you saying we should try to stay away from HCG?

are you going to get the varicocele removed?

I have an appointment with a urologist on the same day as my appointment at the private clinic. If the urologist reccomends to remove it then I’ll do it. Honestly the pain is very slight so if he doesn’t wanna remove it I’m fine with that. I just want my physcological symtoms to be relieved.

I went on TRT because I wanted to resolve my non-existent libido and ED issues. The ED was getting out of hand (pardon the pun) and ruining my relationship. I couldn’t put myself or my partner through that any longer, simply put. I also started getting other symptoms like blood in semen, low muscle mass, difficulty concentrating (though that is more due to Cipro poisoning) and various other issues.

I am doing 20mg of test cyp EOD and HCG 100IU ED, so far not much improvement (very slight), Nothing to write home about though…

My levels are all coming back good, though my E2 was spiking and I am working on reducing that now. My levels were around 600 and free T mid-high range. My progesterone is constantly coming back high (over-range), which is blunting all the positives of the treatment…

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Your dosage of T might be too low, alot of guys need double that amount.

Also, Cipro poisoning? I had to be put on ciprofloxacin for epididymitis, you found there to be permanent side effects?

It’s bringing my levels up to 600+ which is pretty decent all in all, but I agree - maybe 700-800+ is required to really feel “optimal”.

Taking Cipro was the worst mistake of my entire life, that drug is a legit poison that has disabled thousands of people of all ages. It destroys connective tissue and results in damage to your tendons, brain and pretty much every organ. Should have been banned years ago…

I ended up with issues in my knees, hands and elbows and brain fog that almost made me loose my job (I’m a programmer).

I have a varicocele on the left side and been on trt for a while. My T levels are very high (total T 1999). I feel much better but there are other things that aren’t right (non trt related) that I’m dealing with. My cortisol was 17 at 2pm and progesterone was the highest number of the range. I have fairly high RT3 as well. The adrenals & thyroid are such a bitch to understand because all three endos I’ve seen have a completely different take like they are from three different universes. TRT has helped immensely but it’s the other shit that has been affecting me.