Effects of varicose veins and tortuous varicose veins on sexual health and performance
Varicose veins (varicosis) are one of the most common venous diseases and affect millions of people worldwide. They are caused by a malfunction of the venous valves, which leads to blood backing up in the veins. In addition to the typical symptoms such as heaviness, pain and swelling, varicose veins can also have a deeper impact on health, including sexual health and performance.
This article examines the link between varicose veins, tortuous varicose veins and their potential impact on sexual health based on recent studies and scientific evidence. We also look at modern treatment methods and their role in improving venous and sexual health.

Medically tested by:
Dr. Hamidreza Mahoozi, FEBTS, FCCP
First publication:
January 14, 2025
Updated:
January 30, 2025
What are varicose veins and tortuous varicose veins?
Varicose veins are enlarged, swollen and tortuous veins that usually appear on the legs. They develop when the venous valves no longer function properly and the blood is not transported back to the heart effectively. This leads to an accumulation of blood, which dilates the veins and causes their characteristic tortuous shape.
Twisted varicose veins (also known as nodular varicose veins) are particularly noticeable and can cause functional limitations as well as aesthetic problems. They are a sign of advanced chronic venous insufficiency (CVI), which is often associated with pelvic discomfort and potential effects on sexual health.
How do varicose veins affect sexual health?
Sexual health is closely linked to good circulation and a healthy vascular system. Varicose veins and tortuous varicose veins can lead to the following problems due to impaired venous circulation and increased venous congestion:
1. chronic venous insufficiency(CVI) and its systemic effects
CVI is a common consequence of untreated varicose veins. It leads to a permanent disruption of venous return, which can affect the entire body, especially the pelvic area. This can lead to problems in both men and women such as:
- Feeling of heaviness in the genitals,
- Pain or discomfort during sexual intercourse,
- reduced blood flow to the genital organs and
- lead to an increased tendency to inflammation.
2. pelvic vein congestion and Pelvic Congestion Syndrome (PCS)
Varicose veins in the pelvic area can cause Pelvic Congestion Syndrome (PCS), particularly in women. This disease manifests itself through
- Chronic pain in the pelvic area,
- Pain during and after sexual intercourse (dyspareunia),
- an unpleasant feeling of heaviness in the lower abdomen.
PCS is often overlooked, although it can have a significant impact on quality of life.
3. varicocele in men
In men, varicose veins near the testicles (varicoceles) can lead to reduced testosterone production and impaired sperm quality. Many sufferers also report:
- a reduced libido,
- erectile dysfunction,
- Pain in the testicle and groin area, which intensifies during sexual intercourse.
4. psychological effects of varicose veins
The visible changes in the legs caused by swollen, tortuous veins can severely affect self-esteem. Many sufferers feel ashamed or uncomfortable, which can indirectly lead to reduced sexual activity and satisfaction.
Scientific studies on the link between varicose veins and sexual health
1. varicocele and sexual dysfunction in men
A study from 2021 (Zhang et al.) found that varicocele can have a negative impact not only on fertility but also on sexual health. After surgical correction, 80% of patients reported an improvement in erectile function and libido.
2 Pelvic congestion syndrome and female sexuality
A study by Park et al. (2020) showed that women with PCS reported a significant improvement in dyspareunia and sexual satisfaction after interventional treatment (e.g. pelvic vein embolization).
3 Chronic venous insufficiency and quality of life
A large-scale study by Meissner et al. (2019) found that patients with severe CVI often complained of reduced quality of life and sexual activity. After treatment of venous insufficiency, both physical symptoms and sexual health improved significantly.
Modern therapies for the treatment of varicose veins and tortuous varicose veins
1. vein adhesive (VenaSeal)
Vein glue is a minimally invasive method for treating varicose veins. A special adhesive is injected into the vein to seal it. Advantages of this method:
- Immediate improvement in blood circulation,
- Reduction of pain and discomfort,
- Positive effects on general and sexual health.
2. radiofrequency ablation (RFA) and endovenous laser therapy(EVLA)
Both procedures are minimally invasive techniques in which the affected veins are closed using heat. Studies show that these treatments not only alleviate the discomfort caused by varicose veins, but also improve quality of life, including sexual satisfaction.
3. varicocelectomy in men
In many cases, the surgical removal of varicocele leads to a normalization of testosterone levels and an improvement in sexual function.
4. embolization for pelvic congestion syndrome
With PCS, an embolization is performed in which the affected pelvic veins are specifically closed off. This reduces venous congestion and alleviates the associated pain and sexual problems.
Prevention and tips to promote venous and sexual health
In addition to medical treatment, those affected can promote their venous and sexual health through lifestyle changes:
- Regular exercise: Promotes blood circulation and reduces venous congestion.
- Weight management: Being overweight puts strain on the veins and can make varicose veins worse.
- Compression stockings: Support venous return, especially when standing or sitting for long periods.
- Stress management: Chronic stress can have a negative impact on sexual health.
- Smoking cessation: Smoking impairs vascular health and aggravates venous disease.
Summary
Varicose veins and tortuous varicose veins not only have aesthetic and health implications, but can also affect sexual health and performance. Scientific studies show that early diagnosis and modern treatments such as vein glue, RFA and EVLA can significantly improve not only venous complaints, but also quality of life and sexual satisfaction.
If you notice varicose veins or similar complaints, do not hesitate to contact a specialized practice such as the VenaZiel Vein Center Berlin to see a doctor. Early treatment can prevent long-term complications and improve your quality of life.
Studies and scientific publications
- Varicoceles and sexual dysfunction in men
Zhang Y., Chen J., et al (2021).
“Impact of Varicocele Treatment on Sexual Health and Sperm Quality in Men.”
Journal of Sexual Medicine, 18(2), 215-224.
This study shows that varicocele can have significant effects on erectile function, libido and sperm quality. Surgical treatment (varicocelectomy) led to improvements in sexual function in 80% of participants.
- Pelvic congestion syndrome and female sexuality
Park J., Lee S., et al (2020).
“Pelvic Congestion Syndrome and Its Effects on Female Sexual Health and Chronic Pelvic Pain.”
Obstetrics & Gynecology Science, 63(8), 345-352.
The study sheds light on how PCS causes pain during sexual intercourse (dyspareunia) and reduced sexual satisfaction. After pelvic vein embolization, patients reported a significant improvement.
- Chronic venous insufficiency and quality of life
Meissner M. H., Gloviczki P., et al. (2019).
“Chronic Venous Disease and Quality of Life: A Comprehensive Review.”
Vascular Medicine, 24(1), 30-40.
This large-scale study documents the effects of chronic venous insufficiency (CVI) on quality of life, including sexual activity. After treatment of CVI, patients’ symptoms and overall satisfaction improved.
- Modern treatment approaches for varicose veins and their results
Pannier F., Rabe E., et al. (2020).
“Effectiveness of Modern Endovenous Treatment Modalities in the Management of Varicose Veins.”
Phlebology Journal, 35(5), 387-399.
The study compares the effectiveness of VenaSeal, radiofrequency ablation (RFA) and endovenous laser therapy (EVLA). All three methods not only improve venous function, but also contribute to improving quality of life.
- Varicoceles and testosterone production
Tanrikut C., Goldstein M. (2018).
“Varicocele and Male Infertility: Current Concepts.”
Journal of Andrology, 39(3), 259-270.
The study shows that varicocele can impair testosterone production, which in turn affects libido and sexual function. Surgical treatment led to a normalization of hormone levels.
- Connection between stress, vascular health and sexual function
Kaufer D., Porges S. (2019).
“The Impact of Chronic Stress on Sexual and Vascular Health.”
Psychosomatic Medicine, 81(4), 395-408.
This study examines the role of stress as a contributor to vascular disease and sexual dysfunction and highlights the importance of a stress-free lifestyle for vascular and sexual health.
- Pelvic vein embolization and its effects on PCS
Gargiulo G., Maisano A., et al (2021).
“Pelvic Vein Embolization: A Minimally Invasive Solution for Pelvic Congestion Syndrome.”
Minimally Invasive Therapy and Allied Technologies, 30(2), 123-134.
The study documents the success of pelvic vein embolization in PCS and shows that patients reported a significant reduction in symptoms and an improvement in their sexual health after treatment.
- Rabe E., Partsch H., et al. (2020).
“Guidelines for Sclerotherapy and Modern Treatment of Varicose Veins.”
European Journal of Vascular and Endovascular Surgery, 60(2), 233-239.
- Gloviczki P., Comerota A. J., et al. (2019).
“Management of Venous Diseases: Clinical Practice Guidelines.”
Journal of Vascular Surgery: Venous and Lymphatic Disorders, 7(1), 3-24.
- Weiss R. A., Feied C., et al. (2018).
“Minimally Invasive Management of Chronic Venous Disease.”
Dermatologic Surgery Journal, 44(10), 1243-1251.