I get this question a lot! What is the best position to sleep in if you have a varicocele? Well, I have more advice than just “sleeping position” for when you sleep at night. As I emphasize in the Varicocele Healing Guide, nighttime is critical for naturally treating varicocele at home. So, these are crucial treatment advice for you.

When it comes to nighttime, there are 2 major factors to consider:

1. Testicular Temperature: Varicocele disrupts normal testicular heat regulation, often resulting in chronic testicular overheating. Testicular overheating is a significant contributor to varicocele symptoms. Worse yet, chronically overheated testicles damage your testicular veins and worsen varicocele.
2. Testicular Blood Circulation: Varicocele means poor testicular blood circulation. When blood doesn’t circulate well, it pools. Pooled blood is toxic. Varicocele toxic blood damages the testicles, veins, and vein valves. So, to reverse varicocele and treat your symptoms, you need to improve testicular blood circulation.​

• ✓ DO Sleep in a position that maximally drains your varicocele (feel your veins)
• ✓ DO Notice that the best position typically differs day by day
• ✓ DO Try sleeping on your back and stretching your head away from your heels (decompression)
• ✓ DO Try sleeping on your back with your knees bent
• ✓ DO Try sleeping on the opposite side of your varicocele (e.g., sleep on the right side if you have left-sided varicocele)
• ✓ DO Sleep without underwear and pants of any kind
• ✓ DO Sleep with varicocele therapeutic underwear at night
• ✓ DO Keep your sleeping environment cool
• ✓ DO Perform a 5-10 minute inversion before sleep (e.g., feet up on the wall yoga asana)
• ✓ DO Focus on improving your sleep quality (it makes a big difference!)
• ✗Don’t ​Wear any tight-waist underwear, shorts, or pants
• ✗Don’t Allow yourself to be bloated before bed
• ✗Don’t Get stuck in one position all night (you should adjust and move around—it’s healthy)
• ✗Don’t Be paranoid about sleeping position—a good night’s rest is typically more important​

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The average American sits 7.7 hours per day. So, odds are very high that YOU too are at risk.
Sitting for more than 7-8 hours per day is a major risk factor for both infertility and varicocele. But, the challenge is that many of us sit for relaxation, sit during commute, and sit for work! So, the solution isn't to stop sitting, but to make sitting better. 

Most chairs (especially cushion chairs) trap heat and cause testicular hyperthermia--which effectively halts sperm production, and increases varicocele swelling size.  It is therefore critical to sit on better chairs, minimize continuous sitting time, and when possible use cooling devices.

• Men's Cooling Underwear
• Best Chair Types for Varicocele
• Car Seat Coolers
• Cooling Cushion​

Excessive sitting causes postural imbalances such as forward head posture, rounded upper back (thoracic hyperkyphosis), and hip tightness that all translate to poor muscle activation, excessive downward weighing pressure (preventing blood from leaving testicles to return to the heart), and impaired bowel health. All of these exacerbate the Nutcracker Syndrome, and increase abdominal pressure, impair blood from leaving the testicles, and lead to increased varicocele blood pooling. 
​
Here is a 4 minute daily routine you need to  follow to counteract the negative effects of excessive sitting:

Poor bowel and digestive health are causative risk factors for varicocele [science source]. Sitting increases the risk of developing conditions such as constipation, inflammatory bowel disease, acid reflux, etc. Therefore, we must take some precautions to minimize the negative impact of excessive sitting.

• Take Regular Breaks: Follow the rule of 10%: For hour you spend sitting, take a 10% (6 minute) break. Get up, stretch, walk & move!
• Sit With Good Posture! Posture is very highly correlated with bowel and digestive health, therefore always upright with good posture! Think: Chest Up & Head Back!
• Breathe Fully & With Your Belly! Sitting has a tendency of causing shallow chest-breathing. Natural full breath belly-breathing gently massages the abdominal, improves bowel health, improves blood circulation, and flushes out toxicities (via the lymphatic system).
• Exercise Regularly: Your body is designed to move! Actually designed to walk at least 5 KM per day! And, to move through all the ranges of motion! Get off your butt, and be active every day! Sitting all day DOES NOT improve productivity--it impairs it.

• Varicocele Pain Relief Blog
• Varicocele Natural Treatment Blog
• The Best Home Treatments for Varicocele

Can you even take a hot shower with varicocele?
​
Look, there is nothing wrong with using a hot tub or sauna, and most definitely nothing wrong with hot showers. However, excessive or prolonged elevation of scrotal temperatures can have negative implications on pain and infertility. So, do your best to keep your testicles at a normal temperature on average. And, look, reduce long-duration heating (e.g. hot tubs or saunas) if it worsens your symptoms.

I should however make a note that early in your treatment (e.g. three to four weeks), it is ideal to minimize all stressors, and that means no hot tub or sauna. However, after the three to four weeks of treatment, once you have gained some good results, your testicles will be much healthier and more resilient to stress.

Dos & Don'ts of Hot Tub, Sauna, and Hot Showers
​✗ Don't expose your testicles to excessive or prolonged heat stress
​✗ Don't worry occasional heat exposure 
​✗ Don't worry about keeping your testicles cool all day
✓ DO I highly advise a cool or cold shower after hot tub or sauna
✓ DO run some cool water over your testicles after hot tub, sauna, or a hot shower
✓ DO keep your testicles cool in general, not 100% of all day