How to solve this. See the doctor now?

Dear Practo User, Based on the details you have shared, I would recommend that you consult a urologist/andrologist now rather than trying to treat the symptoms on your own. A Grade 1 varicocele does not always require surgery. However, because you are reporting reduced semen quantity/motility along with a change in erectile function and reduced morning erections, it is worth reassessing the situation. Your 2024 testosterone level of 4.49 ng/mL (449 ng/dL) is not obviously low for an adult male, although testosterone should ideally be interpreted according to the laboratory reference range and, if necessary, repeated as a morning test. Magnesium of 2.4 mg/dL is generally within the usual range. Your B12 of 219 pg/mL may be borderline depending on the laboratory’s reference range and can be discussed with your doctor. The most useful next step would be a fresh semen analysis, preferably with appropriate abstinence and, if abnormal, a repeat test for confirmation. Your doctor may also assess blood sugar/HbA1c, lipid profile, blood pressure and other hormonal parameters depending on your examination and symptoms. Your weight (100 kg at 160 cm) is also an important factor. Excess weight can contribute to erectile difficulties, hormonal/metabolic changes and poorer reproductive parameters. Gradual weight reduction, regular physical activity, adequate sleep, avoiding smoking/alcohol if applicable, and managing stress can significantly help overall sexual and reproductive health. Do not assume that the varicocele is the sole cause of your erection or semen concerns. These symptoms can have multiple contributing factors, and a proper examination is important before deciding whether any treatment or varicocele procedure is required. If you develop sudden/severe testicular pain, swelling, redness, or a rapidly increasing scrotal swelling, seek medical attention promptly. Yes, I would recommend getting evaluated now, particularly because these symptoms have persisted for several years. A proper assessment can identify the cause and help determine the appropriate treatment rather than relying on supplements or self-medication.

●𝗬𝗲𝘀 𝗶𝘁  𝗰𝗮𝗻 𝗯𝗲 𝗽𝗲𝗿𝗺𝗮𝗻𝗲𝗻𝘁𝗹𝘆 𝗰𝘂𝗿𝗲𝗱 𝘄𝗶𝘁𝗵 𝗛𝗼𝗺𝗲𝗼𝗽𝗮𝘁𝗵𝘆 𝗧𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁 . ●𝗩𝗲𝗿𝘆 𝗲𝗳𝗳𝗲𝗰𝘁𝗶𝘃𝗲 𝗺𝗲𝗱𝗶𝗰𝗶𝗻𝗲𝘀 𝗮𝗿𝗲 𝘁𝗵𝗲𝗿𝗲 𝗶𝗻 𝗛𝗼𝗺𝗲𝗼𝗽𝗮𝘁𝗵𝗶𝗰 ●𝗪𝗶𝘁𝗵 𝗺𝘆 𝘁𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁 𝗼𝗳 1.5 𝗺𝗼𝗻𝘁𝗵 𝘆𝗼𝘂 𝘄𝗶𝗹𝗹 𝗴𝗲𝘁 𝗽𝗲𝗿𝗺𝗮𝗻𝗲𝗻𝘁 𝗿𝗲𝗹𝗶𝗲𝗳. ●𝗪𝗶𝗹𝗹 𝗽𝗿𝗲𝘀𝗰𝗿𝗶𝗯𝗲 𝘁𝗵𝗲 𝗰𝗼𝗺𝗽𝗹𝗲𝘁𝗲 𝘁𝗿𝗲𝗮𝘁𝗺𝗲𝗻𝘁. ●𝗬𝗼𝘂 𝗰𝗮𝗻 𝗰𝗼𝗻𝘀𝘂𝗹𝘁 𝗺𝗲 𝗻𝗼𝘄 𝘁𝗵𝗿𝗼𝘂𝗴𝗵 𝗼𝗻𝗹𝗶𝗻𝗲     𝗪𝗮𝗿𝗺 𝗿𝗲𝗴𝗮𝗿𝗱𝘀.

First of all repeat scrotum ultrasound... And if u r facing sexual issues then u need to get it treated... To be sexually fit completely

consult for prescription and guidance