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Common gastrointestinal side effects occur in many patients and include: Nausea (most common, typically improving after 4-8 weeks) Vomiting Diarrhea Constipation Abdominal pain or discomfort Decreased appetite These effects result from the drugs' mechanism of actionslowing gastric emptying and affecting gut motilityrather than indicating tissue damage or malignancy

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Compared to men without varicocele, those with varicocele show significantly reduced sperm concentration, total sperm count, progressive motility, and normal morphology, alongside elevated sperm DNA fragmentation index and markers of oxidative stress (51)