Peyronie's Disease: Symptoms, Causes, and Treatments
When it comes to men’s health, most of our family’s concerns tend to focus on heart health, how much we drink, our smoking habits, stress and sleep. Our own concerns? Penis function.
If you’ve recently been diagnosed with Peyronie’s disease (or self-diagnosed it after a few anxious hours of Googling), you likely have lots of questions about what it is, what it could do to your sex life and the available treatment options.
We’ll answer these questions with the current medical wisdom. So let’s get this topic straight — no curveballs, no confusion.
What Causes Peyronie’s Disease?
In the simplest terms, Peyronie’s disease is a penile curvature. But while every guy’s penis may have a slight curve of some kind, a Peyronie’s diagnosis requires something a little more specific: fibrous plaques or flat scar tissue growing under the skin of the penis.
These plaques form in the tunica albuginea — the layer of tough connective tissue surrounding the corpora cavernosa (the spongy tissue within the shaft). They can cause numerous problems, from changing the shape of the penis to shortening it.
Research shows that more than 10 percent of men may have the curves, bends and other deviations representative of Peyronie’s disease. However, severity varies from one penis to another.
The precise cause of Peyronie’s disease is still undetermined, but physical injuries affecting the erectile tissue are considered the most common.
Some experts also believe that Peyronie’s disease could potentially be caused by autoimmune diseases, connective tissue disorders and other health conditions.
Risk factors for Peyronie’s disease include:
Vigorous or intense sexual encounters that cause minor or serious injuries and the development of scar tissue
Sports injuries
Diabetes
Age
Family history of the condition
Prostate cancer surgeries like radical prostatectomy
Keep reading to learn about the signs and symptoms of Peyronie’s disease.
Symptoms of Peyronie’s Disease
The most obvious symptom of Peyronie’s disease is plaques causing the penis to bend. But a curved penis can result in other symptoms, including:
“Bottle-necking” indentations that create an hourglass-like shape
Lumps that become hard and bone-like due to calcium buildup
Peyronie’s disease may also cause sexual performance and erectile function issues, like softer erections. If left untreated, these changes (and the problems they bring to the bedroom) can eventually result in physical discomfort, stress, depression and a reduced quality of life.
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Erectile Dysfunction From Peyronie’s Disease
Peyronie’s disease may sometimes make it difficult to get hard, either physically or psychologically. For this reason, ED is common among guys with Peyronie’s disease — research notes that up to 54 percent of men with Peyronie’s disease also report ED.
What’s worse is that it’s hard to treat ED when Peyronie’s disease is the cause. Erectile dysfunction medications like sildenafil (generic Viagra®), vardenafil (Levitra®), tadalafil (Cialis®) and avanafil (Stendra®) aren’t typically effective.
These PDE5 inhibitors increase blood flow to the corpora cavernosa. So if Peyronie’s has altered the function of these spongy chambers, the drugs may not properly increase blood flow to your penis.
Stages of Peyronie’s Disease
Peyronie’s disease occurs in two stages: the acute phase and the chronic phase.
Acute phase. Plaques develop on the fibrous membrane during this 18-month phase. You may develop uncomfortable or painful erections and notice a bend or curve in your penis.
Chronic phase. At this point, plaques have developed, and your penis will have a clearly identifiable bend or curve — though discomfort may have waned, as the plaque is no longer developing.
How Peyronie’s Disease Is Diagnosed
Diagnosing Peyronie’s disease is a healthcare professional’s job, mostly because you won’t necessarily be able to tell the difference between normal and problematic curves yourself.
Men often have some degree of curvature, so no erect penis is 100 percent straight. That’s why it’s easy to mistake normal curvature for Peyronie’s disease.
It’s worth speaking to a healthcare provider or urologist, who can diagnose the condition following a physical exam. Your healthcare provider will look at your penis for hard plaques and other common signs of Peyronie’s disease.
You might need to use medication to make your penis erect to help your healthcare provider check for penile curvature. Dynamic ultrasound imaging can also help a medical professional view plaques, blood flow and calcium buildup problems in your penis.
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Treatments for Peyronie’s Disease
Peyronie’s disease is treatable, though the treatment depends on your individual issues. Treatments may include injections, oral medications, supplements, surgery or lifestyle changes.
Injections for Peyronie’s Disease
Xiaflex® injections could address plaque buildup. The active ingredient in this medication is collagenase clostridium histolyticum, an enzyme that breaks down collagen forming within connective tissue.
When injected into scar tissue, it can weaken the toughened collection of cells and reduce penile curvature. Right now, Xiaflex is the only medication FDA-approved specifically for the treatment of Peyronie’s disease.
Other medications currently being explored include:
Interferon. This protein-based medication is used to control swelling and may help to break down scar tissue that can develop in the penis.
Verapamil. This medication, which is typically used to treat angina and hypertension (high blood pressure), may help reduce penile curvature and discomfort. More controlled studies are needed.
Oral Medications and Supplements for Peyronie’s Disease
More research is needed on oral medications for Peyronie’s treatment, but several have been studied. Most high-quality trials haven’t shown a significant difference in effects compared to placebo treatments.
That said, if you don’t respond to other treatment options, your provider might suggest:
Potassium aminobenzoate. This supplement may reduce the size of plaques.
Oral vitamin E. Vitamin E pills could help shrink plaques and reduce the severity of penile curvature.
Peyronie’s Disease Surgery
In severe cases, surgery can be performed to remove plaque and potentially reduce penile curvature. A type of straightening surgery called Nesbit’s procedure has a high success rate in instances of Peyronie’s disease where medication doesn’t work.
Surgery could also involve inserting a flexible silicone penile prosthesis (penile implant) like the Penuma.
Other Treatment Options for Peyronie’s Disease
While the options above represent the best science has to offer right now, other treatments are currently undergoing trials for FDA approval.
Lifestyle changes — quitting smoking, reducing your alcohol intake and increasing the amount of exercise you do — can reduce your risk of Peyronie’s disease-related ED.
Your healthcare provider may recommend at-home Peyronie’s disease exercises, traction device therapy or penile traction therapy (PTT) while using medications — but research on these is a bit thin.
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Peyronie’s Disease: Key Takeaways
If you think you have Peyronie’s disease, you might be scared or anxious about it — that’s normal. Regardless of whether you have a history of prostate cancer, prostate surgery, ED or other erectile issues, a curved penis is absolutely cause for concern.
That said, Peyronie’s is both treatable and possible to overcome. Overwhelmed? We’ve boiled down the essentials to help you feel informed:
Peyronie’s disease is a curvature of the penis that can form on the top, bottom or side of the shaft and cause problems for erections and sexual intercourse.
Experts aren’t sure why it forms, but injuries and a family history of the conduction are common explanations.
The curvature usually becomes more prevalent with age, with older men more likely to be affected than younger men. According to one study, Peyronie’s disease is most commonly seen in men entering their 40s and 50s. In comparison, only about 8 percent of guys under 40 are affected.
Psychological effects of Peyronie’s disease can affect your comfort with sexual activity, confidence and physical appearance.
Currently, the only FDA-approved medication for Peyronie’s disease is clostridium histolyticum, which is available as Xiaflex.
Other treatments, such as oral medications or surgery, may help reduce penile curvature and treat issues like pain and discomfort. But they’re not typically used as first-line therapies.
Don’t let this problem stop you from enjoying intimacy. If you’re worried you may have Peyronie’s, talk to a healthcare provider today, get an assessment and get treatment moving.
The sooner you take the first step, the sooner your penis will be back on the straight and narrow.
This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment or medication.