Do I Have Peyronie's Disease and Can It Be Treated?
Key takeaways:
Peyronie’s disease is a condition that causes a curve in the penis and may lead to problems with erections.
Peyronie’s disease can affect physical as well as emotional and mental health.
There are many treatments for Peyronie’s disease, including medications, injections, and surgery.
It can be quite stressful if your penis starts changing its shape out of nowhere. Peyronie’s disease is a condition that can cause this to happen, and it affects up to 13% of males in the U.S. It typically occurs in men between 45 and 60 years old, but has been reported in ages as low as 18 or as high as 80. It was named after the French surgeon François Gigot de la Peyronie in 1749.
You may feel too embarrassed to discuss your symptoms, and this is understandable. Fortunately, many effective treatments are available to treat Peyronie’s disease — and it may even resolve on its own.
Is it normal to have a curved erect penis?
A slight curve, yes. But if you're getting a real bend that may cause pain or difficulty having sex, then you may have Peyronie's disease. For example, some people may have noticed that their penis curves slightly to the left or right when it's erect. But with Peyronie’s, the change is new, or you’ll notice a more extreme curve than what you had before.
What causes Peyronie’s disease?
Just like scar tissue can form in your skin, it can also form inside your penis — and this is what happens with Peyronie’s disease.
In the shaft of the penis, there is a fibrous tissue called the tunica albuginea that covers the corpus cavernosa — two cylinders of spongy tissue. When there is ongoing inflammation of the tunica albuginea, it can lead to scarring.
The exact cause of this inflammation isn’t known. But many times it happens after some sort of trauma to the penis, like in the following situations:
A sports injury, like getting accidentally hit on the penis, can cause inflammation.
Vigorous sex can cause your penis to bend and flex, or you may hit against your partner’s pubic bone. You may not even notice this happening, but if it happens repeatedly it can lead to scar tissue buildup in the penis.
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Am I at risk for Peyronie’s disease?
While trauma to the penis is one major cause of Peyronie’s disease, there are some other things that can make you more prone to having Peyronie’s disease. These include being a smoker or having diabetes, high blood pressure, or Dupuytren’s contracture, a condition that causes tightening of tissue in the palm and fingers.
If anyone in your family has Peyronie's disease, it can also increase the chance that you may get it.
Certain procedures of the genitourinary system (the penis, prostate, bladder, and kidneys) can also cause trauma and lead to Peyronie’s disease, like:
Transurethral prostatectomy, a surgical treatment that removes parts of the prostate using a device that is inserted through the urethra (the tube that carries urine from your bladder through the penis)
Cystoscopy, a procedure that uses a camera inserted into your urethra to look inside your bladder
Symptoms of Peyronie’s disease
The changes you may experience with Peyronie’s disease occur in two phases: an active phase and a passive phase. The phases are affected by how actively the scar tissue is forming.
Active phase
During the active phase, inflammation is causing scar tissue to form. You may experience pain in your penis, but not always. And the pain can happen either with or without an erection. The shape of your penis will also begin to change. Often, a curve or bend that wasn’t there before will now occur during an erection.
Passive phase
After about 12 to 18 months in the active phase, inflammation settles down, and you enter the passive phase. Usually, any pain you had during the active phase is gone. The shape of your penis stops changing further because the scar tissue has already formed.
A curved penis and changes in erections aren’t the only symptoms of Peyronie’s disease. You can also experience the following:
Your penis seems shorter.
Your penis is more narrow or has an “hourglass” shape.
You may feel lumps in your penis, which are most noticeable when you are not erect.
The important thing to remember about Peyronie’s disease is that the symptoms will be a change from what has been normal for you.
How does Peyronie’s cause erectile dysfunction?
About 50% of people with Peyronie’s disease may experience erectile dysfunction, which is the inability to achieve or maintain an erection. If you have erectile dysfunction and Peyronie’s disease, you may have no issues with feeling sexually aroused. So why may erections still be an issue for you?
Erectile dysfunction can happen during both the active and passive phases of Peyronie’s disease. And here are a few reasons why:
Scarring may weaken the muscles in the penis, making erections more difficult.
Scarring can impact blood flow in and out of the penis, causing less firm erections and rapid loss of erections.
Anxiety about physical appearance and sexual function can make erection problems worse.
When you have an erection, you may notice that the part of your penis closer to your body maintains a normal erection, but the part away from the scar tissue and your body is softer. Or you might have a firm erection on one side of your penis, but softness on the side it now bends toward.
Your erection may not become firm enough to penetrate your partner. Or even if you’re able to get an erection, the abnormal shape of your penis can make it difficult to have intercourse. Sometimes you or your partner may experience pain during sex as well.
You may feel depressed or anxious about performing or worried about how your penis looks. These worries may also put stress on your relationship.
The good news is that there are many treatment options for this condition.
Can Peyronie’s disease be cured?
Yes, in some cases. There are also treatments that can lower the amount of scarring and improve sexual function.
Your treatment will depend on what phase of the disease you are in. It’s best to get treatment during the active phase to prevent scar tissue from forming, but even if the scar has fully formed, it’s not too late to still get treated. Here are some of these treatment options.
Medications
During the active phase, certain oral medications can decrease inflammation and control pain, including:
Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen
Pentoxifylline (Trental)
Colchicine (Colcrys)
Some over-the-counter supplements have also been found to decrease curving of the penis caused by Peyronie’s disease. They include:
Vitamin E: Vitamin E 100 mg taken 3 times a day for a minimum of 4 months might prevent the scar tissue from forming. Researchers think that the antioxidant action of vitamin E is what helps. Vitamin E seems to be most effective when used in combination with other treatments.
Coenzyme Q10: In one study, over half of the participants (63%) noticed an improvement in the curving of their penis when taking coenzyme Q10.
Of the medications listed above, the American Urological Association (AUA) only officially recommends NSAIDs for the treatment of pain. This is because there is not enough high-quality research to prove that the others are effective.
The treatments listed below are commonly recommended and approved by the AUA.
Intralesional injections
Intralesional injections are shots given directly into the scar tissue of the penis and can be given during both the active and passive phases. This is a common treatment that is more effective than oral medication. The injections can break up the scar tissue and stop the curving of the penis. Several different medications can be used for the injections, including collagenase clostridium histolyticum (CCH), interferon alpha-2b, and verapamil.
External therapies
External therapies are physical treatments that are applied to the outside of the penis. They can be used during both the active and passive phases. These treatments work by changing the way the scar tissue forms or by breaking up existing scar tissue. They include:
Extracorporeal shockwave therapy: This procedure is done in a healthcare provider’s office. It involves a device that delivers low-intensity shock waves to your penis to break up the scar tissue.
Vacuum device therapy: A vacuum tube, also referred to as a “penis pump,” fits over your penis and stretches and pulls it with suction to break up scar tissue.
Surgery
While it may be hard to consider having such an intimate procedure, surgery to correct the curving of your penis has the highest rate of success (65% to 95%) among all treatments for Peyronie’s disease. Surgery can only be performed in the passive phase to correct curves that are no longer changing.
If you are having significant issues with your erections — to the point where you cannot have sexual intercourse — a penis implant surgery may be done in addition to the treatments above.
Look after your mental health
It’s OK to let your healthcare provider know how you feel emotionally about your condition. They can help guide you if you need treatment for depression or anxiety. These conditions can be treated effectively with counseling with a mental health specialist, and sometimes medications. Even if you don’t have anxiety or depression, a mental health specialist can also help with stress or other feelings that could be making things worse.
The bottom line
Your sexual health is an important part of life. While Peyronie’s disease isn’t necessarily dangerous, it can interfere with your sex life and affect your emotional health. Don’t despair: Peyronie’s disease is highly treatable. The sooner you can get diagnosed, the sooner you can get treated and stop things from getting worse.
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References
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