Erectile dysfunction can occur for a variety of reasons. Sometimes, cardiovascular conditions such as heart disease and high cholesterol can be the culprit. In other cases, ED could be the result of a psychological condition such as anxiety, stress or depression.
One potential cause of ED that isn’t covered often is Peyronie’s disease -- a connective tissue disorder that results in the growth of scar tissue inside the penis. This scar tissue can make the erect penis bend, often at a noticeable angle, causing discomfort and erectile dysfunction.
In most cases, Peyronie’s disease doesn’t prevent you from having sex. However, it can cause erectile dysfunction, discomfort during sex and have a significant impact on your personal level of confidence about sexual activity.
Luckily, there are treatment options available for Peyronie’s disease. In this guide, we’ll look at how prevalent Peyronie’s disease is, the connection it can have to ED and the treatment options that are available for men with Peyronie’s disease.
Peyronie’s disease is the growth of fibrous plaque, a form of scar tissue, inside the tissue of the penis. The plaque, which developed in the tunica albuginea, can change the shape of the penis, resulting in a noticeable curve of bend when the penis is erect.
Around 10% of men are estimated to be affected by Peyronie’s disease, although the severity of the disorder can vary. Peyronie’s disease 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 as men enter their 40s and 50s. In fact, only about 8% of men aged 40 and under have Peyronie’s disease.
Peyronie’s disease has a variety of effects. First, the curvature of the penis can affect both the physical and psychological side of sex, from making the physical act of sex uncomfortable to a loss of confidence or increase in anxiety symptoms during sexual activity.
The psychological effects of Peyronie’s disease can be a significant influence on male sexual behavior. Research shows that many men affected by Peyronie’s disease show some level of concern about their sexual confidence and physical appearance.
While researchers aren’t completely certain on the cause of Peyronie’s disease, most current research indicates that it’s likely caused by an injury to the tissue of the penis.
Injuries, which can occur during sex or physical activity, can cause internal bleeding within the tissue of the penis. Over time, this can result in the development of scar tissue, which can lead to the curvature or bend of the penis that’s present in men with Peyronie’s disease.
Some experts also believe that Peyronie’s disease could potentially be caused by autoimmune disease, which causes the human immune system to attack cells and organs such as the tunica albuginea tissue of the penis.
The most common risk factors for Peyronie’s disease include vigorous sexual activity that leads to damage of the penis tissue, as well as aging. Men with a family history of Peyronie’s disease are also believed to have a higher risk of developing the disorder.
It’s completely normal to have some amount of curvature in your penis -- no erect penis is 100% even and symmetrical. Because of this, it’s quite common for men to mistake normal congenital penis curvature for Peyronie’s disease.
However, if you have a noticeable bend in your erection, it’s worth speaking to your doctor about the possibility of Peyronie’s disease.
Most urologists can detect Peyronie’s disease using a combination of physical examination and technology such as an X-ray or ultrasound, which can reveal the presence of scar tissue in the penis.
It’s important to know that Peyronie’s disease isn’t always permanent. There are both surgical and nonsurgical treatments for Peyronie’s disease, ranging from oral medication and injections to physical exercises used to reduce the buildup of scar tissue.
Sometimes, Peyronie’s disease can make it difficult to develop or keep an erection. It can also cause stress and anxiety -- two common psychological causes of erectile dysfunction for men.
Because of this, ED is particularly common among men with Peyronie’s disease. In fact, data from the Association of Peyronie’s Disease Advocates (APDA) states that approximately two thirds of men with Peyronie’s disease also have some degree of ED.
While erectile dysfunction drugs like sildenafil, tadalafil and vardenafil can’t treat Peyronie’s disease itself, they can often be used to treat ED that stems from Peyronie’s disease.
These drugs improve blood flow to the soft tissue of the penis, making it easier to develop and maintain an erection. You can read more about the specific benefits of each drug in our guide to the most common ED medications.
However, because Peyronie’s disease is considered a physical abnormality of the penis, you should speak to your doctor first before you consider using ED medication to treat Peyronie’s disease induced erection issues.
Currently, there are several surgical and nonsurgical for treating Peyronie’s disease. The most widely used treatment is clostridium hystolyticum, which is sold in the United States as Xiaflex.
Clostridium hystolyticum is a bacteria species that causes the breakdown of connective muscle tissue. When injected into scar tissue, clostridium hystolyticum (or Xiaflex) can weaken the scar tissue and, in combination with stretching, reduce the curvature caused by Peyronie’s disease.
Right now, Xiaflex is the only FDA-approved medication designed specifically for the treatment of Peyronie’s disease.
Another option commonly recommended by doctors is Vitamin E, which is believed to delay the development of Peyronie’s disease. Several other treatments are currently undergoing clinical trials, although none are currently approved by the FDA.
In severe cases, Peyronie’s disease can be treated with surgery. The surgery, referred to as the "Nesbit operation," has a high success rate and is typically used as a final option for cases that can’t be solved through medication and stretching exercises.
Finally, making some changes to your lifestyle can potentially improve the effects of Peyronie’s disease. Quitting smoking, reducing your consumption of alcohol and increasing the amount of exercise you engage in can all reduce the risk of Peyronie’s disease-related ED.