Peyronie’s disease is the growth of fibrous plaques, a type of flat scar tissue, under the skin of the penis.
These plaques, which form in the tunica albuginea, can change the shape of the penis, resulting in a noticeable curve, or bend, when the penis is erect.
More than 10 percent of men are estimated to be affected by Peyronie’s disease, although the severity of the disorder can vary from one person to another.
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 comparison, only 8.2 percent of men under 40 years of age are affected by 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 intercourse.
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 activity, confidence and physical appearance.
Right now, researchers aren’t aware of the precise cause of Peyronie’s disease. However, the most current research indicates that it’s likely caused by physical injuries that affect the erectile tissue inside your penis.
These injuries, which can happen during sex or physical activity, can cause internal bleeding to develop within the fibrous membrane of your penis, called the tunica albuginea.
Over time, this process can result in the development of scar tissue, which causes 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 diseases, which cause the human immune system to attack cells and tissue such as the tunica albuginea.
Several risk factors may increase your likelihood of developing Peyronie’s disease, including the following:
The most common symptom of Peyronie’s disease is the development of plaques on the dorsal side, or top, of your penis. These may cause your penis to bend upwards when it’s erect.
About 70 percent of men with Peyronie’s disease have dorsal plaques that result in an upward curved penis. However, plaques can also develop elsewhere on your penis, causing a range of different symptoms:
In addition to affecting the shape and feel of your penis, Peyronie’s disease may cause sexual performance issues.
Some men with Peyronie’s disease develop softer erections and other erectile function issues, while others might find it difficult to have sex due to the changes that can occur in their penis’s shape and curvature.
Because of its effects on sexual performance and enjoyment, Peyronie’s disease is a common cause of stress, depression and reduced quality of life.
While the plaques caused by Peyronie’s disease can cause discomfort and affect your sexual health and performance, they’re benign and not a sign of cancer or tumors.
It’s completely normal to have some amount of curvature in your penis — no erect penis is 100 percent straight or symmetrical.
Because of this, it’s quite common for men to mistake normal congenital penis curvature for the symptoms of Peyronie’s disease.
However, if you have a noticeable bend in your erection, it’s worth speaking to your healthcare provider or scheduling an appointment with a urologist to talk about the possibility of Peyronie’s disease.
Most of the time, Peyronie’s disease can be diagnosed with a physical exam. Your healthcare provider may need to look at your penis for hard plaques or other common signs of Peyronie’s disease.
To help your healthcare provider check for penile curvature, you may need to use medication to make your penis erect.
For a more accurate diagnosis, your healthcare provider may use dynamic ultrasound imaging to view plaques, blood flow and calcium buildup in your penis.
Peyronie’s disease occurs in stages, which are often referred to as the acute phase and chronic phase. During each phase, you’ll typically experience different symptoms:
This phase usually begins 12 to 18 months after you first notice symptoms of Peyronie’s disease. Some men with chronic Peyronie’s disease experience erectile dysfunction.
Sometimes, Peyronie’s disease can make it difficult to develop or keep an erection. It can also contribute to issues such as stress and anxiety -- two common psychological causes of erectile dysfunction for men.
Because of this, erectile dysfunction is particularly common among men who have Peyronie’s disease. In fact, research published in the journal Urology notes that more than 54 percent of men diagnosed with Peyronie’s disease also report experiencing ED.
Erectile dysfunction medications such as sildenafil (the active ingredient in Viagra®), tadalafil (Cialis®), vardenafil (Levitra®) and avanafil (Stendra®) typically aren’t effective as treatments for Peyronie’s disease.
However, they’re often used to improve erections and sexual function in men with Peyronie’s disease who also have ED.
These drugs work by increasing blood flow to the corpora cavernosa -- the two chambers of soft, sponge-like erectile tissue inside your penis.
This improvement in blood flow can make it easier to develop and maintain an erection when you’re sexually stimulated.
You can read more about the specific benefits of each ED medication in our guide to the most common medications for erectile dysfunction.
Because Peyronie’s disease is considered a physical abnormality of the penis, it’s important to talk to your healthcare provider before you consider using any type of medication to treat ED.
Peyronie’s disease doesn’t always need to be permanent. From surgical procedures to lifestyle changes and medications, a range of options can treat Peyronie’s disease or lower the severity of your symptoms.
One of the most widely used treatments is Clostridium histolyticum, which is sold in the United States as Xiaflex®.
Collagenase Clostridium histolyticum, the enzyme produced by Clostridium histolyticum, is an enzyme that causes the breakdown of collagen that forms connective tissue.
When injected into scar tissue, clostridium histolyticum (or Xiaflex) can weaken the scar tissue and, in combination with stretching exercise, reduce the penile curvature caused by Peyronie’s disease.
Right now, Xiaflex is the only FDA-approved medication designed specifically for the treatment of Peyronie’s disease.
In addition to Clostridium histolyticum, several other injectable medications are used to break down plaques and treat Peyronie’s disease. These include:
Your healthcare provider may recommend performing Peyronie’s disease exercises, or penile traction therapy (PTT), while using these medications.
Several different oral medications and supplements have been studied as potential treatments for Peyronie’s disease, although research on their effectiveness is mixed.
Because of this, oral medications typically aren’t used as first-line treatments for Peyronie’s disease.
Oral medications and supplements that have been studied as treatment options for Peyronie’s disease include:
Although research into these medications is ongoing, most high quality studies have not shown a significant difference in effects when compared to placebo treatments.
In severe cases, Peyronie’s disease can be treated via surgery to remove plaque and/or reduce penile curvature.
One of the more common forms of surgery for Peyronie’s disease, a procedure that's referred to as Nesbit’s procedure, has a high success rate and is often used for cases that can’t be treated with medication.
In some cases, surgery for Peyronie’s disease may involve placing a penile prosthesis, or penile implant, made from flexible silicone inside the penis to treat erectile dysfunction.
Your healthcare provider may suggest surgery if nonsurgical treatments for Peyronie’s disease, such as those listed above, haven’t produced improvements.
Several other treatments for Peyronie’s disease are currently undergoing clinical trials, although at the time of publication none are currently approved by the FDA.
Finally, making certain changes to your lifestyle may potentially reduce the effects of Peyronie’s disease and improve your sexual performance.
Quitting smoking, reducing your consumption of alcohol and increasing the amount of exercise you engage in can all reduce your risk of experiencing Peyronie’s disease-related ED.