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.
What Are The Effects of 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.
What Causes Peyronie’s Disease?
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.
Do You Have Peyronie’s Disease?
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.
Peyronie’s Disease and Erectile Dysfunction
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.
Current Treatments for Peyronie’s Disease
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.
Important Safety Information
IMPORTANT SAFETY INFORMATION
Do not take Sildenafil (sildenafil citrate) if you:
- take any medicines called nitrates, often prescribed for chest pain, or guanylate cyclase stimulators like Adempas (riociguat) for pulmonary hypertension. Your blood pressure could drop to an unsafe level
are allergic to sildenafil, as contained in Sildenafil and REVATIO, or any of the ingredients in Sildenafil
Discuss your health with your doctor to ensure that you are healthy enough for sex. If you experience chest pain, dizziness, or nausea during sex, seek immediate medical help
Sildenafil can cause serious side effects. Rarely reported side effects include:
- an erection that will not go away (priapism). If you have an erection that lasts more than 4 hours, get medical help right away. If it is not treated right away, priapism can permanently damage your penis
- sudden vision loss in one or both eyes. Sudden vision loss in one or both eyes can be a sign of a serious eye problem called non-arteritic anterior ischemic optic neuropathy (NAION). Stop taking Sildenafil and call your healthcare provider right away if you have any sudden vision loss
sudden hearing decrease or hearing loss. Some people may also have ringing in their ears (tinnitus) or dizziness. If you have these symptoms, stop taking Sildenafil and contact a doctor right away
Before you take Sildenafil, tell your healthcare provider if you:
- have or have had heart problems such as a heart attack, irregular heartbeat, angina, chest pain, narrowing of the aortic valve, or heart failure
- have had heart surgery within the last 6 months
- have pulmonary hypertension
- have had a stroke
- have low blood pressure, or high blood pressure that is not controlled
- have a deformed penis shape
- have had an erection that lasted for more than 4 hours
- have problems with your blood cells such as sickle cell anemia, multiple myeloma, or leukemia
- have retinitis pigmentosa, a rare genetic (runs in families) eye disease
- have ever had severe vision loss, including an eye problem called NAION
- have bleeding problems
- have or have had stomach ulcers
- have liver problems
have kidney problems or are having kidney dialysis have any other medical conditions
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
Sildenafil may affect the way other medicines work, and other medicines may affect the way Sildenafil works, causing side effects. Especially tell your healthcare provider if you take any of the following:
- medicines called nitrates
- medicines called guanylate cyclase stimulators such as Adempas (riociguat)
- medicines called alpha-blockers such as Hytrin (terazosin HCl), Flomax (tamsulosin HCl), Cardura (doxazosin mesylate), Minipress (prazosin HCl), Uroxatral (alfuzosin HCl), Jalyn (dutasteride and tamsulosin HCl), or Rapaflo (silodosin). Alpha-blockers are sometimes prescribed for prostate problems or high blood pressure. In some patients, the use of Sildenafil with alpha-blockers can lead to a drop in blood pressure or to fainting
- medicines called HIV protease inhibitors, such as ritonavir (Norvir), indinavir sulfate (Crixivan), saquinavir (Fortovase or Invirase), or atazanavir sulfate (Reyataz)
- some types of oral antifungal medicines, such as ketoconazole (Nizoral) and itraconazole (Sporanox)
- some types of antibiotics, such as clarithromycin (Biaxin), telithromycin (Ketek), or erythromycin
- other medicines that treat high blood pressure
- other medicines or treatments for ED
Sildenafil contains sildenafil, which is the same medicine found in another drug called REVATIO. REVATIO is used to treat a rare disease called pulmonary arterial hypertension (PAH). Sildenafil should not be used with REVATIO or with other PAH treatments containing sildenafil or any other PDE5 inhibitors (such as Adcirca tadalafil)
Sildenafil does not protect against sexually transmitted diseases, including HIV.
The most common side effects of Sildenafil: headache; flushing; upset stomach; abnormal vision, such as changes in color vision (such as having a blue color tinge) and blurred vision; stuffy or runny nose; back pain; muscle pain; nausea; dizziness; rash.
Sildenafil (sildenafil citrate) is prescription medicine used to treat erectile dysfunction (ED).
Sildenafil is not for women or children.