Peyronie’s disease is a connective tissue disorder characterized by the development of fibrous scar tissue, or plaque, inside the penis. This plaque causes the penis to bend or curve abnormally when erect, which can lead to pain, erectile dysfunction (ED), and difficulty during sexual intercourse. While the condition is benign (noncancerous), its impact on sexual and emotional health can be significant.

Up to 1 in 11 men may develop Peyronie’s disease at some point in their lives. The symptoms, causes, and treatment options can vary widely from person to person, making early diagnosis and tailored care crucial for managing the disease effectively.

Let’s explore everything you need to know about Peyronie’s disease: its symptoms, causes, risk factors, diagnosis, treatment options, prevention tips, related conditions, and what it’s like living with the disorder.

Key Symptoms

The hallmark symptom of Peyronie’s disease is a noticeable bend or curve in the penis when it becomes erect. This curve is often upward but may also be downward or to one side.

Other common symptoms include:

  • Lump or thickened tissue: A hard plaque or bump under the skin of the penis, often felt during a physical exam.

  • Pain: Discomfort or sharp pain in the penis, particularly during erections.

  • Erectile dysfunction: Difficulty achieving or maintaining an erection sufficient for sexual intercourse.

  • Sexual dysfunction: Trouble with sexual penetration due to the curve.

  • Hourglass deformity: Narrowing in the middle of the penis, giving it an hourglass appearance.

  • Reduced size: Some men may notice shortening or narrowing of the penis.

These symptoms usually appear gradually and progress over time. Peyronie’s disease often occurs in two phases: the acute phase and the chronic phase. During the acute phase, which typically lasts 6 to 18 months, symptoms worsen, including increased pain and curvature. Once the plaque stabilizes, the chronic phase begins, where pain usually subsides, but curvature and erectile issues may remain.

What Causes Peyronie’s Disease?

The precise cause of Peyronie’s disease remains uncertain, but it generally results from repeated trauma or injury to the penis, even minor or unnoticed. When the tunica albuginea—the tough membrane surrounding the erectile tissue—is injured, scar tissue can form abnormally during healing.

Potential causes and contributing factors include:

  • Penile trauma: Injuries during intercourse, sports, or accidents may cause internal bleeding and lead to plaque formation.

  • Genetic predisposition: A family history of connective tissue disorders may increase the likelihood.

  • Autoimmune response: In some men, the immune system may attack penile tissues, mistaking them for foreign bodies.

  • Abnormal wound healing: A disrupted or exaggerated healing response may lead to excess collagen buildup and plaque development.

The resulting scar tissue loses elasticity and restricts the natural stretching of the penis during an erection, leading to a curve and, in some cases, pain or difficulty with sexual function.

Risk Factors

While Peyronie’s disease can affect any man, certain factors increase the likelihood of developing the condition:

  • Age: Most cases occur in men aged 40 to 70, although younger individuals can be affected.

  • Genetics: A family history of Peyronie’s disease or related conditions like Dupuytren’s contracture.

  • Chronic health conditions:

    • Type 2 diabetes

    • Hypertension

    • High cholesterol

    • Obesity

    • Erectile dysfunction

  • Lifestyle factors: Smoking and excessive alcohol use are linked to poorer vascular health and may contribute to plaque development.

  • Previous prostate cancer treatment: Surgery or radiation therapy can damage pelvic nerves or tissues, raising the risk of Peyronie’s disease.

  • Connective tissue disorders: Conditions like Dupuytren’s contracture (hand deformity) have been associated with Peyronie’s.

How It’s Diagnosed

Diagnosis typically begins with a physical exam by a urologist, who may be able to feel the hardened plaque in the shaft of the penis. If needed, the healthcare provider may ask for photographs of the erect penis taken at home to assess curvature.

Diagnostic tools may include:

  • Ultrasound: This imaging test helps determine the location and density of the plaque and assess blood flow.

  • Medical history: The provider may ask about:

    • Symptoms duration and severity

    • Erectile function

    • Previous injuries

    • Family medical history

  • Erection assessment: In some cases, an artificial erection is induced in-office using injection to better evaluate the bend.

Accurate diagnosis helps determine whether active treatment is necessary and what options may be most effective.

Available Treatments

Peyronie’s disease does not always require treatment. In some men, the condition is mild, stable, or even resolves on its own. However, if the symptoms cause distress or interfere with sexual function, several treatment options are available.

Medications

  • Xiaflex (collagenase clostridium histolyticum): The only FDA-approved drug for Peyronie’s disease. It breaks down collagen in the plaques, reducing curvature.

  • Verapamil and interferon-alpha 2b: These injectable medications may help dissolve plaque and improve symptoms.

  • Potassium para-aminobenzoate (Potaba): An oral therapy that may reduce scar tissue buildup.

  • NSAIDs: Over-the-counter options like ibuprofen can relieve pain during the acute phase.

  • Phosphodiesterase inhibitors: Medications like Viagra may assist men experiencing concurrent erectile dysfunction.

Non-Surgical Therapies

  • Penile traction therapy: A mechanical device gently stretches the penis to reduce curvature over time.

  • Vacuum devices: These may enhance blood flow and help stretch tissue.

  • Shockwave therapy: Low-intensity waves aim to reduce pain and plaque size, though more research is needed.

  • Radiation therapy: Occasionally used to reduce pain, though not a first-line treatment.

Surgical Options

Surgery is generally reserved for severe or unresponsive cases, especially if sexual function is impaired.

  • Plication surgery: Shortens the longer side of the penis to correct the curve. It’s effective but may slightly reduce length.

  • Plaque incision and grafting: Cuts the plaque and adds a graft to restore shape and length.

  • Penile implants: In men with ED and Peyronie’s, implants provide rigidity and may help straighten the penis.

Choosing the right treatment involves considering the severity of the curve, pain levels, erectile function, and personal preferences.

Can It Be Prevented?

There’s no guaranteed way to prevent Peyronie’s disease, but reducing risk factors may lower the chances:

  • Avoid penile trauma: Be cautious during sexual activity and avoid positions that cause excessive bending.

  • Maintain healthy lifestyle habits:

    • Quit smoking

    • Limit alcohol consumption

    • Exercise regularly

  • Manage chronic health conditions: Proper control of diabetes, hypertension, and cholesterol is crucial.

  • Seek early evaluation: At the first sign of symptoms, consulting a healthcare provider may help slow or limit disease progression.

Related Conditions

Peyronie’s disease often occurs with or shares similarities to other health issues:

  • Dupuytren’s contracture: A hand condition involving thickening of the palm’s connective tissue.

  • Type 2 diabetes: Affects circulation and healing, raising plaque risk.

  • Erectile dysfunction: May be both a cause and result of Peyronie’s.

  • Cardiovascular disease: Conditions like high blood pressure and high cholesterol may impair blood flow and healing.

  • Depression and anxiety: The psychological impact of sexual dysfunction can be profound.

Living With Peyronie’s Disease

The experience of Peyronie’s disease varies. About 30–50% of men find their condition worsens over time, while around 67% report stabilization. A small percentage (3–13%) experience spontaneous improvement.

Mental and emotional impacts can include:

  • Loss of sexual confidence

  • Strained relationships

  • Depression and social withdrawal

  • Lowered self-esteem

Support is available. Talking with a therapist, particularly one specializing in sexual health or couples counseling, can be extremely beneficial. Open communication with a partner and medical team is also vital.

Managing the condition through appropriate medical care, mental health support, and lifestyle adjustments can significantly improve quality of life.