Understanding ED: Peyronie’s Disease
Do You Have ED?
The difficulty to get or maintain an erection, sometimes referred to as “ED” for short, can cause problems in the bedroom for men of all ages. One form of ED called Peyronie’s disease causes a bend in the penis that can make an erection painful.
While a curved erection doesn’t always indicate a problem, men who have Peyronie’s disease may have trouble having sex, which can cause anxiety and discomfort. Click through the slideshow to understand more about Peyronie’s disease.
What Causes Peyronie’s Disease?
According to the Mayo Clinic, the cause of Peyronie’s disease is largely unknown. However, research suggests that the condition may develop after trauma to the penis, such as bending or hitting, which can cause bleeding and scar tissue build-up.
While injury may be the cause of Peyronie’s disease in some cases, the National Kidney and Urologic Diseases Clearinghouse (NKUDC) notes that often the condition arises without a traumatic event.
How to Know If You’re at Risk
Heredity and age both appear to play a role in Peyronie’s disease. As men get older, tissue changes can lead to easier injury and slower healing, putting them at greater risk for the condition.
Also, men with a connective tissue disorder called Dupuytren’s contracture have more chance of developing Peyronie’s disease. Dupuytren’s contracture is a thickening in the hand that makes your fingers pull inward.
Scar Tissue Symptoms
The main symptom of Peyronie’s disease is the formation of flat scar tissue, also called plaque. This scar tissue can generally be felt through the skin. Plaques normally form on the upper side of the penis, but may also occur on the bottom or side.
Sometimes extensive plaque goes all the way around the penis, causing a "waisting" or "bottleneck" deformity. Plaque can gather calcium and become very hard. Scar tissue can cause painful erections, soft erections, or curvature.
Curvature and Other Symptoms
Scar tissue on a certain part of the penis reduces elasticity in that area. Plaque on the top of the penis can cause it to bend upward during an erection. Plaque on the side can cause curvature toward that side. More than one plaque can cause complex curvatures.
Curvature can also make penile penetration difficult. Scar tissue may also cause shrinkage or shortening of the penis.
Tests to Take
If you think you may have Peyronie’s disease, the first step is to visit your doctor. A physical exam can help your doctor determine if you have the condition. This exam may involve taking an initial measurement of your penis.
This can help during future visits to determine whether your penis has shortened and to identify the location and amount of scar tissue. Based on this information, your doctor may suggest an ultrasound or X-rays to reveal the presence of scar tissue.
Treatments to Try
Though it may be tempting to request medicine right away to solve this problem, many doctors prefer the watchful waiting approach if your symptoms aren’t severe or worsening.
If you’re experiencing more pain or penis curvature over time, your doctor may recommend medications—often drugs injected into the penis—or even surgery. While research is inconclusive on whether penile injections are effective, two types of medicines that may be prescribed are verapamil (usually used to treat high blood pressure) and interferon (which helps break down fibrous tissue).
Surgery is saved as a last course of action in the case of severe penis deformity. According to the National Library of Medicine, you should wait at least a year before turning to surgery for Peyronie’s disease (NIH, 2012).
Types of Surgery
Surgical solutions include shortening the unaffected side, lengthening the scar tissue side, or penile implants. Lengthening runs a greater risk of erectile dysfunction.
Shortening the unaffected side is used when curvature is less severe. One type of shortening is a procedure called Nesbit plication. In this procedure, doctors remove or cinch excess tissue on the longer side, creating a straighter, shorter penis.
Facing Your Anxiety
Sex-related problems are stressful. Men with any form of ED may feel embarrassed or ashamed to have a problem with their penis, and may even think that it makes them less of a man. This type of anxiety can lead to problems with your sexual partner.
Take steps to nip stress in the bud. Talk to your partner about Peyronie’s disease and how it may affect your performance in bed. If necessary, enlist the support of your doctor or a therapist to help you cope with your condition.
When It Gets Complicated
In addition to the anxiety or stress that the condition may cause you—and perhaps also your partner—some other complications may arise from Peyronie’s disease. Due to difficulty achieving or keeping an erection, you may find it hard to have sexual intercourse at all. If intercourse is not possible, you may also find yourself dealing with difficulty fathering a child.
Seek support from your healthcare team, which may include your doctor and a psychological counselor, to help you face these complex issues.
Hope and Progress
New research is underway to help scientists better understand what causes Peyronie’s disease. A study being conducted by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) seeks to identify a common process that causes penile fibrosis and arterial stiffness in the body. Researchers are hopeful that their investigation into the process at the cellular level will help lead them to an effective therapy to help sufferers of Peyronie’s disease.
In the meantime, do what you can to understand the condition and take the necessary steps to improve your quality of life—both in and outside of the bedroom.