Peyronie’s disease occurs when a buildup of scar tissue causes curved and often painful erections. Sometimes it goes away on its own, but it can also be treated with injections, exercises, or surgery.

A rare form of erectile dysfunction (ED), Peyronie’s disease results in a bend in the penis that can make an erection painful. There are two phases of Peyronie’s disease, which include:

  • An acute phase, during which plaque forms and the penis starts to curve. People may experience pain with and without an erection.
  • A chronic phase beginning 12-18 months after the first symptoms start. In this phase, once the plaque has formed, pain may improve, though people may develop or experience worsening ED.

While a curved erection doesn’t always indicate a problem, people who have Peyronie’s disease may have trouble having sex. This often causes anxiety and discomfort.

Keep reading to understand more about Peyronie’s disease.

The main indicator of Peyronie’s disease is the formation of flat scar tissue called plaque. This scar tissue can generally be felt through the skin.

Plaque normally forms on the top side of the penis but may also occur on the bottom or side. Sometimes plaque goes all the way around the penis, causing a “waisting” or “bottleneck” deformity. Plaque may gather calcium and become very hard.

Symptoms of Peyronie’s disease may include:

  • scar tissue on the penis that may feel like hard lumps
  • painful erections
  • soft erections
  • severe curvature
  • shrinkage or shortening of the penis
  • changes in penis shape
  • erectile dysfunction

Scar tissue on a certain part of the penis reduces elasticity in that area. Plaque on the top of the penis may cause it to bend upward during an erection. Plaque on the side may cause curvature toward that side. More than one plaque can cause complex curvatures.

Curvature may make sexual penetration more difficult.

If you think you have Peyronie’s disease, the first step is to visit a primary doctor. Your appointment may include:

  • a medical history
  • a family history
  • a physical exam that may involve measuring the penis
  • an ultrasound to reveal the location of scar tissue

By measuring the penis, a doctor can identify the location and amount of scar tissue. This also helps determine whether your penis has shortened.

Scar tissue on a certain part of the penis reduces elasticity in that area. Plaque on the top of the penis may cause it to bend upward during an erection. Plaque on the side may cause curvature toward that side. More than one plaque can cause complex curvatures.

A doctor may also refer you to a urologist.

Curvature may make sexual penetration more difficult. Scar tissue may cause shrinkage or shortening of the penis.

There’s no cure for Peyronie’s disease, but treatment may help reduce symptoms. It may also go away on its own. Though it may be tempting to request medication right away, many doctors prefer the “watchful waiting” approach if symptoms aren’t severe.

Medication

A doctor may recommend medications — often drugs injected into the penis — or even surgery if you’re experiencing more pain or penis curvature over time.

Doctors may prescribe a low daily dose of tadalafil or injectable treatments.

Injectable treatments involve a series of penile injections that break down the buildup of collagen.

The American Urology Association (AUA) guidelines recommend the following injectable treatments for Peyronie’s disease:

Nonsurgical options

Researchers are investigating non-drug treatments, such as:

People being treated with clostridium hystolyticum may benefit from gentle penile exercises. For 6 weeks after treatment, doctors may recommend the following two activities:

  • Stretch the penis when not erect three times daily for 30 seconds per stretch.
  • Straighten the penis when experiencing a spontaneous erection unrelated to sexual activity for 30 seconds once daily.

Lifestyle changes

Some lifestyle changes may reduce the risk of ED related to Peyronie’s disease. These include:

Surgery

Surgery is the last course of action in the case of severe penis deformity. According to the NIDDK, doctors typically recommend waiting until the plaques and curvature stabilize before turning to surgery for Peyronie’s disease. Surgical solutions include:

  • removing the plaque
  • shortening the unaffected side
  • lengthening the scar tissue side
  • 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 the Nesbit plication. In this procedure, doctors remove or cinch excess tissue on the longer side. This creates a straighter, shorter penis.

Natural remedies

More evidence is still needed for natural remedies for Peyronie’s disease. American Urological Association guidelines stress that the current evidence is insufficient to recommend their use.

A 2001 study published in BJU International concluded that acetyl-l-carnitine may be “significantly more effective and safe than tamoxifen in treating acute and early chronic Peyronie’s disease.” But, no follow-up study has been published.

According to an article published in Reviews in Urology, vitamin E has been extensively studied for treating Peyronie’s disease. However, recent studies show no improvement in patients treated with vitamin E compared to placebo.

Researchers do not yet know conclusively why the scar tissue in people with Peyronie’s disease develops. However, research suggests that the condition may develop after trauma to the penis, including:

  • sports injuries
  • vigorous sex
  • micro-injuries that occur over time

This can cause bleeding and subsequent scar tissue buildup.

While injury may cause the condition in some cases, the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) notes that the condition can arise without a specific traumatic event.

Some people may be more likely to develop Peyronie’s disease. These can include:

  • people with connective tissue disorders such as Dupuytren’s contracture, which is a thickening in the hand that makes your fingers pull inward
  • people with autoimmune disorders such as systemic lupus erythematosus, Sjögren’s syndrome, and Behçet’s disease
  • people with family members who have Peyronie’s disease
  • people who are older, as tissue changes lead to increased injury and slower healing as people get older
  • people with diabetes-associated ED
  • people who have surgery for prostate cancer

Complications may result from Peyronie’s disease. These can include:

  • emotional stress, depression, or anxiety
  • ED
  • inability to have sex or difficult sexual intercourse
  • inability to conceive a child due to an inability to engage in intercourse

You can seek support from your healthcare team, which may include your doctor and a psychological counselor, to help you face these complex issues.

Can I prevent Peyronie’s disease?

While there is no definitive way to prevent Peyronie’s disease, you may be able to reduce some of your risk factors by avoiding trauma to the penis and quitting smoking, if you smoke.

Are there clinical trials for Peyronie’s disease?

Clinical trials for Peyronie’s disease may involve new medications or new combinations of treatments. It’s best to talk with a doctor about whether or not a clinical trial is right for you. You can learn more about open clinical trials for Peyronie’s disease.

Does Peyronie’s disease go away?

For some people, Peyronie’s disease may go away without treatment. Doctors may recommend “watchful waiting” for mild cases to see if your symptoms resolve.

What happens if Peyronie’s is left untreated?

In some cases, Peyronie’s disease may go away on its own. But if the curvature is severe or you experience severe or lasting pain, a doctor may be able to prescribe treatment and help prevent complications, such as stress and difficulty having sex.

Research is underway to help scientists better understand what causes Peyronie’s disease. Researchers hope their investigation into the process will lead them to an effective therapy to help people with 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.