What Is Peyronie’s Disease?

Peyronie’s disease is a type of connective tissue disorder that causes plaque (hardened scar tissue) to build up under the penis, making it appear abnormally curved when erect. It affects up to 1 in 11 men. 

The plaque associated with Peyronie’s disease is benign (noncancerous). However, it could cause erectile dysfunction (ED) and make sex painful. 

Learn more about Peyronie’s disease, including symptoms, causes, risk factors, comorbid conditions, treatment options, and more.

Peyronie's Disease Symptoms

The main symptom of Peyronie’s disease is a distinct curve in the shaft of the penis during an erection. In most cases, the penis curves upward. 

Other signs and symptoms include:

• A hard lump or thickened area of skin in one part of the shaft
• Pain during erections and/or sex
• Difficulty with sexual penetration
• Erectile dysfunction
• An hourglass-shaped penis
• Reduced length or girth

During the acute phase of Peyronie’s disease, your symptoms may be worse. You may experience penile pain and inflammation either with or without an erection. 

After the plaque has hardened, usually about a year to 18 months after the initial onset of symptoms, the pain usually starts to subside. This is known as the chronic phase of Peyronie’s disease. 

What Causes Peyronie's Disease?

Peyronie’s disease is caused by the buildup of plaque in the tunica albuginea–the part of the penis that helps to sustain an erection. Eventually, the hardened scar tissue causes the penis to bend. This may be due to restricted blood flow, the weakening of muscle tissue, or both. 

There’s no single known cause of Peyronie’s disease. However, some researchers believe the curvature may be caused by:

• Trauma, including penis fractures as well as minor injuries caused by sports, sex, etc. 
• An autoimmune condition, which causes the body’s immune system to attack healthy penile tissue
  

Risk Factors

Peyronie’s disease is most common among white men between the ages of 40 and 60. Men over 60 sometimes develop the condition as well. 

Other risk factors for Peyronie’s disease include:

• Autoimmune and inflammatory conditions
• Smoking
• Excessive alcohol use
• A family history of connective tissue disorders, including Peyronie’s disease
• Type 2 diabetes
• A history of prostate cancer treatment, such as radiation therapy or surgery
  

How Is Peyronie's Disease Diagnosed?

To diagnose you with Peyronie’s disease, your urologist (or another healthcare provider) will conduct a physical examination. They may be able to feel the scar tissue themselves, or you can provide photos of your penis during an erection. 

Your provider may also ask about your personal and family medical history and current symptoms. In some cases, an ultrasound may be necessary.

Treatments for Peyronie's Disease

Not all cases of Peyronie’s disease cause sexual dysfunction or require treatment. In many cases, the symptoms are mild or go away over time.

Currently, the treatment options for Peyronie’s disease include:

• Xiaflex (intralesional collagenase injections): When injected directly into the affected tissue, collagenase can break down the plaques that cause penile curvature. This is the only treatment approved by the U.S. Food and Drug Administration (FDA) for the treatment of Peyronie’s disease.
• Other injectable medications: Other medications, such as interferon-alpha 2b and verapamil, can also be injected into the scar tissue to reduce curving, help with pain, and break down plaque.
• Oral medication: Potaba (potassium para-aminobenzoate), a type of vitamin B, may help to reduce scar tissue. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can be taken for mild to moderate pain relief. Your healthcare provider might also prescribe Viagra (sildenafil) to treat erectile dysfunction.
• Surgery: There are several different types of surgery available for people who can’t have sex due to Peyronie’s disease, including penile grafting, implants, or plication surgery. A penile prosthesis may be necessary in severe cases. 
• Non-surgical treatment: Non-surgical treatment options for Peyronie’s disease include shockwave therapy, vacuum or mechanical traction devices, and radiation therapy.

How to Prevent Peyronie's Disease

There’s currently no known way to prevent Peyronie’s disease. However, some studies have linked smoking and excessive alcohol use to the condition. Quitting smoking and limiting your alcohol intake may lower your risk. 

You should also see a qualified healthcare provider–such as a urologist–as soon as possible to address your symptoms early.

Comorbid Conditions

Conditions that often occur alongside Peyronie’s disease include:

• Diabetes
• High cholesterol
• Heart disease
• Hypertension (high blood pressure)
• Sexual dysfunction (such as reduced sex drive and erectile dysfunction)
• Dupuytren contracture, which causes the skin on the fingers and palms to thicken and contract

Many people with Peyronie’s disease also experience mental health symptoms, such as depression and anxiety, due to their sexual concerns. Almost half of people with the condition have mild to moderate symptoms of major depressive disorder (MDD).

Living With Peyronie's Disease

About 30-50% of patients with Peyronie’s disease notice that the curvature of their penis gets worse over time. However, the condition stabilizes or “plateaus” in up to 67% of affected individuals. Meanwhile, around 3-13% of people with Peyronie’s disease find that the curvature resolves on its own.

If you’re experiencing distress, problems with self-image, or relationship issues due to sexual dysfunction, mental health treatment may help, including psychotherapy, sex therapy, and/or medication.