Do any of your Peyronies therapies have harmful side effects?

Hi Dr Herazy,

Please advise whether any of the Peyronie's Disease medications are known to have any harmful side effects. Also, I'm located in South Africa – is there a local agent I can contact or do I need to purchase the medication online? Thanks.

Kind regards,

Paul

Greetings Paul,

Diarrhea is the only adverse reaction that happens from time to time with some men when they begin taking higher doses of systemic enzymes.  With every order of systemic enzymes that we send out we include detailed instructions explaining what to do if a temporary diarrhea “reaction” occurs.

In all the years that PDI treatment has been used I have not encountered any adverse reaction when the plans are used appropriately and as instructed. Since the PDI treatment concept uses vitamins, minerals, food-based enzymes and herbs the possible range and frequency of side effects are not what is commonly associated with drugs.  As far as your body reaction to the increased nutritional intake that is part of this kind of PD treatment, you are simply eating better.

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I am not aware of anyone doing this kind of work other than PDI located in the U.S.   We send to South Africa almost weekly without any problem.  TRH  

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Upward 40 degree curved penis with Peyronie's disease, 22 year-old thinks sex is over and mentions suicide

I am 22 years old, i was messing around with a girl (not having sex) but, she got turned on and thrusted down on me and her pelvic bone hit on the end of my erect penis and it hurt momentarily and i thought nothing of it and went on with business. When we finally had sex the next week and i felt smaller but just shrugged it off to a bad day. Then it still seemed to stay smaller and it began to hurt.

After 2 months of it hurting when i got an erection and noticing a bend in the middle i scheduled an appointment with a Urologist and wasn't too worried because i figured no matter the cost it would be fixable and i have an upcoming deployment so i would have the money to pay for any reconstructive surgery (which i looked up and found out there is nothing to fix it!).

I went to the urologist appointment and he said real quick it was Peyronie's disease and explained what i injured, to take vitamin E and just it will heal but i'll lose length and girth and will be more liable to injure it further in the future then he abruptly left the room and that was it.

The past week since my visit i have been scouring the internet and becoming very depressed and have been contemplating suicide ( seen another 22 year old post similar which made me feel as i should ask for help also) i have a 40 degree upward bend, the top of my dick when flaccid has a hard feeling to it, sort of a elongated lump. I feel about 3/4 to an inch smaller and much thinner. Also weaker erection but, that has started since the diagnosis which i believe is more mental that actual physical condition. But just a quick prelude, when having sex with girls for the first time i've always been shy and would struggle to hold an erection the first time or two until i was comfortable. Had a good sexual relationship with the girl before and was almost always ready to go no problem, and then that ended and after finally having confidence in my sexual self, i hurt myself and feel i'm ruined forever.

Greetings young man,

No, you are not ruined forever.  You are only ruined if you allow yourself to be ruined.  But, you are too good for that; you have already proven that you are too good to allow Peyronie's disease to ruin you because you have already started to take steps to take care of yourself and to learn about this ugly problem.  You have already showed me in your email that you will be one of those who survives Peyronie's disease one way or the other.

However, it sure as hell is true you are deeply scarred; you are also confused about this mystery condition that came out of the blue to hit you when you weren't looking; you are also shocked at how little the medical profession has to offer you; and you are also upset at the cold and indifferent way the urologist treated you.  When you put all these powerful negative emotions together it can rattle your thinking and put you mentally and emotionally off-balance for just a little bit.  Because of this you have allowed yourself to think about suicide for maybe the first time in your life.   How do I know you are feeling this way?  I experienced something similar when I developed PD in 2002.  In fact the majority of the thousands of men I have communicated with about PD have felt just like you, and have thought many of those same black thoughts.  When you have a lousy medical experience with Peyronie's disease like you did – just like almost all men do – you can understandably have an almost identical emotional reaction – just like almost all men do. The difference is that only a few men are honest enough to talk about it.

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What you must do now is get busy to help yourself because you already know there is very little help for you from the medical side.  Most MDs are rather indifferent to the plight of the men they diagnose with Peyronie's disease.  In your reading and investigation of the PDI website I am sure you have come across the information by now that is repeated many times about 50% of men who develop PD getting over it  (spontaneous remission of Peyronie's disease) without any outside help at all. The message of the Peyronie's Disease Institute is that you always have the option of improving your odds of recovery by supporting your natural ability to heal PD like those lucky guys who do it naturally.   In fact, you could be one of those men and you just do not know it at this time.  There is much you can do to support the natural tendency of the body to always do the most it can to heal and recover to the best of  its ability.

You admit that you are a shy person.  Many times shyness comes from insecurity and lack of confidence that are rooted in past childhood issues.   There is nothing like being naked in front of someone for the first time to test your self-confidence and personal comfort.  Now that PD is an issue these insecurities and self-doubts are challenged even more.   This is a vitally important and complex subject that is central to the negative emotions that so many men feel when they first deal with Peyronie's disease.   I want to say many things to help you with this subject but my time and space is limited.  I strongly encourage you to get one of the books I wrote that I think will help you greatly, “Peyronie's Disease and Sex.”  There are so many helpful topics covered in this book that I am confident will help you think your way through your self-doubts.  Hopefully reading it will guide you to the other end of the problem at which time you will feel differently about having Peyronies disease.  If it does happen that you continue to have thoughts of suicide it is important that you talk to someone you trust for help and advice.

At the end of your email you said”…I hurt myself…”  Actually, that is only partially true.  The truth is that you put yourself in a dangerous situation and you allowed someone else to hurt your penis.  This happened because you did not know any better because you and 99% of the men in the world do not know about Peyronie's disease until they developed it.  If men do not know about PD, you can imagine that women are even more ignorant of it.  Therefore, it is likely that in your life you will never meet a woman who understands how dangerous it is for a man to be jammed and smashed down by her when he is erect.  You know; she never will.  Therefore, it is not up to you to deliver any lecture about PD and sex safety.  But, it is up to you to be smart; do not ever again allow a young lady to get that close to you when you are erect when she could duplicate that kind of injury. You must select a different range of safer sexual positions in which you are more in control of sexual activity, or at least learn to hold on to her waist so that you can limit how far back she can move to avoid a similar injury.

Please contact me again if you need help of any kind and I will do all that I can for you.  TRH 

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Will the drug finasteride (Proscar) (Propicia) affect my Peyornie's disease in any way?

Dr. Herazy,

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My urologist prescribed finasteride (PROSCAR) to shrink my enlarged prostate and lower my PSA level.  Will this affect my Peyronies in any way?

Thanks,

Lou

Greetings Lou,

Finasteride (prescribed under different names depending how it is being used) is used to treat enlarged prostate and prostate cancer,  (under the name Proscar), and it is used to treat hair loss and male pattern baldness (under the name Propecia).  Initially when finasteride was first given approval by the FDA (Food and Drug Administration) the known side effects of  fatigue, dizziness, weakness, breathing difficulty and reduced blood pressure were thought to be acceptable because they were mild.  Since approval by the FDA and greater usage in the general population more disturbing side effects have been associated with finasteride use.

In mid 2012 the FDA announced that finasteride use can increase the risk of a very serious form of prostate cancer, even though it is sometimes used to treat symptoms of a mild form of prostate cancer.

My first thought when reading your email was, “I wonder if Lou told his urologist that he has Peyronie's disease?”  But being your urologist, I assume you have gone to this doctor in the past simply because you have Peyronie's disease, right?  If so, it appears to me that you probably have gone to this urologist for your PD and now your enlarged prostate, and the doctor prescribed the finasteride for you anyway.

You see, there are currently several lawsuits being litigated against against Merk & Co., the maker of finasteride, about the many apparent side effects of this drug, including complaints related to the urogenital system:  Peyronie's disease, reduced semen volume, reduction of the size of the penis, genital numbness and lowered sex drive.  Unlike many drug side effects that stop once a drug is discontinued, the side effects of finasteride that affect the male reproductive system appear to be permanent and do not go away after the drug no longer is taken.  In addition, there are other categories of lawsuits being processed due to the mounting evidence that it also causes depression, anxiety, “brain fog”, memory problems, comprehension issues, reduced exercise tolerance, weight gain, and muscle and joint aches.

The FDA (Food and Drug Administration) has ordered Merck & Co. to revise its labeling of Propecia in recognition of the growing body of complaints that the side effects of this drug appear to cause permanent sexual dysfunction long after it is no longer being taken.  Most disturbing it seems is that the FDA acknowledges that new side effects and complaints against finasteride are being reported over time, creating a new medical condition now called the Post-Finasteride Syndrome.

Please see, Another case of Propecia and Peyronie’s disease.

Your urologist was not negligent or wrong in prescribing Proscar for your prostate enlargement because the FDA has not officially stated that finasteride causes Peyronie's disease or aggravates established cases of PD.  All of these claims are being studied and evaluated to determine if the association between the drug and the side effect are real or merely coincidence.  While the FDA might take perhaps a few years to reach an official conclusion, and your urologist can still prescribe this medication, you must decide if you wish to take it.

Just a few weeks ago I worked with a man in his late-40s who took Propecia (finasteride) for his thinning hair problem.   He was on it for perhaps a few months when he developed many unusual problems of skin eruptions, anxiety, forgetfulness and weight gain.  A few months later he developed severe erectile dysfunction (ED) and a curved penis.  His doctor denied any connection or association between his patient taking finasteride and these health problems that started after taking the drug.   In the face of all the information and evidence that is developing about this drug, I told him that his MD was not being honest because he was trying to protect himself from a possible law suit.  You must assume that an MD who prescribes a drug knows about its growing history of drug side effects.  The MD must make a decision:  Do I prescribe this drug knowing that it is getting a lot of bad reports of side effects and the drug maker is drowning in law suits, or do I continue to use it because the FDA has not pulled it from the market?  It seems to me that MDs play with fire, but it is their patients who get burned while the MD is protected by a good lawyer!

The problem this 40 year old fellow was having as he worked to reduce his Peyronie's scar, was that his response was very irregular and very slow.  Some days the scar was softer and smaller, and other days it would return to its previous density and size; some days the curved penis was straighter and other days it was not.  He was getting very discouraged.  I later learned that he was also taking a beta-blocker drug for high blood pressure, long known to cause PD.  Apparently this double-whammy of two drugs that cause Peyronie's disease was the basis of his slow and unusual response to his aggressive PDI treatment plan.   

Perhaps you should consider that some of the other drugs you are currently taking for different health issues might also contribute negatively against your Peyronie's disease.  For information along this line, please see Could these drugs be the cause of my Peyronie’s disease?  

I cannot answer your question if Proscar will affect your Peyronie's disease in any way.  My guess is that if it is possible for  finasteride to cause Peyronies disease, it would be possible to make an existing case of PD a bit worse and it might also be possible for it to make recovery all the more difficult as I work to reverse the problem with a PDI plan. 

To my way of thinking, being a very conservative person in these areas related to health and well being, I would talk to my urologist.  I would  learn if there are options to explore;  if there is an enlarged prostate drug that does not carry the possible side effect of causing all these different urinary symptoms that could be used as a substitute for Proscar.  If I had an enlarged prostate and I had Peyronie's disease, I would not take Proscar.  I strongly advise that you should do what you and your urologist decide to do.  TRH

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My Peyronie's disease started after I tried to straighten my curved penis with a penis stretcher, should I use another one?

Winter 2010 I used a penis extender for around 1.5 months (4-6 hours each day or less), where I probably made an injury on the left side (too hard penis with too hard stretch), just below the glans.

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I realize now that I probably have had congenital curved penis all my life.

When my penis is rock hard, it curves 30-40 degrees to the left. I think it was less before Winter 2010 when I started using the penis extender.

I wonder if it could have been possible that I didn't injure the penis, but bigger curve at the glans is due to longer extension on the right side compared to the left side (because of scar tissue on the left side) ?

Seriously, I didn't think so much about the curve before, so the curve might only have been congenital before this likely injury. I went to an urologist in May and he indicated that I maybe have had a little injury on the tunica albuginea (which makes the overall curve bigger).

In December I started to use an extender again, with the use of  XXXXXX, said to work specifically for PD. I stopped after 34 total effective days (9 h each day) as I have read some studies where they have used Verapamil injections before usage of an extender. In one study the curvature went from 30 to 0 and lengthened with 1.5 cm 🙂   I stopped using the extender 10 days ago.

Is this something you recommend? To remove the plaque first and then start using the extender after the plaque has been removed? Because it is speculated that some of the reasons the lengthening is shorter with PD, is because of the plaque. I have just started to use DMSO and SSKI (both topical), and will start to use Serrapeptase and Nattokinase as well. I see on this site that you also recommend Neprinol and some copper + +.

I have another question, so I may have to call you for more clearance; when the plaque diminished, will it leave an empty area in the flesh, maybe making the curvature worse and the penis shortened?

Peyronies disease is not just having plaque, but also having one side shorter than the other. It is then vital to use an extender so the shortest side can catch up the longest side, right?

I`m 31, which package do you recommend to me?

Greetings,

First of all, I removed the name of the penis stretcher product from your email because I think all of them are dangerous, as you have already shown us by reporting you injured yourself with one.  I wish to not promote these contraptions in any way.  The name of your particular device is not important because none of them are different from the others in any important or meaningful way.   All cars are fundamentally the same because all have a motor, seats, windows, wheels and a steering wheel; in that sense they are all identical in their basic design.  The same can be said of penis stretchers.  They all have a clamping device that holds the penis at or near the head, a base that is held against the pubic region, a pair of extendable threaded rods that lengthen the device while it is worn on the penis, a book of instructions that tells you what to do if you develop blisters and skin erosion while using the extender, and surgical wool and antibiotic ointment to keep you from hurting yourself further.

You are a rare man.  I have communicated with very few men who are able to wear a penis extender device for more than a short while; some could not wear one for even 10 minutes.  I have worked with many men who told me they could only put it on only one time and threw it away because of pain and apparent injury.   Many of those men who persisted in spite of the pain and superficial tissue erosion caused by these stretchers soon developed Peyronie's disease.  Some men put a penis stretcher on only one time for 30-60 minutes and then never again because they next day they have signs of early penis injury, and later demonstrate full blown Peyronie's disease.

It seems the prolonged pressure from the head clamp  causes local tissue anoxia (oxygen starvation) deep within the penis tissue; this is probably what happened to you.  When there is a lack of blood circulation in the penis caused by smashing it down with the clamp of the penis extender, blood circulation is cut off and a lack of oxygen occurs where the head is compressed.  This is very much like what happens when a tourniquet is worn too tight or for too long – the lack of oxygen caused by poor blood flow will kill tissue.  Any good boy scout or soldier learns that even if your arm or leg is severely cut you must periodically release the tourniquet – even if hemorrhaging starts again – so that fresh blood can deliver oxygen into the injured limb.  If this is not done the entire limb can become damaged and gangrene can develop.   But you report in one area of your email that you wore yours for 4-6 hours daily for six weeks, and you state later you wore another penis stretcher for nine hours daily for 34 days.  That is incredible.  If you were a boy scout you would have flunked the first aid class for leaving the “tourniquet” on for far too long.  No wonder you developed PD.

You state your congenital penis curvature is now worse than it was before you started using your first penis stretcher; your bent penis now curves 30-40 degrees to the left, more than before using the stretcher.  You think that the solution to the problem caused by the first penis stretcher is to use a second penis stretcher.  I do not agree with your thinking, and I will explain why later.

Please think about this statement I am about to make because it is very important in helping you to understand why you have injured your penis, and why I feel you are going about treatment in a totally wrong way:  If you have Peyronie disease, your problem is not that your penis is bent, dented or otherwise distorted; your problem is that you have dense scar tissue within the tunica albuginea layer of  the penis that as a secondary factor is causing your penis to be curved, dented or otherwise distorted.

Think of it this way.   If you cut yourself shaving, what is the actual problem?  Is your problem the blood running down your chin?  Or is the  problem the hole in your skin that as a secondary factor is allowing blood to leak out of the blood vessels and run down your chin? Certainly the blood gets your attention, but it is not the problem.  If you did not have the hole in your skin the blood would not be running down your chin.  If I was to offer you a way to wipe your face clean, it would not address the real problem which is the hole in your skin.   If I was to offer you something that would help you heal the hole in your skin rapidly you would not have to worry about the blood running down your chin.  Certainly when your penis is bent it gets your attention, but it is not the problem.

I emphasize this point because I believe you are seeing Peyronie's disease as being a curved penis, when it is not.  Peyronie's disease is a soft tissue condition of the penis in which a fibrous plaque of scar tissue develops excessively for some reason (congenital predisposition, nutritional deficiency, trauma, chemical or hormonal imbalance, drug side-effect, or a combination of some or all these) in the tunica albuginea, which in turn prevents the even and symmetrical expansion of the erection and a few other nasty symptoms.

You ask, “Is this something you recommend? To remove the plaque first and then start using the extender after the plaque has been removed?”   The answer is simple:  No.  If you did something to remove the plaque first, you would not need to use an extender because you would not have Peyronie's disease.  With no plaque in the tunica albuginea you would not have a curved penis and there would be no point in using the penis extender unless you are one of those men who believes stretching on the penis will make it bigger – and that is an entirely different topic.

You also ask, “…when the plaque diminished, will it leave an empty area in the flesh, maybe making the curvature worse and the penis shortened?”   The short answer is again, no.   As a longer explanation:  When a pregnant woman delivers a baby, does her abdomen stay stretched out?  When a weight lifter stops exercising, does he develop empty areas and voids where the larger muscle tissue used to be?  When you over-eat and your stomach and abdomen expand and bulge out, does it stay that way permanently?  No, to all of that.  All our body tissues are elastic (even bone to a very minimal degree), allowing the removal of unneeded or foreign tissue cells that are eliminated and healed over in the best way the body can accomplish under the circumstance.   The body always attempts to return to the most efficient and normal state it can whenever and however possible.  In the case of Peyronie's disease the body will attempt to reabsorb the strands of fibrous tissue and heals the tunica albuginea to the best of its ability.  In about half of the men who develop Peyronie's disease this attempt at self-repair and self-healing is successful.  In the approximate other half, the condition is not healed and becomes more or less permanent.

This tendency of the body to always attempt to return to normal (homeostatis), or self-heal, is the basis of the PDI concept for eliminating the Peyronies disease scar. By presenting to the tissue a wide variety of helpful and supporting vitamins, minerals, enzymes, and naturopathic modalities like moist heat applications, DMSO, gentle manual penis stretching (which is vastly different from your mechanical penis stretching concept), ultrasound and acupuncture therapy, we attempt to support, promote, stimulate and accelerate that ability of the body to eliminate the Peyronie's scar that works in 50% of men and fails in the other 50%.  What PDI attempts to do is really not so far fetched or bizarre.  We only attempt to assist and  promote a natural process that is successful in 50% of men when they eliminate their PD scar without any help from anyone.  We are not trying to make pigs fly.  The PDI concept of helping PD correction is one of working with the man who has PD so he can do a better job of what he failed to do in the first place.

Another question you pose is,  “PD is not just having plaque, but also having one side shorter than the other. Ii is then vital to use an extender so the shortest side can catch up the longest side, right?”   You ask that question as though having plaque and having a shortened side of the penis are two separate and distinct problems.  I get the impression you believe that the shortened concave side of penis curvature happens independent of the plaque, when that is not the case.   It is the presence of the dense fibrous scar that shortens the side of the penis in which it is located, and not the other way around.

To solve the problem of Peyronie's disease the body must eliminate the mass of dense fibrous scar in the tunica albuginea.  You cannot eliminate that tissue by stretching or pulling on it.  How do I know that?   Simple laws of physics governing our universe explains why stretching a penis with a PD scar will not influence that mass of inelastic tissue. 

We all have heard the expression many times, “A chain will break at its weakest link.”  We all intuitively understand what that means.   When a stretching or traction force is applied to a series in which there are stronger or stiffer areas as well as weaker or more flexible areas, the weaker or flexible parts or areas will give way, break down, fail or somehow give  up before the stronger parts or stronger areas.   In war: when the enemy attacks, the weaker part of a battle line will give in before the stronger part of a battle line.  Toilet paper and postage stamps: when the paper is pulled the area of paper that has been weakened by the small perforation holes will tear before the non-perforated paper has a chance to tear.  Tires on a car:  the softer the tire, the more it will absorb the vibration energy of a rough ride, and the harder the tire the more it will pass the energy of a rough road to your body.  There are countless examples of the idea that a weaker, thinner or more flexible area will absorb energy before a stronger, thicker or more rigid part is able to do so.  This is why a chain will break at its weakest link.  What does this have to do with Peyronie’s disease?

The PD scar is thicker and stronger than normal skin and corpora cavernosa tissue of a penis. When a traction force is applied to the penis, the normal elastic corpora cavernosa and skin tissue will absorb the energy of the traction force as it stretches out before the inelastic scar tissue has a chance to stretch – the scar will not get a chance to get stretched because the healthy penis tissue will absorb the energy as it stretches first.  Don’t believe me?  Do this experiment.  Find  three rubber bands– two that are thin and stretchy and one that is thicker and heavier than the two thin rubber bands.  Loop these three rubber bands together in a series, placing the two thin stretchy rubber bands at the ends and the thick heavy one in the middle.  Now hold this series of rubber bands at the two ends and pull on it so you are stretching the whole thing out to make them all longer.  Notice that all movement and stretch  is coming from the two thin stretchy rubber bands that are at the ends, and no movement or stretch is taking place in the thick rubber band in the middle.  Only when you stretch so far that the two thin rubber bands are near their breaking point and are ready to snap, will the thick rubber band in the middle begin to move a little.  If you continue to pull, one of the thin bands will break before the thick band has stretched only a small amount.  This will happen every time.  Thus, when you pull on a flaccid penis that has Peyronie’s disease you cannot stretch the thick fibrous scar tissue because the normal elastic skin and deeper corpora cavernosa tissue will absorb the traction force to do all the stretching just like the thick and thin rubber bands looped together.  

In Peyronie's disease any apparent inequality of length is caused by unequal expansion of the corpora cavernosa due to the presence of the dense fibrous scar material within the tunica albuginea. The dense and inelastic scar prevents full expansion of the erect penis, and perhaps only a minor amount of actual contraction of the tunica albuginea.  When I work with men who have been successful in reducing or eliminating the their PD scar material their curved penis returns partially or completely back to normal depending on how much scar elimination occurs.  I am told for some the scar elimination is complete and for others only partial; when I treated my own Peyronie's disease in 2002 it was complete elimination of the PD scar.  No mechanical penis stretching is done and no mechanical penis stretching is needed.  In 2006 a research project was undertaken during which we devised and perfected a gentle manual penis stretching method that works completely unlike and contrary to the concepts presented in the mechanical penis stretchers.  Additionally, I find that lost penis length and girth that occurs is a result of fibrous infiltration of the tunica albuginea and this often improves to the degree the body is successful in its attempt to remove this foreign fibrous tissue, owing to the natural tendency of the body to heal itself when given the opportunity.

Your last question about what Peyronie's treatment plan I recommend for you is the most difficult and also easiest one to answer.   Since I am not your treating doctor I can only advise you as I advise all other men who come looking for help in starting self-treatment.  I suggest you use the largest and most aggressive plan of treatment that you can sustain for at least 3-4months while you follow the PDI concepts of Peyronie's treatment that supports and encourages your body to eliminate this terrible scar material.  If you decide to do so, you might use the gentle manual penis stretching technique as part of that effort.

I appreciate your hard work, earnest effort and sincere desire to rid yourself of your Peyronie's disease.   You are like many men I deal with daily.  I commend you for not accepting your problem and encourage you do all you can to heal your problem.  If I can help you in any way, please let me know.  TRH

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Can you help me with a penis that has been shortened by scarring from x-ray radiation?

I have had peyronies since 1977 when  I had a testicle removed and very soon after I contracted peyronies.  The oncologist treating me for the cancer also zapped the peyronies.  My problem is the x-ray treatment scar has shortened my penis form 6″ to 3.5″ also left me with the inability to maintain an erection so when I use the cock ring for intercourse it only leaves about 2.5″ and that ain't much fun. I have just found your web and am wondering if you can help.

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Greetings Mate,

You have a few things going on here at the same time and that will impact the outcome you finally earn. 

While the PDI gentle manual penis stretching technique was developed specifically for the effects of Peyronie's disease, it has been used by many men who wished to change their congenital penis curvature and a few men so far who have had scarring of the penis surface from x-ray radiation treatment.  Based on the reports I have received back from some of these men the  response was most often good enough that they were pleased with the outcomes and they thought it was worthwhile, even in those cases in which total recovery did not happen.

You have dealt with your problem for a very long time, so I assume you will be patient with this process and allow ample time for your tissue to respond to the best of its ability – if at all.  I mention this because I have no idea how bad your scarring is, where it is located, how deep it is, and most importantly, I have no idea how well and how faithfully you will use the stretching technique to assist changes to happen.  I can only hope you will follow the detailed technique instructions exactly as they are presented and that you will not try to use only penis stretching as the only way to try to regain lost penis size.  This is usually the best way to fail to get help.

To work well it is necessary to help your scarred tissue also from the inside by also using systemic enzymes, DMSO, vitamin E and Scar-X.  When these are combined with the stimulus of gentle manual penis stretching it might be possible to regain perhaps a part of what you have lost, perhaps a lot.  I have no way of knowing.   I cannot predict or promise anything to you because there are so many variables and unknowns.  The important thing is that you try to do this in the best and most aggressive way possible for at least 3-4 months.

If you decide to follow for a few months a therapeutic trial to see if changes can be made in your situation, please advise me by email when your order is placed.  I will supply specific information for you.  This is not what our therapy protocol is normally used for, so I will have to guide you through a few special steps.   TRH

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Questions about taking Neprinol in a Peyronie's treatment plan

Hello Dr Herazy,

I have a question regarding the intake of Neprinol and the absorption of proteolytic enzymes. I understand that they need to be taken away from meals. My understanding is that on an empty stomach they act/are absorbed in one way, and with food they act in another way. On your site somewhere you say they they should be taken 90 minutes before or 90 minutes after eating. 90 minutes before eating sounds extreme. Surely they are out of the stomach and on the way to the intestines in a lot less time than that. And by the same reasoning, taking them 90 minutes after eating … wouldn't there still be food in my stomach at that time? 90 minutes before suggests REALLY away from food; but 90 minutes after suggests that mixing it with food then is OK. Can you clarify this a little further. I just want to be sure what I take can be as efficacious as possible. My practice has been to take it 15 to 30 minutes before eating. (At which time I also take other herbs (for other non-PD concerns) that also need to be taken on an empty stomach.  Thanks.

Walter

Greetings Walter,

What you are asking about is called “gut transit time,” or the amount of time it takes for food to pas through the digestive tract, as well as absorption rates for different molecules that pass through the stomach wall. As you can imagine, this is a variable factor from one person to the next. The 90 minute stipulation is a good average for most men following a Peyronie's treatment plan,  but it might far shorter or far longer than it should be for some people; yet, it is a good average.

If you feel that you need to increase or decrease these times for taking Neprinol based on your personal digestion physiology, by all means please do so. Having said that, I would caution you that you should err on the side of assuming there is food in your stomach longer than what you think. Please give yourself a bit more additional time when taking the enzymes before a meal, and give yourself a bit more additional time before you eat after taking the enzymes. The world will not come to an end if you take your enzymes to close to the time you are going to eat, or you eat too soon after taking enzymes, but your therapy will be diminished and Peyronie’s treatment is too important to make this kind of error.

You write that you take your systemic enzymes 15-30 minutes before a meal. That might be perfect for you, but it might not be enough time for the next person. Further, that might not be enough time for your stomach to get the enzymes into your blood stream and into the fibrous tissues. How would you know?

You write that taking Neprinol 90 minutes before a meal sounds extreme to you, but I must wonder what you base that on. All I propose is that you give your gut ample time to get all the systemic enzymes through the gut wall, into the blood stream, and disbursed to start working on the excess foreign protein that is in the Peyronie’s scar. Maybe this can take place in 17 minutes, or 59 minutes, or 90 minutes, no one knows for sure because these particular digestive enzymes have never been studied for absorption times or delivery times. So why not make sure you allow enough time to allow it to happen so you get the best results from each and every dose you take?

If all you are doing is using that “full stomach” sensation to judge if food is still in your stomach you might be incorrect. Many people have food still being digested for hours after a meal – they might be exceptions, but it does happen. Further, gut transit time – the time food stays in the stomach – changes in the same person from one meal to the next depending what kinds of fats, carbohydrates and proteins are in each meal, and changes based on your emotional state, how well or poorly you chewed your food, how physically active or rested you might be at that time, how warm/cold you are, and other factors.

Lastly, let me guess that your question is not based on the usual situation in which you can control your food and enzymes schedule perfectly. I will guess you are asking this question really based on those days when your schedule for eating, working, and taking a handful of different therapy items is totally out of your control. We all have too many of those days when we forget to take Neprinol 90 minutes before we eat, or we absolutely will not be able to take the Neprinol 90 minutes after we eat. What do we do then? When we cannot allow ample time to take systemic enzymes on a good schedule because of forgetting or something we cannot control, what should we do? Do the best you can. Then promise yourself that the next dose will be taken at a better time to allow for better absorption and delivery. That is all you can do.

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Give your gut ample time to empty food, and to absorb Neprinol, so as to maximize the ability of Neprinol and other proteolytic enzymes to the target Peyronie’s disease fibrous scar material.

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