I know you say to get diagnosed by a doctor, but all of my symptoms fit Peyronie's to a T. I feel that going in to be diagnosed would be throwing money, and time away. Are there other conditions that would produce the same symptoms? I am ready to commit to your plan, as it seems to be the only thing that might help. Also, are there any other health benefits from your plan? I have prostate problems,for which my doctor prescribed finasteride, and have since developed what I believe to be Peyronies. I have subsequently quit taking the finasteride, and was wondering if your plan helps at all with prostate issues.
Thank you for your help.
I cannot force you to receive medical care or to be examined, but only to advise you that it is typically the wise thing to do.
Many cases of PD are strongly suggestive of this problem, making a formal diagnosis seem superfluous. There are no other medical conditions that cause an exact clinical presentation of a classic case of Peyronie's disease.
Please read Will the drug finasteride (Proscar) (Propicia) affect my Peyornie’s disease in any way? to learn more about the relationship between this drug and PD.
The PDI treatment concept was intended specifically as a way to increase the ability to remove the PD scar material in a natural way as when the condition simply disappears during the normal healing process. However, I have had many people tell me that many chronic health conditions have cleared up while following the improved nutritional approach that is integral to the PDI concept of PD treatment. Even so I would not approach treatment of a chronic prostatitis hoping that it might clear up while working to eliminate the PD scar. You would have to be much more specific and direct in your therapeutic selection than what is found in a PD treatment plan. This is the reason we do include a few prostate treatment items under the “Prostate Support” tab of the PDI store. I suggest you undergo a brief therapeutic trial of care in this way while still following your medical doctor's advice about your prostate. TRH
Hello Dr. Herazy,
I'm a 27 year old graduate student from another country. When I was 23 years old, I was diagnosed with clinical depression and was prescribed Clomipramine. After taking this drug for the very first time, something very unusual happened to my penis (within 60 minutes of taking this drug). My penis had swollen up (not erect, swollen like a balloon). It remained like that for 6 or 7 hours and eventually the swelling subsided. Obviously, I did not take Clomipramine ever after that day. I also did not tell anyone because I did not want anyone to find out that I had been prescribed an anti-depressant (it is sort of a taboo thing in my country).
Since that day, my penis has been curved towards the left and more importantly, my erect penis is significantly shorter and less thick.
I'm going to be in the US for another 3 years for my PhD, and I would like to receive your treatment before I return to my country.
I was wondering if you've ever heard of cases similar to mine. Please let me know.
Also, any other suggestions/advice would be appreciated.
I have not been able to locate any information indicating that Clomipramine can lead to Peyronie's disease, although there is abundant information about it causing alternation of the erection mechanism.
If you would like to discuss your penis curvature complaint when you are in this country please feel free to contact me. TRH
Do you suggest any other products (i.e. stretching video, or other supplements) that are not in the small treatment plan?
Hello, I started my treatment with PDI two weeks ago. I am 47 years old and have never taken viagra or anything like that. I started first with pain during an erection in July of 2012. I went to my doctor and he felt to see if there was any scar tissue, but felt nothing. A month or two later I started to get a curve in my penis to my right side. I am not sure of degree but over this first year it has worsened. (I took pictures before I started as suggested) I purchased the PDI system, the most mild, because it seemed to most match with my condition. Do you suggest any of your other products (i.e. stretching video, or perhaps other supplements that are not in the mild treatment?) The reason why I ask is because of my age. I noticed that one of the descriptions for the mild treatment was 25 years of age. I want to attack this early and hard so as to have the best possible result.
If you wish to add to your small PD treatment plan you can certainly add any of the therapies not currently being used.
However, before doing so, I suggest that you explore a higher dosage of several therapies that are in the PDI small plan, like Nattokinase, Fibrozym, vitamin C, and the DMSO and copper topical treatments. It is far better to work with higher dosages of what you already have available to you, than to merely collect a larger assortment of therapies that you do not actively work with. Using a smaller dosage of a large assortment of therapies seems to be less effective than taking a larger dosage of a small assortment of therapies.
Please contact me to discuss how you can use your small plan better than you are now.
To answer your question, acetyl-L-carnitine, PABA and the stretching video are always good therapeutic choices to expand your treatment profile after you have exhausted combinations and dosages of what you are now using. TRH
Would liposomal nutrient delivery be a good way to treat Peyronies disease or Dupuytrens contracture?
Are you aware of liposomal delivery of nutrients. It is a vastly superior way to get right through the cell walls with little or no degradation in the digestive process. I am switching over most of my regular supplementation to be liposomal and even make my own liposomal C.
I really believe that this way to deliver the nutrients (and enzymes?) is the wave of the future and will become the standard. Especially for intracellular use of nutrients. Would it not be a good way to treat Peyronie's disease or dupuytren's contracture?
Thank you, i believe you are very dedicated to helping people.
Yes, I am very much aware of the new technology in which water and fat soluble nutrients are encased in a micro-sized sphere of fat that enables it to be passed through the digestive tract wall, into the bloodstream, and eventually through the cell walls of all tissue cells throughout the body. These spheres are so small (100 to 400 nanometers across) that they can only be seen with an electron microscope. Larger size spheres that contain more nutrients can be made but they would not easily pass through the gut membrane, nor pass through the cell walls.
There is much interest in this new technology because so often orally consumed nutrients are not adequately absorbed by all people into the body. Liposomal delivered increase the absorption of oral nutrients, and protect delicate nutrient molecules from breakdown when subjected to the digestive process.
Many times a person will only absorb and benefit from a small portion of the nutrients that are taken. With the promise of liposome technology the nutrients easily pass through the digestive system intact and undiminished. The combined effect is that the nutrients are absorbed better and carry greater potency, with less chance of
However, this is still a relatively new technology and it is evolving and improving over time. I am somewhat hesitant to get into it or promote its use before it has been sufficiently refined and proven its worth.
There are several key points to keep in mind at this early stage of liposome development:
1. Be sure that the PC (phosphatidyl choline) or fat content is sufficient. For example, a 1000 mg dose of vitamin C will usually need about 350 mg of PC, and even more might be better to assure the nanometer size is sufficiently small for maximum passage into the cells.
2. Deal with only a reputable company to learn the liposome size in the product. This information must be guaranteed by the manufacturer. If the liposomes are too small they will not carry enough nutrients. If the liposomes are too large they cannot pass through the intestinal lining or the wall of the targeted cells. A guanteed range of 100 nm to 400 nm (nanometers).
3. Read the manufacturers report on size testing. Only large laboratories have a SEM (Scanning Electron Microscope), so they need to offer proof of this critical determination. How they are able to manufacture liposome is proprietary, so I do not know how you propose to make your own nutrient liposomes. I would be very suspicious of a company that tells you that it will help you to do it. TRH
Exercises for Peyronie’s disease
Peyronies disease exercises presented in this article are not intended to increase the size of the penis, or to make the organ in any way stronger in the usual sense. These exercises are chosen because they attempt to get to the cause of the Peyronies problem, the nodule of scar tissue located below the surface of the skin.
Peyronie’s disease is all about the presence of fibrous scar tissue within the deep layer of penis tissue called the tunica albuginea. When this scar tissue develops within the penis, under the skin surface, it drastically affects how the penis appears when erect and often how it feels in regard to pain.
Some people mistakenly focus only the obvious physical appearance changes that are common with PD. They equate Peyronie’s disease with the penis curvature or hourglass deformity that develops because of the internal scar, but they fail to realize the distortions occur because of the scar they cannot see. As a result they approach treatment as though getting rid of Peyronie’s disease was as simple as getting rid of the bent penis they see, like straightening out a bent paper clip. But, Peyronie’s disease is not a curved penis; the curved penis is merely the end result of the real problem which is the scar tissue found under the skin. The real problem of Peyronies is a tendency to produce an excessive healing response to trauma. Therefore, this discussion of various Peyronies disease treatment exercises will focus on several strategies that are intended to increase the natural ability of the body to eliminate or heal that offending scar material.
We know self-correction or natural healing of the Peyronie’s scar is indeed possible, and happens frequently by medical standards; it happens in about half of the diagnosed cases of PD. Spontaneous healing or natural elimination of Peyronie’s disease is the primary reason that standard medical treatment of early cases includes a waiting period of at least 12-18 months before considering doing surgery. During the standard 12-18 month waiting period it is hoped that the body will be able to simply eliminate the Peyronies scar as it happens in about half of the cases.
These Peyronies disease exercises are presented because each represents a slightly different way to assist the tissue to correct the basic problem of the scar material.
Peyronie’s disease stretching exercises
Gentle manual Peyronie’s disease stretching exercises should not to be confused with the Middle Eastern practice called jelqing. Jelqing is essentially an ancient method of penis enlargement performed by forcefully stretching penis tissue repeatedly, squeezing more blood into the cavernous penis tissue spaces than it can normally hold while also being stretched. Jelqing is sometimes mistakenly recommended as by some who do not understand the real problem of Peyronie’s disease. They think that forcefully stretching and unbending the penis will take care of the problem as though the bend was a simple issue that could be fixed like a bent paper clip. Not only is this ineffective for treating Peyronies disease, jelqing can cause more injury in a penis that has already demonstrated that it is capable of producing too much scar tissue.
As proof of the brutality of jelqing, many cases of Peyronie’s disease start after a man injures himself while using this technique. How anyone could think jelqing is a reasonable way of treating peyronies is a mystery.
The Peyronie’s disease stretching exercises that were developed in a research project of the Peyronie’s Disease Institute in 2006 are greatly different than jelqing because they are extremely gentle. They approach soft tissue stretching from the standpoint of increasing tissue length much in the same way a ballerina attempts to become more flexible by using very light stretches over a prolonged period of time.
Massage and exercise video for Peyronie’s disease treatment
A group of simple treatment exercises for Peyronie’s disease were first applied by Peyronie’s Disease Institute in 2004, and presented in a video. These exercises were selected on the basis of their ability to increase blood flow and increase lymphatic drainage to the pelvis in general and penis in particular. None of these massage and exercise techniques are ever applied directly to the penis, since this could possibly result in additional injury and more internal scar development. Instead these massage and exercise techniques are applied to the area immediately around the genitals to loosen tight and contracted soft tissue while avoiding further injury.
This Peyronie’s disease exercises video presents a series of Kegel exercise instructions increase the blood flow and health of the lower pelvis, deep tissue massage to the deep pelvic soft tissues to increase drainage of the lymphatic tissue which in turn will increase blood flow of the involved area, and lastly a series of instructions to increase energy movement in the area of the penis.
Peyronie’s disease treatment exercises
These various Peyronies disease exercises make sense because they attempt to address the potential underlying problems that could prevent the natural healing of the dense internal scar tissue that is at the heart of this problem. Schemes that merely try to enlarge the penis ignore the need to reduce or eliminate the Peyronie’s scar.
When these Peyronies disease exercises are added to an aggressively applied Alternative Medicine treatment program of diverse vitamins, minerals, herbs and enzymes it is sometimes possible to assist the tissue to remove the Peyronie’s scar. The earlier in the disease state this is started, and the more aggressively it is done, the better the therapy results tend to be.
Dear Dr. Herazy, I would like to know if your method of penis stretching exercises would allow an improvement in my congenital twisted penis. I do not have PD; however, does your method help men with congenital curvatures too?
Actually I need to tell you my story: I underwent surgery to eliminate the congenital curvature, but there are now non-absorbable stitches into my penis and they are hurting me. The surgery was almost nine months ago, in August, 2012, and I think of removing these stitches from me to help the pain. So I have a question: how much time do I need to wait so that I can remove these stitches without losing the correction I have obtained with the surgery?
Well, and there is another thing: my penis was curved left and down before the surgery. After the surgery, I realized that my penis is not pointing to the left, but it still curved down, with a bend near the base of the penis. Thus, I would like to correct the bend downwards that still exists, and finally reach the complete correction of my penis.
I would greatly appreciate if you could answer my important questions.
Yes, the PDI method of gentle penis stretching has helped make safe changes even in some congenital penis curves and bends, but it is not possible for anyone to know ahead of time which will and which will not respond. Even though we initially tested the gentle manual PDI penis stretching method only on men with Peyronies disease, over the last few years I have received back reports of success from men with congenital curvature. The best and safest method is to simply apply the work and use the technique for a month or two to determine how well you will respond.
However, you have had penis surgery, so this changes a lot of things. Too bad you did not ask me these questions before you had your penis surgery. Once you have had tissue removed, and had stitches inserted to hold you into a certain position, there is less that our gentle penis stretching technique can do for you.
Now, since these surgical changes have been made. you really should be asking these questions to the doctor who tried to correct your congenital penis curvature with surgery. This is the person who should have all the answers regarding how your penis will respond in the future.
Hi, I am 18 years old and fear I am suffering from Peyronies Disease. I do not believe I have suffered any physical trauma. My penis is straight for a few centimeters and then bends at about a 50 degree angle when erect. In addition, my erections are not as hard as they used to be and I can lose them fairly quickly. When lying down, my erection is not rock hard, so if I lean by body slightly to the right my penis looks straight, but is obvious when standing up.
I spoke to my GP and he brushed it off and said “its natural to have a bend” and said how the erection part is psychological.
My concern: I took propecia for about a year. Before taking this pill I had a NORMAL penis. No bend, rock hard erections. For 16 years I had no bend and then I developed one, could that be normal or do I have Peyronies disease?
Another concern: when I masturbate frequently, my over-all erections are decently hard. However when I go 2+ weeks without masturbating my erections are bad. For separate reasons I am trying to stop masturbating, but I am extremely concerned that if my erections got worse after 2 weeks, what will happen after a month? Or 3?
I'm really really worried. I can't stop thinking about this. If I could at least have the satisfaction of knowing it probably won't get any worse then I can deal with it. But it seems people are saying it could get worse (as my bend has gotten slightly worse over that past 2 years). If my erections get any weaker ill probably have to look into medication. I'm 18 years old, I cant deal with this, the last thing I want is to go to a urologist and look into medication. I stopped taking propicia 1.5 years ago, and I recall reading that people returned back to “75%” of their pre-finasteride erections after stopping, if thats the case with me I can accept it and try to move on. What do you think?
I hate this.
Greetings young man,
There are many side effects of Propecia (finasteride), among them reduced erection quality and Peyronies disease. For additional information please see Another case of Propecia and Peyronies disease and Will the drug finasteride affect my Peyronies disease in any way? In the absence of trauma, and without known genetic predisposition or family history of this problem, there is strong presumptive evidence that you could have Peyronies disease due to your use of the drug finasteride.
It would seem that the urologist you spoke to did not listen to what you were saying. While it is indeed true many men are born with a curved penis, that is not the situation in your case; you had a straight penis for many years and it became significantly distorted after using Propecia for a year.
It is not normal to have a straight penis and firm erections for 16 years, and then within a year or two for all that to change into a 50 degree bent penis with weak erections. That does not sound like a congenital malformation to me.
I suggest that you reconsider going to a different urologist the next time – one who listens to what you are saying – for an examination to make a diagnosis of your current situation. Armed with this knowledge you will know how to proceed. Right now you are only guessing and supposing, and worrying yourself sick, without knowing for sure what you are dealing with. If it does happen that you have Peyronies disease I suggest that you very soon begin a conservative regimen of care using Alternative Medicine to assist your body to possibly eliminate this problem. For information about this please go to Peyronies disease treatment.
Sometimes the effects of finasteride usage are reversible once the drug is discontinued, and other times they are not. It is my opinion you cannot assume your problems will resolve themselves, partially or completely, by simply no longer taking Propecia. I suggest you actively do all you can to assist your body in its effort to eliminate the Peyronies disease once you know for a fact that is your problem.
Please let me know if I can assist you in any way or answer other questions for you. TRH
Dear Dr. Herazy
I was diagnosed with peyronie's disease 3 weeks ago. I presume this is the acute phase. I was reading a lot about heat treatment as well and I read that you also recommend moist heat before applying external therapies. I also read that heat increases inflammation. I read that one of your clients applies heat when he is watching TV or reading. Is this heat not counter-productive in the acute phase because of the inflammtion.
Greetings again Sam,
Most cases of PD we work with are well beyond the initial acute phase of penis injury, and so applying heat prior to other external therapies is not counter-productive.
I suggest that if you are in the acute stage of injury that you get any acute inflammation down with ice, applied for 20 minutes at a time. When the acute stage subsides in perhaps a week or two, heat would be approprite. TRH
Dear Dr. Herazy
I have had an penis injury and developed Peyronie's disease about 3 weeks ago. The Urologist I saw prescribed Colchicine. I did order the large plan from you. Will you advise to continue using the Colchicine when I start taking the vitamins and enzymes.
Sorry for the delay in getting back to you; so many email questions to answer lately.
Yes, there is no problem in combining the two. I suggest you contact the doctor who prescibed the Colchicine to you for confirmation of this opinion. TRH
Hello Dr. Herazy,
Joe here in Maine. I recently ordered some more supplements through your website and I am currently using the medium plan.
I wanted to know if you knew of any good urologists in New England that I should be aware of. My general practitioner doesn't know very much about Peyronie syndrome and I went to see a urologist here in Portland Maine who really didnt know much about alternative treatments like yours. Not long into my visit with him he was talking about surgery, prosthetics, etc . . . His recommendation was for me to wait 6 months and see if the scar tissue went away or not and then come back for a second visit.
I want to do more to help myself. I began by taking the manufacturer's recommended dosage on each bottle. After 3 weeks I increased the amount of Fibrozym to 3 pills 3 times daily (with food). Soon, I will want to increase my daily intake of my supplements again but I'd like to have professional advice on how to do this. (Which treatment do I increase next, by how much, etc?)
So if you know of any good doctors that support the therapies you do, and are located in my neck of the woods, please let me know. I am only a few hours north of Boston.
I do not know of any urologists in your area I can recommend to you. You will just have to call around and try to find what you are looking for. I suggest you can a urologist office, and ask to speak to “the doctor's nurse.” The doctor's nurse is the doctor's right hand, and sees it all and does it all; a very good person to get to know. Ask the doctor's nurse about the doctors use of alternative medicine, and anything else you would like to know about.
Unfortunately most urologists are very quick on the trigger to suggest and do penile surgery for Peyronie's disease. Watch out for that kind of doctor.
You are making a mistake by taking Fibrozym with food; it is to be taken between meals. All enzyme products are to be taken between meals when using them for Peyronies treatment.
To answer your question about increasing theapies as you progress in your treatment I would need to know what and how many of each of the therapies you are taking. Please call to set up an appointment time and we can discuss this to get you started in the right direction. TRH
Hi Dr.Herazy, I was dignosed with Peyronies disease 3 weeks ago. I have two questions.
1) can Peyronie's disease symptoms appear just 3 weeks after penile trauma
2) can you use everything (including the ultrasound machine) in the large package at such an early stage.
There are always exceptions in each case of Peyronies disease; so many rules get broken along the way that I tend to think there are no rules. One of the great many variables in PD is the amount of time required from onset to the time actual signs and symptoms develop. While some PD cases mature rather rapidly, most do not.
If you penile trauma was three weeks ago, and you have pain, penile distortion or a lump below the shaft surface, more than likely these complaints are not actually related to Peyronie's disease but to the acutal trauma you sustained. Only after some time has passed, and the tissue has had sufficient opportunity to respond to the injury, will the actual soft tissue changes occur that are consistent with the phenomenon known as Peyronie's disease.
Yes, you can use the large plan plus the ultrasound machine to treat the early injury to your penis in an effort to assist healing and recovery without PD ever actually developing in your case. Many men do this to beat the problem even before it starts. I would also suggest frequent applications of ice to the area of injury.
Lastly, you mentioned your penis trauma occurred three weeks ago, and that you were diagnosed three weeks ago, also. By this you make it sound like the same day (or almost the same day) you were injured you were also told by an MD you have Peyronies disease. This is not possible. If you badly injured yourself, and the physical presentation was severe, it is still not possible to call it PD so soon into the game. Time is usually needed for the tissue changes to develop that eventually become Peyronies disease. What the MD might have said, “Joe, that is a really bad injury you have to your penis. I would not be surprised if over time it developed into Peyronies disease.” That would be a lot more sensible and clinically defendable.
Please let me know if you have any other questions. TRH
Can Verapamil topical and Neprinol ingested be used in combination?
Yes, the two can be used together – one as a topical and the other as an internal therapy – but that would still not constitute a very solid or effective treatment plan.
Please review some of the treatment information on the PDI website to get an idea of how to organize a more effective plan of treatment. TRH
I was advised to add Lysine to my plan by a health store owner. In researching on web, in forums and such, I am finding conflicting information as to whether Lysine will be beneficial or make the Peyronies condition worse. I would appreciate your professional advice as to adding Lysine or not.
With great appreciation.
I would not add lysine to treat Peyronie's disease, based on lack of sufficient background information to define how it would be an effective treatment, and the lack of reasonable research documenting it had some degree of success in this regard. TRH
Is Peyronie's disease curable, really, using your natural approach?
We have looked all over the internet for a Peyronie cure, and your site is the only one that seriously discusses the idea of using vitamins and things like that to treat this problem. My husband's doctor mentioned the possibility of surgery to correct his curved penis, but only as a last resort because even though his clinic does this kind of surgery he does not like the way that this kind of surgery often winds up. The thought of penis surgery scares us both to death. After reading some of horror stories about how Xiaflex can destroy any tissue like muscles, nerves and blood vessels that it might accidentally contact we have decided to not use this method. My husband is concerned about using Xiaflex because we have read several different men say that they reported adverse reactions that were never entered into the research results. This sounds to us like the drug tests were controlled so the final outcomes look better than what actually happened to these men. Also, I have read more than once that some medical doctors advise against any injections to treat Peyronie's disease because the injuries created by the injections themselves can cause more scarring. That leaves us with working with your vitamin approach that makes sense to both of us because we have always preferred to work naturally whenever possible.
My husband developed a bent penis just a few months after we got married and now we are desperate to find something that will help him take care of this problem. Any information would be greatly appreciated.
Thanks for the simple and direct question.
Yes, Peyronie's disease is curable, but not in the usual sense. See Medical Peyronie's cure is lacking. Natural healing and spontaneous elimination of Peyronie's disease happens in about half of the cases usually sometime during the first 12-18 months after the problem starts. There is no medical cure for Peyronie's disease at this time.
This is why PDI suggests that men consider looking at ways that might increase their ability to heal this problem naturally. Drugs and outside intervention have not proven effective against the Peyronie's scar. Medical doctors are reluctant to suggest surgery since the side effects and poor outcomes can be so unpredictable and devastating. The PDI method is not intended to heal Peyronie's disease; it only provides nutritional and other natural help to support the immune response so your husband can do a better job of healing this problem.
Ideally your husband's body, through action of the immune system, should correct since that is how the body is supposed to operate to stay healthy and well. When it does not happen then it is our suggestion to try to increase or support that natural healing ability in an attempt to help the immune response work better. Sometimes this works and sometimes it does not. There is no way to know ahead of time if it is possible to stimulate the tissue to heal better with help; it works for some men, and for others it does not. I find that men who are aggressive with a large treatment plan and persistent with it, will get results in about 70-80% of cases; I get 10-12 positive reports of success for each one report of failure using the PDI approach of natural treatment.
So when you ask is Peyronie's disease curable this is the best answer I can give you.
Hello Doctor Herazy, I have been getting a painful erection each night (sometimes a few times a night) for the last few months. What worries me is that the pain is slowly getting worse. The pain when I am erect wakes me up at night and I do not know what to do about it.
I have no idea what started this to act up. I have not injured myself and my penis is not bruised. My erections are as strong as usual, and I have no pain when I urinate or ejaculate. Speaking of ejaculation, I have a very vigorous and active sex life, but sex is getting to be a problem since the pain makes it difficult to keep an erection. Sometimes the painful erection is so severe that I just go limp in the middle of intercourse.
I called my medical doctor and he suggested some tests that sound expensive. Instead of doing that I went to the internet and Googled “painful erection” and found your website. I have learned that pain while erect is a sign of Peyronie's disease, and would like your thoughts about this as a possible explanation for my problem.
Can you please help me understand what is making my erections so terribly painful suddenly? If it keeps up much longer I will have to go see a doctor I suppose.
Greetings T. K.,
There are a few conditions that can explain your current problem of pain while being erect:
- Trauma – you deny any injury
- Priapism – persistent or prolonged erections; can last for hours at a time; not related to night
- Phimosis – constriction of penis by foreskin or prepuce
- Peyronie's disease – a possibility
- Lichen sclerosis – leathery skin condition
- Disease of the penis – chlamydia, genital warts
- Cancer – very rare
You do not mention any other complaints that are going on with you for me to have an indication of what might be going on in your situation. I suspect you can probably eliminate several of these possible causes since you are aware of other aspects of your history.
The most common complaints associated with Peyronie's disease are:
- Nodule or bump under the surface of the shaft caused by a mass of fibrous tissue (like a scar).
- Penile distortion while erect caused by the same mass of fibrous tissue.
- Reduced penis length and diameter cause by fibrous tissue contracting penis.
- Painful erection caused by inflammation of penile tissue, as well as the presence of the fibrous tissue in the deep layers of the penis.
- Reduced erection quality, again caused by the presence of the fibrous tissue that prevents full closure of the penile veins that create the hydraulic pressure of an erection.
Some of these complaints related to Peyronie's disease, like painful erections, are not always seen in a case of Peyronie's disease. The only mandatory finding to confirm a diagnosis is the presence of a mass of fibrous tissue. Many times the loss of penis size does not occur early when Peyronies is present, and many men do not notice the telltale lump of Peyronie's disease. What I am saying is that it is possible to have Peyronie's disease and not be aware of it except for a painful erection.
My suggestion is that you should go to a urologist for an examination to get to the bottom of your complaint.
You might also be interested in reading Nine causes of pain in the penis.
If it should turn out that you do have Peyronie's disease I suggest that you undergo an early round of self-directed natural treatment of Peyronie's disease to determine if you can reduce the internal scars without the need of drugs or surgery. TRH
What I want to know is, is your Peyronie disease natural treatment effective, and how safe is it?
In the past year I have visited many Peyronie's disease forums and discussion groups and read all kinds of opinions. It seems strange to me is that while I read mostly negative comments from the people on the PD forms about the use of vitamin E, acetyl-L-carnitine and other natural supplements, the medical research about these very same treatments is fairly positive. The men who answer questions on these forums about using vitamins and natural treatment ideas say it does not do any good, yet I have read several medical studies saying that the results are good. Who should I believe?
How long have you been doing this work, how safe is it, and what kind of results do you get? How do I know which ones to use to get the most help?
I like what I have read on your site so far about using Peyronie disease natural treatment because it makes sense to me. It makes sense that taking vitamins and minerals and things like that could help the body to heal better. Doing something like that to help my problem to heal better and faster makes more sense than doing nothing while I am supposed to wait for my curved penis to get so bad that I need surgery. That is a crazy way of approaching this problem. Why not try to get rid of a problem with natural therapies rather than letting it get so bad that surgery is necessary?
Thanks for any information or insight you can give to me.
I cured my own problem in 2002 with Peyronie disease natural treatment. I did not have any adverse reaction while I experimented with dosages of different therapies. Since that time I have worked with well over a thousand men who have also reduced or eliminated their Peyronie's scar or plaque using these methods you see on the PDI website. You can read some Peyronie natural treatment testimonials here.
I consult with men on a daily basis about their treatment of Peyronie's disease using natural methods. In that time I have not had anyone complain of an adverse reaction greater than having diarrhea caused by high dosages of systemic enzymes that irritated the bowel lining; all were easily controlled by simply reducing the dosage.
The effectiveness of this treatment is real, but it is difficult for PDI to calculate and provide meaningful statistics for a few reasons:
- Everyone follows a different treatment program. Some men use a small plan, a medium plan, or a large plan. Additionally, 99% modify their starting plan as they search for the correct dosage that causes their PD scar to reduce size, shape, density and surface features.
- Compliance is variable from person to person. Some men are good at following whatever plan they are using, other men are bad at taking pills and doing different parts of their plan.
- No way to monitor physical condition or care, so there is no way I can verify how men are following their plans or their results. Must take each man's word that he is doing what he says he is doing.
- No way to know the exact condition of the Peyronie's scar, or the penile distortion, at the start of care or at the conclusion of care. Must take each man's word about his condition at the start and end of care.
- No one is rejected or excluded from this work. PDI works with men from around world who are not standardized. We work with men of all ages (teenagers to 80+ years, all races, variable duration (just diagnosed to 20 year old PD) and severity of Peyronie's disease, some have had surgery and others have not, any and all possible causes, and many concurrent health problems (anywhere from a 25 year old athletes with no other health problems to a 70 year old alcoholic with liver disease and cancer). Any legitimate study would eliminate many men while looking to so that a standardized group is created. PDI does not do this.
As a result of this wide variation, complete lack of control of our participants and complete inability to verify treatment or treatment results, there is no way to produce meaningful statistics about PDI treatment results. At this time PDI is still working only to develop and improve its treatment ideas. Once we have created what we think is the best Peyronie disease natural treatment procedure we will be ready to test those ideas by using formal research level procedures.
Within these limitations imposed by the way we are working with Peyronie disease natural treatment, the best I can tell you is that about 70-80% of men see positive changes in their Peyronies scars when they use the methods described in the PDI website. This is a remarkable number because – according to current medical thinking – these men are not supposed to respond at all. Yet most see some positive changes, ranging from slightly to complete reduction of the the size, shape, density or quality of the surface features of their Peyronies scars.
Hi, so a couple months i started trying jelqing penis stretching, i squeezed too hard and the next few days i was in pain, it's been a month now and my penis still hurts and i cant maintain a good erection. i damaged the left side the upper shaft under the top of the head. it looks and feels indented and red and also feels like there is a gap or tear in the tissue, maybe the tunica not sure, please help i don't know much about this stuff and i'm scarred i'm currently taking serrapeptase, maca, gingko, astragalus, kanabo nerve fix, icing, heat, with epsom salt, also i think there is some thrombosed veins and some curvature too. i feel so dumb i got carried away and did this to myself while penis stretching. thank you. i want to prevent things from getting worse.
Join the club; you are not alone. It seems I get several emails and calls a week from men who injure themselves while doing penis stretching as part of their jelqing routine. I have warned repeatedly over the years that jelqing is such a potentially dangerous thing to do. Some guys are just not satisfied with what they have. They try to get a bigger penis with jelqing and injure themselves so badly that they actually wind up with a smaller penis that does not work as well.
To get over your immediate injury I suggest that you get on some over-the-counter anti-inflammatory medicine like aspirin, use a lot of ice, do not use heat at all until most of the pain and swelling is gone. The serrapeptase makes sense to me, but I do not know enough about the other things you mention to comment on them. I would suggest you also take a good dose of essential fatty acids since these will act as an anti-inflammatory for you.
If you do not get a lot of relief in a few day, please see a urologist to help you manage your problem. I will bet you are not the first guy this urologist has seen who got hurt by penis stretching.
Please read a few articles from the PDI website that explains how jelqing and strong penis stretching can cause more problems than you care to think about. Please review I think I have Peyronie’s disease from jelqing. What should I do? and Penis stretching for Peyronie's disease.
If it turns out that you develop Peyronie's disease from this jelqing injury please consider getting some help with Alternative Medicine to assist the healing process. TRH
Dear Dr. Herazy: I have seen three urologists, one of them the best in Florida. They all have told me that none of this Peyronies treatment can work. Please explain to me how can you prove them wrong.
I do not have to prove them wrong. In 2002 I eliminated my own Peyronie’s disease using the simple and direct methods you see on the PDI website. I am fine today.
To answer your question in the most direct and simple way, the PDI Peyronies treatment works by trying to improve, support and encourage the natural ability of the body to heal Peyronie's disease. It is not perfect, it does not always work. From my experience it works in about 80% of the cases when done aggressively, correctly and faithfully as outlined in the PDI website. Nothing works all the time. When I talk to men who do not get help using the PDI concept of Peyronies treatment I find that it is because they did not use this method correctly; they altered or cheated the process and reduced its effectiveness.
If you decide to believe your doctors who have never used this approach, then that is your decision. But before you make a final decision you should know more about this different concept of health care.
I suggest to you that you do some thinking on your own. While it is very important to discuss things with your medical doctor, it is also just as important that what you decide is reasonable and sensible to you. Decide if this is a rather simple way to look at this problem of Peyronies treatment sense to you, or not:
1. Does my body have an immune response that heals and cures many health conditions? The answer is generally, yes. If your body is functioning as it should, correcting Peyronie's disease should be a natural thing to do; this is why about 50% of men get rid of PD on their own without any outside or additional help.
2. Is it true that PD is eliminated by about half of the men who come down with this problem in the first 12 months after developing it? The answer is generally, yes, men cure their Peyronie's disease in about half of the cases. You might run into different percentages of those who self-correct, and these are usually lower. However, just as there is controversy about what percent of men have Peyronie's disease, there is even more controversy about how many men self-correct for this problem. No one knows for sure any of these numbers, so these are generally estimates of what someone thinks.
3. If Peyronies disease is cured in about half of the cases within the first 12 months after developing it, does this or does this not mean that there is a natural cure for PD? The answer is that it does. When a problem is eliminated
4. If PD is cured in about half of the cases within the first 12 months after developing it, what is wrong with my immune system that I did not correct my PD like those 50% of men whose PD just goes away on its own? The answer is too complex for anyone to answer at this time, so we flood the body with as much natural vitamins, minerals, herbs, enzymes and other therapies to help the body do a better job to heal and correct the original problem.
5. If the body can heal PD 50% of the time, is there something that I can do to improve, support or encourage my own body to do a better job of correcting or eliminating my PD like the other half of men who do it without any outside help? The answer is that about 70-80% of men see positive changes in their Peyronies scars when they use the methods as outlined in the PDI website.
Medical doctors, when they develop Peyronies disease, face a real dilemma because they know the limitations and dangers of medical care. Many eventually come to the PDI website and use this method. I am helping 2-3 MDs right now correct their PD problem. Medical doctors are aware of the limitations of what they offer the average Peyronies treatment patient; they are aware of the risk of creating additional injury when any drug is injected into the tunica albuginea of the shaft; they are aware of the potential danger of the new collagenase drug, Xiaflex; they know and have seen the horrors of Peyronies penis surgery when it goes bad. This is why they hesitate to use for themselves what they prescribe for others.
It is a tough thing when people tell you different things. You must make up your own mind about your Peyronies treatment. Does it make sense to first try to help your PD to heal better by using the natural PDI approach, and then later if that fails to try a more radical and risky treatment? Or does it make sense to first risk getting more scar tissue from your surgical Peyronies treatment when you have already demonstrated that you make too much scar tissue. In doing this Alternative Medicine work treating PD since 2002 I have seen no evidence of side effects or complications from using this conservative methods. In that same time I have communicated with literally many hundreds of men who have had bad reactions to drugs and surgery to treat Peyronie's disease.
You must consult with your doctor about your Peyronies treatment, ask good questions, listen carefully to the answer you are given, and then make up your own mind about your eventual care.
Let me know if I can help you in any way. TRH
I have a question about using a penis extender to reduce my curved penis.
I have had some moles removed from the top of my penis some time ago. I have a scar from my pubic bone that runs about 2-3 inches toward the head. Recently I have noticed when I have a partial erection my penis is curved upwards. I do not feel anything along the top that would feel like plaque or a bump or anything that shouldn't be there.
Could the scar be causing my curved penis condition? Do you think that a tension device like a penis extender would help my situation?
Guessing simply because you have an Anglo-Saxon last name, there is a possibility you could be genetically predisposed to Peyronie's disease. Your brief description is consistent with Peyronie's disease. The surgery you describe could have resulted in excess scar formation at the site on the top portion of the shaft where you were cut, causing an upward bend. Many men find that even Peyronie's surgery which is intended to reduce penis curvature will heal with increased scar formation and make their Peyronies worse.
The fact that you, as a layperson, cannot detect a noticeable scar or fibrous mass would not be unusual; many men cannot locate a Peyronie's scar when it is rather obvious to someone trained in this area.
You ask about a penis extender or mechanical traction device being used in your situation. You obviously have not read too much of the PDI website. Many men develop Peyronie's disease after being injured by such mechanical penis stretcher devices. For information about this, please refer to What do you think of a mechanical penis extender for treatment of Peyronie’s disease? and My Peyronie’s disease started after I tried to straighten my curved penis with a penis stretcher, should I use another one? and Penis stretcher: Big problem as Peyronie's treatment
I suggest you get a formal diagnosis of your problem so you know exactly what you are dealing with.
In my opinion, if it turns out you do have Peyronie's disease it would be good for you to attempts to try a brief therapeutic trial of Alternative Medicine treatment to see if you can stimulate a natural healing or recovery as it happens in about 50% of men who develop PD when the problem clears up on its own.
If you have additional questions please let me know. TRH
I have read that ultrasound using hydrocortisone as the conductor is an effective Peyronies treatment. Are you familiar with this protocol?
I saw my local urologist today who basically gave me little hope via conventional methods, and told me to continue my own self-administered regimen of supplements, topical solutions, and traction.
Ultrasound seems promising. Do full instructions come with the ultrasound device and what conductor do you recommend–DMSO?
I have DMSO but would also like to try hydrocortisone if you think that would work.
With thanks in advance,
Yes, I am familiar with the protocol of using ultrasound to drive in a drug; this technique is called phonophoresis. The problem you face doing ultrasound with the hydrocortisone cream you have is that it is likely not a good sound conductor; you cannot use just any kind of cream or contact medium for ultrasound and expect it to work. This is the beauty of using the PMD DMSO gel or the Dusa-Sal DMSO gel that is available from PDI with your ultrasound machine; they both are excellent conductors of ultrasound energy.
With the PMD DMSO gel or the Dusa-Sal DMSO gel products, it is not the DMSO that is the sound conductor but it is the gel component of the product that conducts the sound. It has enough water in it to make it an excellent sound carrier.
I think it would be an interesting experiment to try your cortisone cream to treat your Peyronie's disease. I can see nothing wrong with it, but I suggest you talk to your doctor first about it for confirmation. Here is how I would do it:
1. Get the ultrasound machine ready.
2. Apply a moderate layer of cortisone cream on the shaft over the known area of the Peyronie's scar.
3. Apply a generous layer of either PMD DMSO gel or Dusa-Sal Gel over the cortisone cream.
4. Turn on the machine and treat as instructed in the information you will receive with the machine from PDI. We have an excellent 3MHz ultrasound machine available through the PDI store that comes with full instructions how to use it specifically for the problem of Peyronie's disease.
Please keep in mind that this methodology should only be used as one of many different therapies against your Peyronie's disease, and not as a stand-alone or solo therapy. Never attempt to get rid of PD using only one therapy, or you are sure to be disappointed.
Please let me know the results of your idea when a little time has passed. TRH
Dear Dr. Herazy,
Since November 2012 I know that I suffer from Peyronies Disease. In the first weeks after I got the diagnostic finding, it was not such a big problem for me. But now i get more and more fear. Because I am afraid, that I could lose my whole ability to erection and I have suicidal thoughts. Sex has such a big quality of life for me.
Since now, I have no zigzag of my penis, because it seems that the plaque is around the penis, short behind the glans. In former times my penis was 19-20 cm, and now I have still 14,5. This is not such a big problem for me until now, but I want to keep these 14,5 cm. I can also observe, that my ability to have an orgasm is lower. I have informed myself on German websites, but all these information are confusing and sometimes are contradictory. The German Urologic Center in Darmstadt says, if you don´t get an operation, the Peyronies Disease will progress and progress due to the fact that with every erection at the edge of the plaque, there will occur new cracks which will lead to new scars. The inevitable end is the impotence. I am so desperate about this point.
In the past I had problems with erectile dysfunction and my libido. Other disorders were bad sleep, oscillation of my mood and so on. My testosterone value was very low. But nobody wanted to substitute my testosterone. On a German website I read, that its significantly that Peyronies disease correlates with a low value of testosterone and erectile dysfunction. In any case, the mainstream on German websites is, that medical treatment will affect the disease only marginal. And now I read your article about vitamin E. My question is, can I, in my role as a patient do anything with medical treatment which has chances of success to improve the disease a little bit. Please help me, I am so desperate, please, please help me. I feel so alone.
Your fear is built on your feeling of helplessness that nothing can be done to help your condition; many men with Peyronie's disease share your thoughts and feelings of desperation.
I have a feeling that you did not spend much time reading and learning from the PDI website about self-treatment of Peyronie's disease before you wrote your question to me. If you had spent a little time reading a few of the more than one thousand different pages of information on the PDI website you would know there is much you can do to try to support the natural healing ability of Peyronie's disease. I suggest that you read the PDI home page and a few of the links that are found there. From the standpoint of Alternative Medicine treatment all your effort must be directed toward increasing your natural ability to heal Peyronie's disease, as it happens in about half of the men who develop this problem.
You mention my article about vitamin E treatment of Peyronie's disease. You must realize that by itself no one vitamin or natural therapy is going to be effective against a problem as difficult as PD. Success requires a wide variety of different approaches used aggressively, and used at the same time, to help your body recover from Peyronie's disease – even then no results are guaranteed.
I think you have misunderstood what the website of the German Urologic Center in Darmstadt might have said about the progression of Peyronie's disease. Peyronie's disease does not progress indefinitely; many times the condition stops progression after a year or two, and then remains essentially stable unless it is aggravated by injury or drug intake. Surgery is offered in cases of Peyronie's disease, at least by all reputable medical clinics, only if extreme pain or extreme penile curvature makes sexual intercourse impossible. I have never heard of Peyronies surgery offered as a way to halt the progression of the disease.
Your low testosterone and distressed emotions are both capable of reducing your ability to develop an erection. There are many websites that discuss how a many can increase his testosterone naturally; if this does not work for you, you are always able to get a prescription to help you.
You are not alone. Read the stories of the many men who have overcome their Peyronie's problem. Go to the Peyronie's Disease Institute testimonial page. Also, there are many helpful pages to get ideas about PD treatment. To mention just a few posts: Does this Peyronie’s treatment really work? and Does anyone know the best treatment for Peyronie’s disease? and What type of Peyronie’s treatment should my husband try? Read and learn how you can work to increase your ability to repair and remove the PD scar. Please let me know if you have further questions about helping yourself. TRH
My husband just got diagnosed with Peyronie's Disease. He has no pain, we have a healthy sex life and have
found other ways to deal with the curve, but he would like to reduce the curve and stop the plaque in it's
tracks. He does take other supplements. I have ordered the Medium Plan, should we stop all of his other
supplements while he is taking your plan. And have there been any side effects with you supplements.
He takes Lipitor for cholesterol, will this effect anything. Please let us know. We are anxious to begin and
want to know if he gets results, how long do we stay on the plan, after the plaque is reduced.
I will await your reply.
Thank you so much
It is good for a man to have a dedicated and loving woman to support him during this difficult time when he is treating himself for reduction of the Peyronie's scar or plaque. You really should spend a little time reading some of the questions and answers in this area of the PDI site to learn how to go about treatment. The more you know the better his results will become.
If he wishes to take the other supplements while he is following his PD treatment plan, I see no reason to discontinue using them.
The only side effect is occasional diarrhea that affects a small percent of men due to the detoxification effects of the systemic enzymes. You have already received instructions how to handle this small problem if it arises.
Lipitor is a member of the statin group of drugs that have been implicated in causing Peyronie's disease. The official verdict has not been reached as of this time, but there is growing evidence that all of the statin drugs have the potential to start Peyronie's disease. To learn more about this, please read My husband has a curved penis, is this normal? I suggest that you read about his subject to educate yourself, as well as discuss this with the doctor who prescribed Lipitor for your husband. You might want to discuss the possibility of getting off him Lipitor while you attempt to control his cholesterol in more conservative ways so as to avoid aggravating his Peyronie's disease.
I usually suggest that once the plaque or scar is gone to stay on the plan for at least six months to assure no return of the scar material. TRH
What is the maximum “safe” daily dosage of Vitamin E (for example, Unique E) in IU that is recommended for treatment of Peyronie's disease. I have read that daily doses in excess of 1500 IU of d-alpha tocopherol can be potentially toxic. I am planning on taking Vitamin E, with Nattokinase 200mg 2x/day, and PABA 1000mg 3x/day. Any comments on this regimen are appreciated.
Please search this website for many articles I have written about safety of taking vitamin E within a Peyronie's disease treatment plan. For example: Peyronie's disease treatment and vitamin E and Peyronie's disease vitamin E therapy.
To answer your question directly, I usually recommend that a man takes 800-1200IU of Unique E daily in a Peyronies plan.
Concerning the brief plan that you have outlined, above, I suggest that you consider adding some external therapies to this plan (DMSO with related copper peptides and vitamin E as topical applications, gentle manual penis stretching, ultrasound, etc.). Your plan as you describe it is not fully developed. I suggest that you look at the small, medium or large PDI plans to get an idea of what a well rounded plan looks like.
I think that I got some positive results from taking Neprinol. I will continue to take at least six pills/day.
My question is for the ultrasound machine that you have. I was wondering if this could help with some of the ED possibly.
Taking any therapy by itself as a solo treatment is not a very effective protocol; usually Neprinol must be combined with other therapies for maximum effectiveness.
Having some degree of erectile dysfunction (ED) with Peyronie's disease is not uncommon. It is due to the presence of the Peyronies scar preventing full closure of the veins that trap blood to create increased hydraulic pressure needed for an erection to occur. The answer for this kind of ED is to reduce the size of the PD scar material, or get rid of it altogether, so the veins can close again as they did before you developed Peyronies.
Here is some additional information about this subject: Should I use Neprinol as part of my Peyronie’s disease treatment?
The ultrasound machine is proving to be a good therapy to add to a basic PDI style treatment plan, based on the reports I am getting back from men who are using it in combination with broad therapy plans.
I was diagnosed by Dr. Levine about 7 years ago with Peyronies disease when I was 51 years old. When I told him I did not want to be cut on he politely told me he could not do anything more for me. I have read way too many horror stories about Peyronie surgery. Like I think I read on your website it does not make sense to operate on something that has already shown it is going to heal with an abnormal amount of scar tissue.
What I want to know is what can we do for our sex life after Peyronies has left me this way? My wife and me have had to be very careful about our sex life because my upward curve is close to 90 degrees, so there is a lot we can't do any more. We have learned to be satisfied with limited contact because my bent penis prevents complete entry. I am a lucky guy to have a wife who has stayed with me in spite of all this.
Thanks for all that you do.
What I have written many times on the PDI website is that a man should be extremely careful and reluctant to undergo Peyronies surgery because of the increased risk of developing even more scar tissue and a worse case of Peyronie's disease after being cut on. I have warned that before agreeing to undergo penis surgery it is very prudent to first use all of the possible non-surgical and non-drug options possible for at least a year before even thinking about being cut on to remove the PD scar tissue. I am not against Peyronies surgery; I am against hasty and premature surgery as though it is the only option, and as though it is a simple and sure-fire cure for this terrible problem. It is not.
You ask for advice about your limited sex life, but I must back you up a bit and suggest that you might not have a limited sex life if your curve was improved or reduced. This is a good place to start to help your sex life, by working to improve your Peyronie's disease. It sounds like you have not tried to increase or support your ability to get rid of your PD on your own. I suggest that you read How to start Peyronies treatment.
The subject of sexual problems when Peyronies is in the bedroom is huge, and the subject of possible solutions is complicated. There is so much to be said about improving sexual performance and compatibility in spite of a curved penis that must refer you to the book, “Peyronie's Disease and Sex.” I wrote this book a few years back to address this problem that affects most couples who deal with Peyronies; few couples are exempt; sex problems are common and just a matter of degree. What I can tell you since writing this book is that almost all people who read it and follow the ideas in it will improve their sexual ability and regain either a small or large degree of their lost sexual pleasure. As an outside observer in this area I can tell you that I have yet to find a couple whose sex life is not helped by using this book; some to a great degree and some to a small degree but everyone seems to gain something. TRH
Dr Herazy, I appreciate the work with Peyronies disease you have done and are doing. I have read your newsletters with great interest over the past year or so. I would love to get your opinion when you have time.
I have Peyronie's disease or what has been diagnosed as Peyronies disease due to the upward curve. However, mine appeared rather spontaneously. I had no injury. I have no pain. The curve does not seem to be changing (for the better or worse).
I read somewhere on the internet there appears to be a link between Propecia & Peyronies. I suspect mine might be similarly related as I took Propecia daily from '97? (or whenever it was approved as a “hair loss” preventive measure) until 2012 when I read of the possible connection.
Have you heard of this? If so, would Peyronie's treatment be the same?
I can feel a mass about the size of a dime—it feels like it does not go very deep—I mentally picture something as thick as a nickle although that may not be correct.
Things I've done:
Called my Doc May/June 2011 (as soon as I noticed)—referred me to a urologist
Saw the urologist—referred me to a specialist in VA Beach
Saw the Peyronies specialist in Nov 2011—prescribed Potaba, Vitamin E, L-Carnitine, & Cialis
Still taking all but the Potaba
May/June 2012 –Saw a specialist @ Johns Hopkins—-had not heard of any connection between Propecia & Peyronie's disease — said to come back whenever it reached the point of preventing intercourse & they would be glad to do surgery
August 2012–Saw a Peyronies specialist @ Mayo (liked him much more)—he said there wasn't much that could be done differently than I was doing except maybe try a vacuum pump—-I've tried but w/ no success
Any suggestions for what I can do to help my Peyronie's disease would be appreciated.
The Peyronie's disease specialist who was unaware of a connection between Propecia and Peyronies is either sadly unaware if what is going on in the world, or just did not want to spend the time to talk to you about the mounting evidence against Propecia in regard to Peyronie's disease and several other health problems. For information that might be of interest to you please read Another case of Propecia and Peyronie’s disease. In the absence of known trauma and known genetic predisposition, Propecia (finasteride) causation is an interesting possibility to consider.
If you do indeed have a case of Peyronies disease caused by Propecia the natural treatment would be essentially the same as for cases caused by trauma or other chemical causation.
I suggest that you consider trying to increase your natural ability to heal and correct the damage done to you that resulted in a Peyronies scar. From my experience the more aggressive and consistent the treatment, when guided by the response of the scar structure to your therapy plan, the more likely you will help your body to heal. A good place to start reading is How to start Peyronie's disease treatment. TRH
Hello, I developed curvature a few months after back surgery. Prior to the back surgery I had no urological problems. The night of my back surgery, I could not void and had to be catheterized. The nurse made several attempts with a disposable “cath” then opted for a foley. It took a couple of tries to get in but she was finally successful.
My question is if it is possible I was injured during my back surgery by improper positioning or is it more likely that the multiple attempts to “cath” me was the culprit or neither of these and Peyronie's disease was inevitable.
Of course, as the saying goes, “anything is possible.” You might have been made to lie face down in a strange position with your body weight resting squarely on your bent penis for a long time, resulting in tissue damage that developed into Peyronies. Could be, I suppose – but I rather doubt it.
It is also possible that you are genetically predisposed, and it was simply your time to develop Peyronie's disease without any obvious provocation at all. Perhaps you are taking a statin drug, a beta blocker or Propecia, and your current problem with a curved penis is just a drug reaction.
Given the story that you relate about the nurse struggling to insert the catheter up your urethra, based on the information you have related, in my opinion it is far more likely and reasonable that during your repeated catheterization attempts is when your actual injury took place that lead to your Peyronie's problem. For more information see Possible Peyronie's disease cause – Catheter and cystoscope trauma. In my work with the Peyronie's Disease Institute I speak and write to many men with some frequency who report the same kind of story with the same end result.
I suppose you could think back to the time when all of this was going on to remember if there were clues when the nurse was having a difficult time for clues to help you decide how it happened: if the nurse seemed to be rushing, if the nurse said something about pushing hard or jamming the tube up your urethra, or if it is now apparent somehow that direct force was being used. Anything like that would give support to the idea your urethra, corpora cavernosa and tunica albuginea were injured while all of these repeated attempts were being made.
Regardless of how it happened, the real pressing question is what are you going to do about the fact that you have Peyronies now? Many men have used the ideas and suggestions found on this PDI website to increase their natural ability to recover from Peyronie's disease. To learn more about how you might be able to eventually increase your ability to heal this problem, please go to recovery over Peyronie's disease.
If I can help you in any way, please let me know. TRH
I continued jelqing for months even though my penile curvature was getting worse and now I might have Peyronie's disease
Dr. Herazy, Firstly, I would like to thank you and this community for even being here to help those who suffer with penile curvature. Finding information online regarding Peyronie's disease has been very tricky and even an anxious affair due to the condition's unnecessarily embarrassing nature. Anyway, a little background: I am a 23-year-old male who has had a healthy sex life for the last seven years. While dating my previous girlfriend, we had some bouts with sexual difficulty, mostly on her end due to numerous urinary tract infections and her mental condition; she has been on anti-anxiety and antidepressants for some years now. This made her very self-conscious during sex and, admittedly, other factors like privacy created tension. I have never experienced this before and thought something was wrong with me, and for some stupid reason, I wondered if my penis was somehow inadequate. So, I looked into enhancement options and discovered the murky world of jelqing and stretching.
I followed the exercise regiment very closely, with my workouts beginning in February of 2012 and ending at the end of October of 2012. I made sure to warm up every time with a hot wrap and never pushed myself too far, or so I thought. I discovered that my penis grew in length and girth, going from about 5.5 inches erect to 6.5 inches; flaccid, my penis has always been about one inch, no joke. Now, it is usually two but often three inches in length when totally flaccid. My ex at the time noticed it and was shocked I managed to change the size and shape of my penis. I was taking L-Arginine, L-Lysine, and Zinc on my workout days, including Pygeum Africanum, Lecithin, Flaxseed Oil, Fish Oil, Super B Complex, and a solid Multivitamin. But during the last week of October, after we had broken up, I think I went too hard and stretched too far, feeling an uneasy sensation in my penis. It's important to note that I had noticed the progression of a curve for months preceding this but with no pain. It is also important to note that I have always had a slight curve to the left, as several photos taken years ago prove.
Anyway, after this weird feeling from stretching, I finished my workout and decided to take some days off. But the pain got worse and I noticed a small bruise/discoloration and what appeared to be a reddish stretch mark running about two inches on my penis. So, I scheduled an appointment to see a urologist. I saw him and he said I essentially “sprained” something or caused a microtear near the glans of my penis. He told me to abstain from sexual activity for six to eight weeks. He didn't feel any plaque and said that he couldn't diagnosis Peyronie's because there wasn't significant curvature or plaque. While I didn't exactly abstain as much as I should have, I did mostly stop masturbating for weeks on end.
The pain is now completely gone but the discoloration and stretch mark (maybe inflamed vein) are still there, though they seem to have faded a bit. I am now living in Chicago and have scheduled an appointment with Dr. Levine for March 1st. I need some kind of closure on this; I need to know if I have to start treatment or maybe I just have a congenital curvature. The curve hasn't increased since my injury and, as stated above, I noticed the enhanced penile curvature while flaccid months before my injury. While erect, there's not much of a difference between the way my penis looks now and a few years ago when I was sixteen. The only difference is the discoloration/bruise, stretch mark/inflamed vein, and a bigger, more curved flaccid penis.
I am currently taking a Multivitamin, L-Arginine, CoQ-10, Acetyl L-Carnitine, and Vitamin E. I also was using Bio-Oil and Cocoa Butter, but have cut back significantly; I liked how smooth it made my unit feel. I have continued sexual activity with no pain and no loss of erectile function. Based on what you all know and what I have told you, can you point me in the right direction? Can you give me advice? My current girlfriend and ex have been very supportive through all of this, including my brother, best friend, and mother. I just want some kind of pointers and opinions; it can be quite suffocating with everyone telling you “you're going to be fine” or “you're overreacting.” This is a serious condition and I am not sure where to turn. Dr. Levine has me scheduled for an ultrasound the morning of our appointment so he can check it out before meeting with me. I seriously hope there is no scar tissue or, if there is, it is something I can deal with. I have grown fond of my curved flaccid penis and don't mind it; life is too short to dwell and panic about these things as long as I can have a functional sex life. Please. And thanks in advance for reading my story and any opinions. It means a lot!
Thank you for your detailed report and insightful commentary concerning your experience with jelqing and penis stretching.
In many posts I have written about the dangers of forced penis stretching: for example please see I think I have Peyronie’s disease from jelqing. What should I do? Too many men take a cavalier attitude about remodeling their penis to Adonis proportions. The websites that sell the books and tapes attempt to support the idea that all problems of low self-esteem and difficulty with female relationships will simply disappear with a sausage-like member tucked in below the belt. Life is perfect for men who have an unusually large penis. They do not discuss the many problems and tragedies that occur with these strategies of forced stretching. The jelqing websites try to create the idea that the penis can be squeezed and molded like a slab of clay can be tugged and strangled into an exaggerated size to please a lady or gratify a weak ego. When penis tissue is taken forcefully and repeatedly beyond a certain point of limitation it will suddenly fail.
At this point you can only be certain that you have a bruise or micro-tear of the external tissue of the shaft. You might be one of the luckiest guys in the world to only have a superficial injury, and not a deeper problem in the shaft at the level of the tunica albuginea; if it turns out that you have injured the tunica you are perhaps a step closer to having a case of Peyronie's disease. Even so, with injury to the tunica and an early case of Peyronies to deal with, about half of these cases repair or reverse on their own without outside intervention – spontaneous recovery is the medical term for self healing. This is mentioned so that you can appreciate the gravity of what you have done and the position you are in at the moment.
When you wrote that you “… never pushed myself too far, or so I thought,” you made a critical point about jelqing that gets to the heart of the craziness about this brutal practice. Did you ever watch a movie in which the bomb squad is called for help to defuse or take apart a complicated explosive device? The tension and drama of those scenes where the bomb wires are being cut is based on the person never knowing if he is cutting the correct wire or in the correct sequence until it is too late. The trick of taking apart the bomb is that you can be doing it correctly when everything is going well, until the moment you make a mistake and the bomb and you blow up. Jelqing is not much different. You can think you are doing it correctly and safely, until you make a mistake and injure your penis to cause a problem like Peyronie's disease. Who knows how far to go until after you have gone too far? Who knows how hard to squeeze and stretch, until after you have squeezed and stretched too much? Everything can go well until after everything does badly, when the whole jelqing idea blows up in your face.
Based upon what you have written, I suspect that you have injured yourself enough to have caused Peyronie's disease. I am lead to this conclusion by your statement, “… I had noticed the progression of a curve for months preceding this but with no pain. “ By this you say that for months your penis was becoming curved and yet you continued to jelq for months. Since I have not examined you I can only speculate, although you will learn in time if I am correct or not. I further suspect that you do not have at this time a curved penis when erect only because your condition is still too early and you are in the stage where the plaque has not yet formed the telltale Peyronie's scar that is far more capable of causing penile curvature. Further based upon what you have written, “While I didn't exactly abstain as much as I should have, I did mostly stop masturbating for weeks on end, ” even when the doctor told you to abstain from sexual activity you did not. Not only did you not stop having intercourse, you only reduced masturbating. You need to read a bit about the subject of hedonism.
If you do not develop Peyronie's disease as a result of your immaturity and lack of self-respect, and I hope you do not, it will be a miracle. Please try to use this experience as a way to learn something not only to learn about the dangers of jelqing and Peyronie's disease, but more so to learn about yourself and what aspects of your personality are in need of growth and maturity.
If it does turn out that you have an incipient case of Peyronie's disease, please consider that there is much you can do to assist your body to heal and repair the problem. If half of the men who develop Peyronie's disease eventually heal it on their own without assistance and their penile curvature goes away on its own, there is the possibility you can assist your recovery over Peyronie's disease by using information found on the PDI website.
Good luck to you, sir.
I developed Peyronie's disease about 10 years ago. I guess there wasn't much treatment then because my doctor put me on vitamin E for a couple months ,but it didn't help. I had almost a 90 degree bend to the left and had torn tissue on the left side. He did surgery to correct it and he did a penis implant. As a result I lost about 50 to 60 percent of size. Now after about a year and a half to two years my implant no longer works, but I am still able to get a erection but have a problem keeping it for very long!! Now at best I can only get maybe half an erection, but can't keep it very long!! Is there any hope for me now and can anything be done to improve size now after all theses years. Will I be able to ever get a hard on again and keep it?
Any doctor who performs a penis implant surgery is supposed to completely and in great detail explain what he is going to do and tell you exactly what is going to happen as result of surgery: what you can expect in the near and distant future, your risks and rewards, as well well as your odds for partial and complete success, the pros and cons of that kind of surgery, and if the changes are permanent or reversible, and what it might take to reverse the surgery – all before actually doing the implant surgery. This is called informed consent; it means the surgeon must inform you of you everything you need to know in order to be able to make an intelligent decision about whether you want the surgery or not. I hope this was done for you.
I suggest that you contact that doctor who did your penile implant and tell him the problems you are having. Ask him those same questions you have asked me, and do not let him push you out of the office until you have a clear answer you can understand. Bring someone with you who you trust for this discussion. Tell the doctor that you want that person in the room to help you process the information he will give to you. Do not go into the room without that person with you because you need to have someone there to catch ideas and information you might miss. You have a right to this person being there so do not let anyone tell you that it cannot be done.
No matter what kind of answers or promises you get from this first surgeon who did the actual operation, then please, please, get a second opinion from another surgeon before you actually let anyone cut on you again.
You might want to read, Should my husband have a penile implant?
If you need further help, please let me know. TRH
Hi Dr. Herazy, After talking to you on 6/3/11, I started treatment on April 15, 2011 with the medium treatment plan, I read your handbook and have done the external treatments with heat included 3 times a day ( I have followed the plan and all your methods faithfully including the diet plan and no cold drinks etc.(boy is that tough especially when it is triple digits are here in Casa Grande AZ and will be for the next 3 months. I have dotted all the i's and crossed all the t's but with little signs of progress, I'm trying not to get depressed since I only started on April 15th of 2011, Spend most of the day doing the program including Nel Gung and Kegel exercise. I do not do the message part
since I was not included in the medium package. Not sure if that part would be beneficial at this time. What would you suggest I do next to kick it up a notch. I already ordered another month of the medium package but maybe I should add Acety-l-carnitine or perhaps Neprinol to help expedite the process. I finally got the ability to have sex after changing diets two plus weeks later. I have no pain but everything is still status quo from the start as for the symptons go. Curviture is still there and hasn't lessened any. I have only one scar and had it about 10 months prior to starting the PDI program. FYI I also have dupuytrens tissue mass build up in my right hand and I am treating that with DusaSal.
There are several things that confuse me about your email, especially the dates. Would you please contact me by a direct email to me at email@example.com so I can understand what it is that you are saying. I want to help you as much as possible, but I first need to get these dates clear in my mind. After that I will be able to study your usage pattern to get an idea of how you are using your plan. Contact me soon, please. TRH
I have been diagnosed with Peyronies disease. It came on very quickly.
I work as a consultant. I am 62 years old. Until recently I enjoyed a very energetic sex life. I began to notice around May of last year pain when I acquired an erection. My penis remained straight despite the pain. I was able to ejaculate and erection was not a problem.
I was on a job. My wife visited me mid October last year. Then she went home. I had two more weeks until the job ended. I decided to wait until I returned to California and give my penis a chance to heal. During first sex after two week layoff my penis was bent to the left. I was stunned. I can feel the hard areas along the left side of my penis. My urologist suggested vacuum therapy.
I bought a device with a large tube that still permits my penis to bend. I am an engineer. To me this is just teaching my penis to continue bending. Now I learn there is multi-tube device and suggested therapy.
Where is this mythical multi-tube device ?
Greetings John K,
I do not endorse the idea if using a vacuum erection device (VED). You can read this information in Peyronie's disease treatment with vacuum pump (VED).
Over the years I have encountered too many men who had negative experiences after using the VED, either causing injury that resulted in Peyronie's disease or they noted that the device simply made the penis larger than usual for a few minutes but did not help the actual problem of PD. The fundamental issue of Peyronie's disease is not the penile curvature weak or erections of Peyronie's disease that get your attention. The real problem of PD that causes all the other nasty problems that you are experiencing is due to the existence of the Peyronie's scar inside the shaft of the penis. Using a VED will not get rid of the Peyronie's scar; it will only stretch the tissue temporarily.
As an engineer I am sure you are familiar with the concept of trying to apply traction to a material that has rigid and less rigid areas; the traction force will be absorbed by the less rigid areas and will not allow the more rigid area to be stretched by the traction force. This is the fallacy of the VED concept to treat Peyronie's disease, as well as the mechanical penis stretcher or extender devices. This idea was discussed in some depth in a post I wrote called My Peyronie’s disease started after I tried to straighten my curved penis with a penis stretcher, should I use another one? I would appreciate a comment or two from you concerning the engineering and physics principles that are discussed in this post.
As far as where you can get a double-walled VED device, I can only suggest that you speak to a urologist who advocates the VED idea. The problem with the double-walled VED is that while it does not allow for the lateral bending of the distorted PD penis (which is good), it also does not allow for the expansion or stretching of the tissue (which is not good on one hand since this is supposed to be how this device is purported to help PD, but is good because it is less likely to injure the penis while it is being used).
Overall, it is my opinion the VED is not an effective therapy for Peyronie's disease. Note, that it is not only my idea that the VED is not a great Peyronie's therapy; many urologists are against their use for the same reasons I cite. Having said that, you will note that makers of the VED and those MDs who advocate the penis pump product for PD will point to a few positive published research reports for the VED. My answer to those positive VED research reports is the same concerning the thousands of positive research reports for hundreds of new drugs that come out annually. These hundreds of new drugs, because of the positive research behind them, receive FDA approval each year . And each year hundreds of them are taken off the market in a year or two after they are proven worthless or injure hundreds of people in the short time they are used. TRH
I've had a mild curvature to the side, enough for me to be pretty self-conscious but not enough to interfere with intercourse, for about ten years. Extremely rarely does it cause mild pain.
I'm 30, in good health, I haven't used ED drugs, and I haven't tried PD treatment before. What plan do you recommend for someone like me who has had Peyronies for almost 10 years?
Also: Do the plans include instructions for maintenance therapy once the scar has faded?
The problem with a Peyronie's disease situation like yours is one of instability and vulnerability to re-injury. I see it happen often: A man with a nuisance kind of problem he can live with will suddenly have an accident during sexual activity and make his PD worse. With even a minor curve the penis is more likely to suddenly bend while thrusting than a straight shaft. A curved penis , even when mild, is an accident waiting to happen; the problem is that you have no way to know when that accident might happen and how bad it can be. In my opinion the reason for you to do something about your PD is based more on prevention of this kind of problem, rather than being self-conscious.
Please go to Suggestions to help you decide how to start Peyronie's treatment. You will see a lot of help there for yourself and it will put things into perspective for you as you decide how you wish to proceed. Based on the protocol outlined in the chart I think the age of your condition supersedes the fact your problem presents with only a mild curve at this time.For this reason it would seem appropriate that you begin using a large level treatment plan for Peyronie's disease.
Complete instructions are included for the use of all therapies that are ordered. Some men follow a maintenance program and some do not; usually the maintenance program consists simply of a low dose of systemic enzymes.
Please let me know if I can help you in any way. TRH
I began using your small treatment plan about 4 weeks ago with what I feel have been very good results. My upward curvature was most extreme at the end of the penis, but still not very extreme based on what I've read on your site. When I first noticed the problem, the pain was terrible during intercourse but has gotten much less over the course of treatment. I want to thank you for your website as it gave me hope without a sense of over confidence about getting healed. I read both booklets and with some adjustments sex is back to being very, very good although there is still some dull pain.
My question is about locating the scar. While I can definitely tell where painful areas are when erect, it's difficult for me to locate exactly where the scar is when applying PMD. Do you have any suggestions on what it should feel like or will there be any noticeable areas on the skin? The only thing I can tell is that a good portion of the penis from head to about 3/4 of the way to the base is somewhat harder in the center (like along the urethra.)
Thank you again for your work, and any advice is appreciated.
Most men with Peyronie's disease need help to locate the Peyronies scar.
The painful areas you feel when erect might not exactly correlate to the location of the actual Peyronie's fibrous scar tissue. You do not want to be treating painful areas; you want to be treating where the scars are located and this will in turn reduce your pain and assist in your overall recovery.
It is a rarity to be able to see an elevated area of the skin that is caused by the internal Peyronie's scar tissue; for the most part, it is a waste of time trying to actually see the Peyronie's scar from the exterior. The best way to locate the scar material is when flaccid, meaning not erect.
Do not be discouraged if the scar you have is large since it does not seem that the size has much to do with difficulty or time required to eliminate it. Larger scars can take just as long as smaller scars to treat.
Try this: forget about finding a “scar.” Just try to find something – anything – within the mass of erectile tissue that feels unlike the other tissue. Find something that is unlike the rest of your penis. When you find it, mark its location with a marker pen or something that will stay on the tissue for a day or two. Go back each day to that area and re-think what you are feeling. You are trying to see if it becomes easier to make sense of it. It could be that you have an unreasonable expectation of what a “scar” should feel like, and you are missing what is really rather obvious only because your expectation is wrong. Really, how could you know what a PD scar feels like if you have never had to do this before? Trouble locating the scar is a common problem.
PDI has much success with the methods we present to you. Just because your doctor could not locate your scar does not mean it is not there. And it definitely does not mean that you cannot find it just because he can’t. As so many men with PD finally come to understand, you must take control of your situation and begin to get well on your own. A large part of being in control of your treatment is to have a vivid image of the scar physical qualities in your mind.
If you need additional help to locate the offending Peyronie's scar, please contact me directly. TRH
I have had Peyronie's Disease for probably 4 years or so (not initially diagnosed) and the initial bend and associated pain is no longer apparent. I have several plaques on the shaft and these cause somewhat of an hourglass effect and an associated constriction.
I no doubt have suffered from depression during this period partly due to feelings of guilt and helplessness. I have taken l-carnatine and more recently Neprinol. I have found that if nothing else doses of vitamin E have also been good for my skin health.
More recently I have been diagnosed with Ehlers-Danlos syndrome. I am in quite good health and have not experienced any loss of sexual function. In taking the Neprinol – this is probably of no association – I now wake with an erection.
I recognize that I should have acted earlier but as it took several attempts to find a doctor that could actually offer help I had already somewhat resigned myself to my fate. As described there has been substantial improvement from the original condition and I am looking to continue my recovery. What program would you suggest that I try? I look forward to receiving your advice.
As I suggest to all men who contact me with the same basic question about what program to get started with, I think you should visit the page Suggestions to help you decide how to start Peyronie's treatment. This is a good starting point for anyone who wishes to increase his ability to naturally heal and eliminate the offending Peyronie's scar tissue. The basic idea is to support and encourage the strongest healing response possible by using the largest and most aggressive plan you can use for at least 2-3 months.
It is encouraging to think that you saw some degree of improvement by just using acetyl-L-carnitine and Neprinol. This is not a good plan design, so if you decide to use what we offer as a viable treatment plan I would guess your results would be considerably better than what you did on your own.
Fifty percent of men who initially develop Peyronies will cure or eliminate it without any outside help. You saw what your body could do when you helped it a little in a lop-sided way. The PDI therapy idea is simply to encourage that natural healing ability by supplying at the same time and in an elevated dosage all possible nutritional elements to help that healing process along.
If I can help you in any way, please let me know. TRH
Not every curved penis is Peyronie's disease
To offer a definitive and accurate answer to the question “Does Bill Clinton have a curved penis or Peyronie’s disease?” would require the presence of several pieces of clinical information determined by direct medical examination:
1. History of pain while erect, or less commonly pain while flaccid, or both
2. A mass or nodule of foreign scar tissue located below the surface of the penis shaft, detected by manual palpation or ultrasound examination
3. Structural deviation of the shaft of the penis during erection, (bending or curvature, hourglass, bottleneck, rotation or torque, or indentation deformity)
4. Erectile dysfunction, either total or partial, caused by the internal Peyronie’s scar material interfering with the pneumatic mechanism that creates a normal erection
Since none of the above information has been presented in any factual way, the curious public has only to rely on hearsay and innuendo. Taking the sketchy information and various unconfirmed newspaper reports as credible, the only safe conclusion at this time is that former President Clinton does not have Peyronie’s disease.
A diagnosis of Peyronie’s disease can be complicated. Peyronie’s disease is not determined solely on the presence of a curved penis, any more than the absence of penile curvature indicates a man does not have Peyronie’s disease. Simply because a penis is curved does not support the conclusion that the cause is Peyronie’s disease, especially when the presence of the curvature is solely based on the observation of a layperson.
However, whether Mr. Clinton has Peyronie’s disease, or even a curved penis, cannot be confirmed in any meaningful way at this time due to the legal maneuvering and sealing of many court documents in which this question has been apparently asked and answered under oath. As such, the presence or absence of a curve in Mr. Clinton’s penis is apparently known, but is not currently available for the public record.
Whether or not Bill Clinton, the 42nd U.S. president, does or does not have a bent penis, and is consequently assumed to have Peyronie’s disease, became an important political question during two different sex scandals in which President Clinton was famously involved.
The first, in 1994, centered on the sexual harassment suit that Paula Jones filed against President Clinton for conduct that was said to have occurred in 1991 at the Excelsior Hotel in Little Rock Arkansas. Her lawsuit was eventually dismissed on the grounds that she failed to prove damages as a result of her encounter with Clinton. When Jones appealed the dismissal Clinton agreed to a $850,000 out-of-court settlement.
The second, in 1998, became known as the Lewinsky scandal. This high profile sex scandal centered on the extra-marital affair between President Clinton and a 22-year-old White House intern, Monica Lewinsky. Eventually the scandal resulted in the impeachment of President Clinton by the U.S. House of Representatives and a subsequent acquittal on all impeachment charges of perjury and obstruction of justice by the U.S. Senate after a stormy 21-day trial.
Both of these women hoped to prove that Mr. Clinton was sexually active in their presence by offering that they saw a “distinguishing characteristic” of his private anatomy, suggested by others to be some degree of penile curvature.
However, the public record regarding Mr. Clinton’s alleged bent penis has been purged from their testimony. Because the Jones and Lewinsky cases involved a sitting U. S. president, all testimony and affidavits that would quickly answer this question about Peyronie’s disease were sealed by court order and remain so. Detailed review of Monica Lewinsky’s August 6th and August 20th grand jury testimony, released on September 21, 1998 reveals no questions asked or answered about his penis. Detailed review of Paula Jones’ testimony during her deposition to the U. S. Senate on February 17, 1998 also reveals no questions asked or answered Mr. Clinton’s penis.
As a result of the court enforced silence on this subject the public does not know what these two women said about what they saw. The Washington Times has reported that several sources with close ties to the Paula Jones case indicated that in her sworn affidavit she alleges Mr. Clinton’s displayed a distinctly angled bend of his erect penis.
Even if it was widely known that both women said Mr. Clinton has a bent penis, this isolated information does not definitely prove that the former president has Peyronie’s disease; it would only mean that his penis is curved.
However, the New York Times newspaper has reported that on October 3, 1998 a detailed genital examination was conducted on Mr. Clinton by the chief of urology from the National Naval Medical Center, Capt. Kevin O'Connell whose interest was to specifically rule out Peyronie's disease. The New York Times has reported that Dr. O’Connell, as a result of this examination would testify if given the opportunity, that Mr. Clinton does not suffer from Peyronie’s disease. But this information is also under a court seal, so the best that can be done currently is to speculate.
Some normal penises are curved while other normal penises are straight; just part of the normal variation that exists between men that makes us all unique. When those court documents are finally opened and made public, few of us will be around to care about the private parts of President Clinton.
My question is, do you know of any link between Peyronie's disease and PSA?
Since I acquired Peyronies, my PSA has increased over a couple of years.
In my opinion there is a possible link between an elevated PSA test and Peyronie's disease, actually two links, but only in an indirect way and probably not as you might expect. I will discuss that association a bit later after a few preliminary remarks so all readers can be more familiar with the PSA test.
Every man needs to know that PSA (prostate-specific antigen) is a protein made by normal prostate gland tissue in the adult male. A recent ejaculation, any inflammation of the prostate whether caused by acute injury, benign (non-cancerous) enlargement (BPH or benign prostatic hyperplasia) associated with aging, or prostate cancer can elevate the PSA level found in the blood.
In the mid-80s the PSA test was approved by the FDA only to monitor the progression of prostate cancer that was previously diagnosed. In the mid-90s the PSA test was approved by the Food and Drug Administration (FDA) to be used in conjunction with a direct digital rectal examination (DRE) to annually test men who did not have active prostate symptoms as a screening procedure for prostate cancer.
However, due to recently becoming aware of the limitations of the PSA test and the potential harm that can arise with its use, it the FDA acknowledges the PSA test is not a dependable prostate cancer screening procedure; it yields a false-positive result in about 75% of positive tests (only one correct test result out of four positive tests) . This means that three men who do not have prostate cancer will receive an incorrect test result for every four positive tests. Prostate biopsy operations are performed on a routine basis when a PSA test is positive, so this means that three out of four prostate biopsies are unnecessary and expose those men to unnecessary risks and side effects.
On the other side of the coin, a false-negative PSA test can also come back with a low or normal readying even thought active prostate cancer is present. This does not happen nearly as often as a false-positive PSA test, but it does occur, giving a man and his doctor, as well as his family, a false sense of security that cancer is not present when in fact he might have prostate cancer that requires immediate treatment.
As a cancer screening test the PSA, when it is actually correct, can help detect the presence of small cancers that do not cause symptoms. However, simply locating a small prostate cancer does not result in a man living longer. Several types of prostate cancer detected by PSA testing grow so slowly they are unlikely to be a cause of death. Further, detecting cancer early might not help a man survive a fast-growing or aggressive tumor that often spreads to other tissues and parts of the body long before it is detected. For this reason the FDA now takes a different position about the PSA detecting prostate tumors: early detection of slow growing and non-malignant prostate tumors that do not threaten a man’s life can result in “overtreatment” of low-threat problems, and this routine screening use of the PSA test has been called “overdiagnosis.”
Active and aggressive treatment of a low threat and slow growing prostate cancer is called overtreatment because the side effects and complications that arise from this kind of cancer treatment are often far worse and more life threatening than the cancer itself. Beginning with suppression or weakening of the immune system that makes a man more susceptible to infection anywhere in the body and other diseases, urinary incontinence (inability to control urine flow), bowel and urinary dysfunction and erectile dysfunction are a common side effect of cancer treatment.
More commonly now only those men who report actual prostate symptoms will be given a PSA test along with a digital prostate examination to determine the cause of their symptoms. The exception to this more limited use of the PSA test is for those men who are who are at greater risk of malignant prostate cancer (black men or those men whose father or brother had prostate cancer). For this group it is recommended that they begin to screen for prostate cancer in their mid-40s.
For these men in a high risk group, PSA testing spread out over a period of several years rather than several months gives the most accurate and revealing diagnostic information. One individual elevated PSA test may be a reason for only mild concern, because often the next PSA test will be normal. But a series of slowly raising PSA tests over a period of a few years is another matter and warrants further prostate testing.
PSA testing is also controversial for men 75 years old and above. This age group is far more likely to have a slow growing cancer. This type of cancer posses very little immediate health risk compared to the other cancers, heart, lung and kidney diseases, diabetes, degenerative neurological and vascular disease (that often occur as multiple health problems) in the elderly. For this reason PSA screening is not recommended for elderly men with multiple health problems or a single major medical problem, or when life expectancy is less than 10 years.
So now, Dave, with all that on the table, allow me to offer my thoughts about a possible connection between Peyronie's disease and the PSA test.
When a man has a PSA test and the results come back positive, the doctor treating doctor will do additional tests that will probably include a prostate biopsy. After the prostate biopsy the man might be catheterized (a thin catheter tube inserted up his urethra – the urinary passage in the penis) to help him void urine. I have written in the past about the issue of abusive catheterization leading to PD in Possible Peyronie's cause: Catheter and cystoscope trauma. In this sense, men who have had a PSA test can develop Peyronie's disease indirectly as part of the process of having their prostate gland treated.
As a second possible link of PSA tests and Peyronie's disease, please consider the man who goes to his medical doctor for symptoms of prostate enlargement (urinary frequency, urinary dribbling, difficulty starting or stopping the flow urine or pelvic and penis pain). As these things often progress, this man could be given a PSA test to assess the condition of the prostate and subsequently be prescribed the drug Proscar (finasteride) to reduce prostate enlargement (benign prostate hyperplasia – BPH). There are a growing number of lawsuits now pending which claim that Proscar can cause Peyronie's disease; for additional information please see Will the drug finasteride (Proscar) (Propecia) affect my Peyronie's disease in any way?
I would be interested to learn more about your situation, Dave. In particular, if you have ever taken Proscar in relation to prostate enlargement; and if have, if your Proscar was taken before you knew you had PD. Now that you have Peyronie's disease I believe there is no direct connection between your prostate gland or Peyronie's disease and the raising pattern of your PSA readings.
For additional information please see Prostate screening and Peyronie's disease. TRH
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.
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.
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
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.
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
My urologist prescribed finasteride (PROSCAR) to shrink my enlarged prostate and lower my PSA level. Will this affect my Peyronies in any way?
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
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.
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?
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
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.
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
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.
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.
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.
My first sign of Peyronies was just 5 weeks ago, a small indentation on side below mid-shaft. A week later I noticed a slight bend in the same area. Last week the bend was even a bit worse and I did masturbate, not rough though. Since that time I have almost no ability to get a full erection. I believe some of this is mental as I had no problem before and am quite upset mentally about this problem. Injury can be seen (not felt) below the skin when nearly erect. Looks flat elongated and possibly a bit larger recently. So I am now nearing 6 weeks since first signs.
Believe I hurt myself originally during aggressive sex with a slip and bend.
Daily I have been taking since day one 1800mg fish oil, 3- 100mg doses of ubiquinol, 3- 500 mg doses of ALC, 3- 500mg doses of Arginine, 4- 100 mg doses of vitamin E. Daily vitamin B, C and Zinc (30mg). I have no pain with exception of occasional burning sensation at base of penis and above that area.
My question is am I doing the right things at this point? Also, I have heard from many and read that traction often works over time. Is this something I should consider? My case is very new and I saw it almost Immediately. Is it too early to begin massaging the scar?some. I workout daily and am in reasonably good shape. Not overweight and have a near impeccable diet. I am severely stressed by this.
First of all, you do not know for a fact that you have Peyronie's disease. You might simply be feeling the effects of the sudden bending injury to your penis. Typically it takes longer to notice signs and symptoms of an actual case of Peyronies disease, although it is possible since most everything about PD is variable from one case to another. Because of this I strongly encourage you to go to a urologist for an examination and to have your problem diagnosed so you are sure of what is actually going on with you at this time.
Please be careful with any future sexual activity that could potentially re-injure your penis, whether it be intercourse or masturbation. The last thing you need is another injury on top of this one. This is something for you to keep in the back of your mind for the rest of our life.
If you do indeed have Peyronie's disease the actual Peyronie's plaque and later scar formation will never be visible. These are tissue changes that go on under the surface of the skin in a layer of tissue called the tunica albuginea, and can be located by light and sensitive touch.
Your list of supplementation is interesting but I cannot comment on what you are taking because the quality of the supplementation is just as important as what you are taking and the quantity you are taking. Since I have no idea about the quality of these items I cannot assume you are doing the right thing for yourself. If you are interested in using a supplement program to assist your recovery I suggest you consider using those on the PDI website since I have utmost confidence and experience with them when used to increase healing of Peyronie's disease. I can tell you from looking at your list of supplementation that you are incorrect in addressing your problem by only taking supplements and not using what I will call external therapies to assist recovery from the exterior of the body. I will be able to work with you when it is these products you are using.
Every month I hear from men whose Peyronie's disease started after using a penis traction device; they can and do cause injury. For this reason I think it would be wrong thing to use for any man, especially after having sustained an injury such as the one you describe.
Please do not massage your penis directly because doing so could cause further injury. Perhaps you have read about the PDI Massage and Exercise video. Well, in that video we clearly instruct men with PD to not directly massage the penis. The message we propose to use is applied to areas and tissue other than directly over or to the penis. You can find out more about this by clicking Peyronies disease exercises.
Right now it appears that you are guessing about a lot of things when it is important that you should be doing the right things. Please spend some time reading different aspects of this subject, as with the article Guide for Peyronie's disease treatment. If you have additional concerns or questions please let me know. TRH
I was injured by rough masturbation, and now I have a bent penis. Will I be able to have sex with my girlfriend?
I am 21 year old and i used to masturbate for the last four years until I developed a bent penis. My penis head is not covered by skin and its by birth, not from circumcision. About 2 years back i found that masturbating on the bed is more exiting than by hand for me and due to that one day i slightly bent my penis and had a slight pain in the middle of the penis. But that didn't bother me too much so i masturbated like that regularly. My question is this now. For the last 6 months that have passed i realized that i was doing it in the wrong way and that i have hurt my penis, and i discovered I have a bent penis with a bend in the middle of the penis on the left side, but i don't have any pain in erections now. i used to masturbate with my hands 2 times a week. There is no difficulty in ejaculation and pain in erection,and yaa doc. One more thing when half erected it bents downward easily and not upward as its tight some time i had seen hour glass shape when its not erect and i m still a virgin, and very upset with my peyronie condition. Can it become straight again? Can i be able to have sex ever with my girlfriend? i am too much depressed. sir plz help me…its very important for me……
Greetings young man,
Rough or unusual masturbation practices can injure the penis, especially when repeated many times, and can lead to Peyronie's disease. Please read I am 19 years old and I need your help with a curved penis after rough masturbation
A bent penis and an hourglass shape indicate you could have Peyronie's disease. However, your young age, lack of pain, and the fact that you do not mention a lump or knot of tissue under the surface of the penis indicates that you might not have Peyronie's disease at all. At this time, you are only thinking it is PD, and maybe it is not. First things first. You should go see a doctor who specializes in this kind of problem, a urologist, who can tell you definitely one way or the other if you have Peyronie's disease.
If you have Peyronies disease then you can discuss with the doctor the best way to proceed to help yourself. At your young age, and having relatively mild symptoms, I suggest that you be extremely reluctant to allow yourself to be talked into surgery. It might eventually be necessary, but I would offer to you that it only be done as a last resort after you exhaust all possible conservative Peyronie's treatment measures that would help your body to cure any Peyronie's plaque you might have at this time.
Many men continue to have sex in spite of having Peyronie's disease, even with a bent penis. It depends on how badly it is curved and where it affects the penis. All is not lost. But you need to learn more about this problem and change how you masturbate. Please read Peyronie's disease and masturbation.
I suggest that you read and learn about natural ways to help your body eliminate the Peyronie's problem, and reverse your bent penis, if it turns out that is what is going on with you. Please let me know what you learn and what you decide to do. TRH
Hi Dr. Herazy,
I've been following your instructions and using your products now for about two years. My progress has been slow, but thanks to you, I HAVE made progress and almost back to normal…..as far as the severe bending and curvature. There is now only a small knot remaining at the upper right on top, near the head of the shaft and appears to be all that is remaining. I will continue your Peyronie's treatment procedures. My question is, and it's VERY important to me is : Can I get my size back ??? Since this issue began, I've lost at LEAST an inch in both length and girth even though my erections are “near” normal. Is it possible to use a pump with care and restraint to gradually build back up ?? This is driving me crazy with worry.
Greetings David V,
First of all, congratulations in getting your bent penis under control and eliminating all but a small knot of scar tissue.
However, in spite of all the reading and instruction I know you have read, it seems to me you are making a huge mistake to only gauge your treatment success based on reduction of your severe penis curvature. You must have read a hundred times it is necessary to use the size, shape, density and surface features of your scar to guide your treatment. Once you begin to do that your treatment will be a lot more effective and you can expect to see more changes in your curved penis and lost size.
I suggest avoiding a penis pump, or VED. With those devices it is not possible to know that you are not injuring yourself until it is too late. There is a better way to get back lost penis size.
In regard to getting back your lost penis size, let me give you some advice. I have reviewed your file of past purchases and see that you have not used the gentle manual penis stretching technique. This would be a very logical addition to your current plan as I understand it. Please continue with your current treatment plan, but add in the gentle manual penis stretching to see if you cannot possibly reduce the last of that small remaining scar as well as coax back some of your lost dimensions. TRH
I have used your basic plan in 2010 and after that I discontinued since I was able to get erections and intercourse was not painful. Later I have been diagnosed with an enlarged prostate but PSA is normal. Now I have irritating and burning pain after ejaculation for many hours and my penis appears to become short although the curvature is not significant. The amount of semen is also very little. I am 47 years old. Never used Viagra or any other enhancing drugs.
I am deficient on Vitamin D and taking an Omega supplement which also has Vitamin E. What plan you would recommend for me and can you provide me details of medication in each plan. It was listed in this site but could not find now.
I suspect that you did not correctly or completely finish your course of initial care and that this is the reason some of your symptoms of small curvature has come back. Since you discontinued care because your erections improved and intercourse was no longer painful, I suspect you made a fundamental mistake in understanding how the PDI treatment should be used. It appears to me you did not monitor the condition of your scar in terms of reduction of the size, shape, density and surface features of your Peyronie's disease scar to know for a fact that your true problem was gone. While it is good your pain improved and your erection quality improved, that is not a good way to determine success or failure in treatment. I also suspect that you got a small reduction of your scar (enough to make intercourse less painful and erections stronger) but that there was more work left to be done to reduce the scar further that you did not do.
Many of your current complaints could be due to the prostate enlargement you mention; you should discuss this with your doctor. For this I suggest that in addition to using the medication he has prescribed for you, that you consider using multiple vitamin supplement that will supply all the nutrients that you need for your general health, plus special nutrition and herbal support for the prostate gland; it is called Prosta-Support. Additionally, it would be good for you to talk to your doctor about performing a simple and economical prostate massage on yourself a few times a week using the Aneros prostate massager.
You should consider using at least a medium Peyronies treatment plan, and even a large Peyronie's treatment plan if it is in your budget because it is larger and more diverse, to help your body completely eliminate the remainder of your Peyronie's scar. TRH
I live in Australia and purchased the ultra sound device with my last order. The power supplied here is 240Volt – Is the ultra sound suitable for use in this Country ??
Yes, the ultrasound machine we have available is made in two voltage ratings. For the US and a few other countries it is made as a 110 volt unit. For most of the rest of the world it is made as a 230 volt unit which will work when using 220, 230 or 240 volts power sources. TRH
Hi, I live in Estonia and I have pretty much surfed all the internet and cant seem to find any other Vitamin E supplements other than alpha tocopherol in my country. Right now I'm taking 300 IUs of alpha tocopherol daily, what would you suggest?
The vitamin E product we make available on the website of the Peyronie's Disease Institute contains all four factions of vitamin E: the alpha, beta, delta and gamma tocopherol members of that family. Please find it at Unique-E vitamin E. TRH
Hi, Dr. Herazy.
I'm wondering if your treatment program might help me improve my penile torsion–my penis has a counter clockwise rotation some 45 degrees. I'm 40-years-old and married.
One more thing–is having a penis that twists in one direction or another really rare or fairly common?
Thanks for any advice.
Since you do not mention having Peyronie's disease I will assume that your twisted shaft is a condition you have had all your life, or a congenital twist that is simply the way you are. I mention this because it could also be part of the deformity pattern that develops as a result of Peyronie's disease, since many men note this finding along with a curved penis and loss of size that results from the presence of the Peyronie's scar. When I had Peyronie's disease back in 2002 I also had a torque or twist in the shaft; mine was also counterclockwise, and it was resolved along with the 35 degree bend to the left, upward 10 degree bend, and loss of size when I was able to heal the PD scars that were causing that mess.
But I assume your twist is unrelated to PD and is only something that makes you the unique and wonderful guy that you are. For information about how some men are born with a different looking penis please refer to How can I tell the difference between Peyronie’s disease and a congenitally curved penis?
Previously I have described how many men have used the PDI gentle manual penis stretching technique to partially or completely reverse congenital penis curvature and bends. Please refer to Will the PDI Manual Stretching Technique help a congenital penis curvature?
It is not I often learn of men who have a congenitally twisted or torqued shaft; most often it is congential curvature that is mentioned. Further, when twisting is mentioned I believe the amount is not often as much as our 45 degrees. However, when it comes to these kinds of variations of the penis there is a tendency for men to not broadcast this information. I would suspect that it is more common than generally spoken about. For these reasons I will say that your situation is not all that common, but certainly not rare.
I would suggest that if your torqued shaft is presenting a problem to your sexual function that you could consider a brief therapeutic trial of maybe three months or perhaps more using this PDI protocol to see if you can reduce the degree of variation you have. TRH
I am young student of just 22. I am feeling some cord-like lesions (around 4) around my penis and the penis is curving just right at the base lesion,the curve is though minor but my penis is loosing girth at the base and I am sure this is peyronies. I can find the lesions i.e plaque very soft and moving like veins. please help me. Depressed a lot. Went till suicide.
Greetings young man,
I will be happy to help you.
First of all, you do not know you have Peyronie's disease. You think you have Peyronie's disease. You could easily be wrong because a few things you mentioned in your email does not fit a good description of this problem.
1. You are far younger than average to develop Peyronies.
2. Seldom does Peyronie's present itself as multiple cords.
3. Seldom does Peyronies in the early stage appear as a soft lesion, but usually firm to hard.
4. Seldom are the Peyronies lesions moveable to any great degree.
5. Seldom does someone have four separate lesions that are easily located; most men cannot find one.
6. You did not mention pain, which is a rather common complaint in the early phase of Peyronie's disease.
7. You did not mention trauma, which is usually a large part of Peyronie's disease when someone your age develops it, so this is a missing part of your story that is almost always mentioned from someone like you.
Based on the above, I have serious doubts your problem is Peyronie's disease. I suggest the first thing you should do is to go to your local doctor for a complete examination to determine the actual problem that is going on. My suspicion is that you have a small congenital anomaly or curved penis you were born with that you are just now noticing; that the four cords are indeed veins; and that your overactive imagination is suggesting that you have lost girth.
If you read some easily available information like, What is Peyronie's disease? , you can learn more about it.
Lastly, you are more than a penis. You are an important and valuable person with or without Peyronie's disease. Anyone who thinks less of you because you might be missing an arm, an eye, a leg, or the use of your penis, would only do so because of immaturity and distorted values on their part, and the fact that they do not know you. You need to organize your thinking and control your emotions which are now only being guided by fear and poor judgment. Look around you for just a few moments to see how fortunate you are and how good your life is at this moment, and in the future that you are creating. Put your personal, moral and spiritual values where they belong . Realize how good life is regardless of small problems that arise while we live the wonderful life that we choose for ourselves.
There is a lot that a person like you could do to help yourself heal if it did turn out that you have a case of Peyronie's disease. That is why we have so many people who come to this website to help their body reverse and correct the Peyronie's problem. Go to Testimonials from the Peyronie's Disease Institute to learn about the many people who have used the PDI therapy ideas and eliminated their problem by supporting their natural ability to heal the Peyronie's scar.
Keep your heart and your mind on the positive. Please keep in touch with me and let me know soon what you learn. TRH
I saw a picture of a individual on your site with Peyronies where the claim was, he was 45 degrees. It didn't seem to me like his curved penis was 45 degrees, obviously there's more than one way you can measure.
I always believed the side with the curve is the side you measure. The problem is that when measuring Urologists can do it differently because there is no set standard. Its like penile length measurement,some doctors/researchers will press the ruler to the pubic bone, but others will only touch the ruler lightly to the abdomen. When measuring girth some measure at the base, some in the middle. Some researchers /doctors stretch the length only with some doing it once,others a few more times & elongating it ,others use pharmaceutical induced erection.
The bottom line is that a congenital curve or Peyronies curve (if it doesn’t hurt) doesn’t matter if its 0 degrees or a 1,000 degrees if intercourse can be done without pain for both parties.
Often I will notice that the person will only estimate the degree of penis curvature, and usually on the exaggerated side. Actually, while the degree of curvature is of course important to know and record, it is really much more important and significant to know the size, shape, density and surface features of the PD scar that is causing the curvature. You see, the curved penis is just a result or secondary factor to the real problem of Peyronie’s disease – the Peyronie’s plaque. Too much time and attention is paid to the secondary problem (the bent penis) and not enough to the cause (PD scar). I can certainly understand why the curved penis and distortion get so much attention from people, but being all engrossed only in the curvature does prevent a man from focusing on the actual problem and how to treat it correctly.
I have worked with men who swear they cannot penetrate with a 10 degree bend, and other men who say that their 60 degree bend only slows down penetration. The problem of penile distortion and resultant difficulty of sexual intercourse is a complex problem, that is made so because human emotions and motivation are a part of the equation. Many times the amount of difficulty of penetration, or pain during intercourse, with a couple who must deal with Peyronie’s disease is due to lack of natural lubrication and lack of preparedness of the female partner; if she is tense and fearful that she will hurt him, she is less likely to be relaxed and fully sexually stimulated to produce the level of natural readiness for that makes penetration easy. If you are interested in this subject because of some difficulty with sex now that you have Peyronies, please see my book “Peyronie’s Disease and Sex.”
Your last comment is quite true. Most men would not care or do much about their Peyronie's disease if they could still have intercourse without a problem.
Hi Dr Herazy
When I was 58 years old (I am now now 62 years old), I had a severe case of Peyronie's disease which came out of the blue. When erect, my bent penis had an angle bend of about 60 degrees about half way along, so my future looked pretty bleak.
I investigated surgery and it frightened the hell out of me. There were no promises of success and I formed the opinion that the surgeons/urologists had locked in their opinion and you were just fodder for their work. Then I found your web site and treatment plan. I did the lot other than the Japanese herbs which irritated my stomach. I hit it really hard and kept at it. It took about 6 months before I really noticed some improvement and it gave me some cheer. I kept at it and it took about 18 months in total to really get my penis back to pretty well straight.
I'm very pleased to say that I'm fully functional and have been since the recovery.
I've been meaning to tell you of my success and I can recommend to anyone – follow the full treatment plan for as long as it takes. It's a pain to do as it's got so many pills/lotions/etc, but it works. And it's been a darned side cheaper than surgery could ever have been.
Greetings and thank you Greg,
Thank you for the report of your success, but especially thank you for being dedicated enough, tough enough and stubborn enough to stick with it to work for your recovery. Yes, you are right a lot of work and sacrifice are needed for recovery against Peyronie's disease. I see that most men who fail to earn the degree of improvement that you did are not willing or able to work the way you did. Too many try to change the PDI method to make it something that it is not, and they fail. You did it the right way and you beat the monster that was taking your life from you.
If PD was an easy problem, and easy to reverse, it would not be the kind of life changing problem that it is. There are many more men getting the kind of results you got in the last few years because the PDI method is getting more refined. For more information please see Is it really possible that Peyronie’s disease completely disappears?
Before I make a few comments, Greg, allow me to remind the readers of a few things based on what you have told us in your email. First, this recovery that took place was in a case that was for Peyronie's disease that was 2-3 years old when you started your care; this was far after the time it should have cleared up on its own. This means Greg's case was past the time it should have gone away on its own, so we are confident that it was just not a spontaneous recovery that would have happened anyway. Greg was successful in helping his body do what it was not doing on its own. Second, his doctor wanted to cut on him, he was that bad and his sexual activity was that effectively reduced that he was fair game for the scalpel. This was not a minor or easy case. Thirdly, he said, “I did the lot” meaning he did not hold back he was aggressive. This is always key to recovery. Please take note.
For full disclosure I think I am am accurate to say that you and I have never spoke or communicated about your treatment plan, or to answer any questions from you during your 18 month Peyronies treatment . My recollection is that you did your treatment pretty much on your own while learning how to approach your self-care from the PDI website exclusively. This is good because it has always been my intention to make the PDI site so informative and inclusive that a man like you could read and learn on your own, and be totally self-sufficient to reach total recovery, as you did. Congratulations.
Having mentioned all that, allow me to say it is my guess that I could have probably helped you along the way and made your journey a bit faster, or a bit easier, or a bit less expensive, or all of these. I get feedback from the men I work with that the personal input and ideas I can offer will often make nice changes in the rate and degree of their recovery. I mention this because most men I work with usually wrap up their plans in less than a year; sometime in six months or so.
Now that you are back to where you want to be, please keep in mind that anyone can re-injure themselves by being careless or assuming too much. There are several things you need to keep in mind as you resume sexual activity as before: Make sure your erection is a solid as you are able. Make sure she is ready for intercourse with a lot of foreplay and natural lubrication, or use copious amounts of silicone based lubrication if necessary. Make sure your selection of sexual positions are safe; do not use any intercourse positions that you have had trouble with in the past in keeping connected during intense activity (when you pop out of her you are extremely vulnerable to re-injury so keep your arm around her waist or hold her hips to make sure you do not get injured), so steer clear of those , please.
Again, nice work and congratulations, sir.
I have Peyronie's disease. Is there anything i can use or do to lessen the pain when getting an erection?
Hello Dr Herazy,
About 3 months ago i had a vasectomy done, and to try and “clear out the system” i was masturbating a lot more then usual. Over time I began having throbbing pain from the shaft of the penis which would pulsate towards the tip when getting an erection, i don't recall this pain prior to the surgery or frequent masturbation. But it seemed as though it had worsened and after a self examination i noticed a BB sized ball towards the bottom of my shaft, so i made an appointment with my urologist.
Well I just had that appointment today and after a short physical exam by him he indicated that the BB sized ball was plaque/scar tissue and that i have Peyronie's disease. He has prescribed me Verapamil gel and is advising me to take Vitamin E UI pills, but he was up front letting me know this may not cure my problem. Now like most men i immediately came home and did further research, but all i'm finding are most men talking about the “extreme curvature” to their penis. And in my case its the pain when getting an erection that i'm more concerned about but i cant find anything that relates directly to that. Let me also point out that although i have a slight natural curve to my penis that i've had for years i do not have anything extreme going on in that area.
So my question to you is there anything i can use/do to lessen that pain when getting an erection? Now that i've located the plaque it seems to be radiating from that area. It has become very frustrating when trying to be intimate with my wife as i focus more on getting that pain when developing an erection then trying to enjoy the intimacy. Any help/suggestions would be greatly appreciated!
Greetings Johnny J,
Sorry to learn of your problem and the pain you are in. Please follow the advice and direction of your doctor. I agree with him that a course of topical verapamil and vitamin E by itself is seldom successful. This is why I developed the Peyronie's Disease Institute to explore and develop an alternative medicine approach to treating PD. As another option, I suggest you spend some time reading the PDI website to determine if this alternate approach that seeks to increase your natural ability to heal, repair and eliminate the Peyronie's plaque makes sense to you. A good place to start is Natural Peyronie's Treatment Options.
Frankly, when I communicate with men who start Peyronie's disease treatment I am told that pain usually goes away in a few days. Pain during an erection seems to be rather easy to control with the therapies in any of the treatment plans you might select.
You need to understand that Peyronie's disease is a process that takes time – sometimes up to 18 months or so – to fully develop all levels of symptoms and signs of this problem. In fact, I have many times communicated with men who find that their problem continues to develop (deteriorate) well into the 2nd or 3rd year. Do not assume that your condition will remain the same as it is right now. If you have no particular curve associated with your Peyronies problem at this time, be grateful because some men start out with a wicked curve. However, it is a rare case of PD that does not eventually display some level of penis curvature or distortion. If you do not have at this time any aggravation of your fundamental naturally curved penis, it will probably not stay that way. It is just a fact, so be prepared.
Whatever you and your wife decide is the appropriate level of intimacy at this time, please be sure to be careful so that you do not exacerbate your Peyronie's disease. Do not stop having sex; have sex in a gentle and sane way so that you do not cause further injury to your penis. You were abusive and overly aggressive with your masturbation to the point that you developed PD. Do not repeat that mistake by making your PD worse. It can be done and it can be a nightmare you do not want to visit. Use additional sexual lubrication during intercourse and select those techniques that avoid the possibility of accidental slipping out and jamming/ramming the penis that would injure it further.
Let me know if I can help you in anyway. TRH
I think I have a natural penis curvature or I was born with a bent penis to the left side by about maybe 35 degree max. I already asked a urologist and after checking me he told me to not do surgery and told me that I do not have a scar tissue or anything. After I did some research on the internet I found that there is some exercise that can help to fix my bent penis and also some people talk about using vitamin E cream mixed with Cetaphil moisturizer. So please just let me know if this can help or not. And if not, what can I do to get better in this case? Thank you in advance and hope to hear from you soon.
As I have written many times in this blog, men have changed their congenital penis curvature using the methods described on this website. I do not think that applying a moisturizer lotion mixed with vitamin E is capable of making significant tissue changes that would be required to alter a 35 degree curved penis. Applying topical lotions that are intended to make the skin soft are far too superficial to accomplish what you have in mind.
You did not describe the exercise that you have in mind to correct your curved penis. This would be key, I believe, because there are many ways to influence the tissue in most areas of the body by stretching the tissue. As far as the penis is concerned, however, you must be very careful about being too aggressive and causing injury to this delicate tissue. From my experience the penis stretching programs I see on the internet are far too abusive to consider doing. For example, many cases of Peyronie's disease have been started by mechanical penis stretchers and jelqing. In response to these abusive methods, several years ago I worked with a group of men through PDI to develop what I call the PDI gentle Manual Penis Stretching Technique that uses a very light but sustained traction to stretch the penis tissue over a period of time when accompanied by a wide variety of internal and external therapies that assist this stretching process. I get back good reports from those men who use a broadly diversified and gentle approach to correcting their penis curvatures.
Please review a few posts to give you a better idea about what this method can do for a bent penis that started from birth, Will the PDI Manual Stretching Technique help a congenital penis curvature? and Could Peyronie treatment plans still possibly help my congenital curvature? and Can my congenital penis curvature be fixed by surgery or is there some other way to get help?
I ask that you investigate this methodology to see if it makes sense to you. TRH
Hi Dr. Herazy,
I'm using the DMSO, Super CP serum and Nattokinase for congenital curvature with some success however the skin on the penis is becoming extremely wrinkled. I also have Ehlers-Danlos syndrome so my skin is more elastic than the average person.
I'm assuming this is due to the damage DMSO is causing to the epidermis. Is there anyway to counteract this and when I stop using the products will the skin return to normal? At present I'm using several drops twice daily.
Congratulations on making improvement with the congenital curved penis problem. Many people say it cannot be done, but we know that these things do improve when you do it correctly.
Well, first of all, for those who are not familiar with Ehlers-Danlos syndrome, allow me to say briefly that it is a congeniral disorder in which loose joints, scoliosis (spinal curvature), easy bruising and sprained joints are common, along with skin that more stretchy or lax than normal, and a general weakness of most tissues. For this reason I am not surprised that you might also develop Peyronie's disease along the way, since the underlying abnormality of this problem is thought to be an inherited weakness or abnormality of tissue collagen, which is glue that holds tissue cells together.
You are the first person in over 10 years of doing this work who has reported that the skin has wrinkled after using DMSO and you are the first person who has used it who also has Ehlers-Danlos syndrome. There is a correlation. No one else has ever reported this kind of response from DMSO.
DMSO would not affect normal skin in the way that your skin is affected. You must know by now that your situation is unusual and that you are not going to respond like other people to this simple DMSO therapy. Typically when DMSO is applied to normal skin it will bring the normal oil that is located on the skin surface and bring that oil down into the deeper strata of the epidermis; this causes normal skin to sometimes become dry and itchy and not much else. Simply reducing the frequency of DMSO application is all that is necessary to correct the dry and itchy skin response.
I would assume – and I stress, assume – that your skin is reacting in the same way and only becoming wrinkled by the lack of oil since DMSO is stripping from the surface and taking it deeper into the tissue. But, then again, even on a good day your skin looks and feels different than other people since it tends to be super-soft and smooth compared to most everyone else.
I ask that you please go to your specialist who you are seeing about your Ehlers-Danlos syndrome for an expert opinion. Please follow your treating doctors recommendation, and pose these same questions. Please let me know what you learn. TRH
Hello Dr Herazy I am 34 years old and my penis bends down and left like a hook I have really hard erections and was wondering what can be done I don't think I have a plaque I have had this all my life . When my penis is flaccid if I stretch it out I can feel my left corpora cavernosa like a tight string and the right loose. Can I be fixed by surgery ? Thank you for your time.
Of course, I cannot answer you in any direct or meaningful way since I have not examined your curved penis.
Your question has been asked and answered several times. Please review the post Questions about straightening a congenital penis curvature and Stretching a congenital penis curvature. There are several other posts on this topic, all you have to do is enter “congenital penis curvature” in the search box and read all that comes up.
In doing this work this 2002 I have been surprised that many men report back to me that they have used the PDI gentle manual penis stretching method with success. It is always used in conjunction with a variety of other therapies for best results. I am not saying to forgo penis surgery, but if you do that as a first method of correction there is absolutely no way to undo bad results. (Surgery to correct bad surgery usually results in in worse results.) I suggest to anyone that usually the best results occur while using conservative measures first, since there are little to no adverse consequences; if they are not effective you can always try more aggressive methods later. TRH
I have a personal interest in Peyronie's disease. At about 70 years of age I developed what was diagnosed as a true case of Peyronies. Prior to that I had no particular problem having multiple partners and three wives resulting in four offspring. The true signs of Peyronies were of rather rapid onset, over a period of a few months. My Urologist suggested Topical application of Verapamil creme which I used for approximately six months to no avail. I experienced no pain and my wife and I continued to have pleasurable sexual experiences.
The architecture of my penis varied over a period of time. It was and is noticeably curved to the left. The Glans was small but has subsequently achieved normal architecture. The curvature and a shortening of two inches prevails. (From a true 6″ to about 4).
I am now 81 years and seldom achieve orgasm and then only after prolonged oral and manual stimulation with adequate lubrication.
However my question and interest is regarding the “natural” curvature of the penis. I started masturbation at age 13 and as I recall my underdeveloped penis was relatively straight. However as length and maturity developed a definite but slight (10 Deg.) curvature to the left seemed to develop. This conformed to the natural curvature of my right hand which was the one used to masturbate. This continued until my full adult development and remained so for many years. Other than a marked curvature the symptoms presented no problems.
My thesis is that as the penis develops during adolescence the bend will be the result of the constant “abuse” of the organ during frequent masturbation. A nurse friend and lover of mine use to joke she could tell the left handed males from the right by the deviation of the penis. I have observed many males with straight penises and I am sure their masturbating habits were as common as mine.
Do you think that this may lead to Peyronies later in life. Review of the literature reveals little information specifically relating to this issue.
C. A. H. DDS MS
You are correct, there is no specific reference in the literature in regard to this particular, and somewhat common, question about repeated masturbation altering the shape of the penile shaft to conform to the hand that is habitually used. There is also nothing noted in the literature tying Peyronie's disease and masturbation together.
I believe the reason there is so little interest to investigate the thesis is that it is rather implausible and has no evidence of occurrence in related or similar scenarios. By this I mean if we take an approximately similar situation of a 13 year old boy who does something with approximately the same level of frequency or habituation as you or the average boy would masturbate, I cannot think of one example in which the body would be deformed or adapt to the repeated physical contact he would experience.
Giving this a few minutes thought, it seems to me that the best general area in which to explore or consider something like what you are suggesting would be in the area of sports or farm work, since it is common for 13 year old boys to be so engaged and to continue to be engaged in sport and farm work activities for many years thereafter. Not only would the sport or farm activity start at this early age, and continue for many years subsequently, but it would typically be performed at a frequency similar or greater than such a boy would masturbate. For example, a 13 year old boy growing up on a dairy farm would be obligated to milk cows twice a day, pitch hay daily, scoop manure several times a week and many other repetitious and physically demanding duties that significantly impact his developing body. Yet, no deformity of the hands or upper body develops as a result of his work, other than the development of callus tissue on the hands which is only temporary.
History does not report that when children during the Industrial Revolution were put into servitude at the age of 5 or 6 to work 10 hours a day 6 days a week that their bodies were in anyway significantly or predictably misshapen by contact with machines or tools they used.
Come to think of it, I have worn a belt snugly around my waist since 5 years of age or earlier yet I do not have an indentation to conform 8-12 hours of compression for a life time.
What you ask about is a common idea, but I do not see evidence to support it. TRH
I have recently ordered the alternative large package and I would like to ask you the following.
I have the Peyronie disease and for other reasons I am taking a supplement of (Solgar) called pycnogenol. If I have well understood this product is related to collagen. Can you please advise me if this is good for the Peyronie's disease or bad and whether I should stop taking it or not?
I am very familiar with pycnogenol, which is an extract primarily from the bark of a pine tree, pinus pinaster, although the same pycnogenol can removed from peanut skin, grape seed, and witch hazel bark. The reason that it is not included in the PDI lineup of therapies is that it has not been subjected to any testing for Peyronie's disease that I can determine. Not everything possible that could be remotely effective for Peyronie's treatment is included in our PDI treatment concept; only those things that have received a sufficient level of testing and produced some positive research findings but insufficient to be considered a complete cure. Pycnogenol has not been tested at all in that manner and so will not be considered for inclusion until it is.
When you consider how to go about treating your Peyronie's condition you have to determine that it is not the scar you are treating but your total body and your ability to heal and repair the PD scar. The best route for Peyronie's disease treatment is different for each man. This is why there are so many variations of the different plans that are being used.
Pycnogenol is often mentioned as being effective for treatment of many diverse problems: asthma, allergies, skin problems, elevated blood pressure, reduced blood circulation, muscle soreness, pain, arthritis, menopausal symptoms, painful menstruation, diabetes, retinopathy and erectile dysfunction, to name just a few. It is also commonly used by those who are interested in its anti-aging benefits.
It is your decision to continue taking it or not. TRH
Any reason why these 10 items were not included in the Peyronie’s Large (Best) Treatment Plan I received?
I ordered the Large (best) plan – order number 4789358764 Double checked by Dawn
In the instructions – Dosage: start of Care
there were 22 items listed for the therapy.
this is what did not come with the Large (best) package
Ascorbplex 90 or 180
Acetyl – L – Carnitine
HJG and KBG Honso Herbs
Any reason why these would not have come in the large (best) Treatment Plan?
Also – While I assume all of the activity – nutritional, eastern medicine, Acupuncture, strectching, applicants, exercise all work together somehow – Is it truly a holistic plan or do some parts tend to work better than others.?
The Peyronie’s disease large treatment plan does not contain everything that is available from the PDI store; it is not intended to be an all-inclusive plan – just large. If you go to the PDI website and look at the description of the Peyronies large plan you will see there are 12 items in the large plan, and this is the number of treatment items that you received. your order was complete and correct. To say it another way, you did not receive everything in the PDI store because only 12 items are in the large plan and that is what you received. It is a large plan, not an “all inclusive total kitchen-sink nothing-left-out therapy plan.”
There are several reasons that not every possible therapy is included in this large plan. First, it might not be necessary to use such a huge array of all possible therapies to correct your problem. If it does prove later to become necessary to include additional items in your therapy plan there will be additional items that can be used later. And, the plan is limited to 12 items to simply keep the costs down for the person just getting started in care.
I suggest you spend a little more time reading some of the information available to you on this site to understand how this process works.
Please let me know if you have additional questions so I can help you in your recovery from Peyronie’s disease. TRH
My doctor wants to put cortisone injections into my Peyronies scar, what do you think of that?
Will steroid injections reduce the inflammation and pain of my Peyronies?
Did my Peyronie's disease or curved penis begin because of always using the same hand while masturbating?
I have a personal interest in Peyronie's disease. At about 70 years of age I developed what was diagnosed as a true case of Peyronies. Prior to that I had no particular problem having multiple partners and three wives resulting in four offspring. The true signs of Peyronies were of rather rapid onset, over a period of a few months. My Urologist suggested Topical application of Verapamil cream which I used for approximately six months to no avail. I experienced no pain and my wife and I continued to have pleasurable sexual experiences.
The architecture of my penis varied over a period of time. It was and is noticeably curved to the left. The Glans was small but has subsequently achieved normal architecture The curvature and a shortening of two inches prevails. (From a true 6″ to about 4).
I am now 81 years and seldom achieve orgasm and then only after prolonged oral and manual stimulation with adequate lubrication.
However my question and interest is regarding the “natural” curvature of the penis. I started masturbation at age 13 and as I recall my underdeveloped penis was relatively straight. However as length and maturity developed a definite but slight (10 Deg.) curvature to the left seemed to develop. This conformed to the natural curvature of my right hand which was the one used to masturbate. This continued until my full adult development and remained so for many years. Other than a marked curvature the symptoms presented no problems.
My thesis is that as the penis develops during adolescence the bend will be the result of the constant “abuse” of the organ. A nurse friend and lover of mine used to joke she could tell the left handed males from the right by the deviation of the penis. I have observed many males with straight penises and I am sure their masturbating habits were as common as mine.
Do you think that this may lead to Peyronies later in life. Review of the literature reveals little information specifically relating to this issue.
C. A. H. DDS MS
You are correct, there is no specific reference in the literature in regard to this particular, and somewhat common, question about repeated masturbation altering the shape of the penile shaft to conform to the hand that is habitually used.
I believe the reason there is so little interest to investigate this idea is that it is rather implausible and has no evidence of occurrence in related or similar scenarios. By this I mean if we take an approximately similar situation of a 13 year old boy who does something with approximately the same level of frequency or habituation as you or the average boy would masturbate, I cannot think of one example in which the body would be deformed or adapt to the repeated physical contact he would experience.
Giving this a few minutes thought, it seems to me that the best general area in which to explore or consider something like what you are suggesting would be in the area of sports or farm work, since it is common for 13 year old boys to be so engaged and to continue to be engaged in sport and farm work activities for many years thereafter. Not only would the sport or farm activity start at this early age, and continue for many years subsequently, but it would typically be performed at a frequency similar or greater than such a boy would masturbate. For example, a 13 year old boy growing up on a dairy farm would be obligated to milk cows twice a day, pitch hay daily, scoop manure several times a week and many other repetitious and physically demanding duties that significantly impact his developing body. Yet, no deformity of the hands or upper body develops as a result of his work other than the development of callus tissue on the hands which is only temporary.
History does not report that when children during the Industrial Revolution were put into servitude at the age of 5 or 6 to work 10 hours a day 6 days a week in factories and coal mines , that their bodies were in anyway significantly or predictably misshapen by rigorous and repeated contact with machines or the tools they used.
Come to think of it, I have worn a belt snugly around my waist since at least five years of age or earlier yet I do not have an indentation to conform to 8-12 hours of compression from a belt over a life time – and I am 67 years of age.
Lastly, and perhaps most importantly, I think you have made the case that handedness while masturbating does not lead to any particular curved penis pattern. You wrote that many men have straight penises although they were all likely to have masturbated at the same age and the same or greater frequency and gusto than what you used. The fact that those straight penises exist tends to refute what you have proposed.
What you ask about is a common idea, but I do not see evidence to support it.
However, what you describe in your email does sound like Peyronie's disease. I would suggest that the apparent injury that started your Peyronie's problem was not because of your right (or left) hand holding your erection with any particular hand repeatedly, but from some accident that occurred while as a young man or even later in life. TRH
Where can I purchase the 3mhz ultrasound machine to treat my peyronies? I couldn't find it here. rabalar.
Please go to 3MHz ultrasound treatment of Peyronie's disease for the information you need. TRH
After doing some research I am convinced that I am in the early stages of Peyronie's disease. Very recently, the skin directly before my penis head has swollen a little on the left side and left a small dent on the right side under my head.
I haven't told anyone. What do you suggest I do?
First, I suggest that you go to see a urologist who has experience with Peyronie's disease and get a diagnosis of your problem. Until your diagnosis has been firmly established you are merely guessing and that is not good for you.
Second, if you are told you do have Peyronie's disease you should begin the largest plan you can sustain for 3-4 months while you attempt to accelerate and support the natural tendency of the body to heal and eliminate the Peyronie's plaque. You can find more information about this process at Start Peyronie's Treatment. TRH
I am a young man in my thirties. My torture with Peyronie's started two years ago. Following masturbation I damaged myself at the tip of my penis. I knew at the time is was a major event and one that would change my life irreversibly for the worse. It was caused by pulling the foreskin back too far with force.
Following it, I had considerable pain for a year and a half. I went to casualty, multiple doctor's but no-one could tell me what it was. Surprisingly, the first doctor I saw guessed maybe Peyronie's because I had a bit of fibrosis at the tip but it was not a nodule – it was clearly calcification along what I thought was a nerve. It soon circled round the head as a thin band. The pain continued and intensified and after a few operations on the skin, a circumcision was suggested as the only cure.
I had that done and it removed the ring of tissue, but no I just had pain when I came to a climax. The original injury happened just before climax so I hypothesized that it was still the same problem. Gradually the pain turned into Peyronie's with a big nodule just behind the head, neither at the top, bottom, left or right but in the middle. Where I had the pain at the top left, scar tissue was forming. The pain was intense, day in, day out. I am a very fit young man and nothing seemed to stop it, sometimes its subsides but then it comes back to remind me and worse than before.
I have tried pentox with Cialis and also Tamoxifen having gone to a specialist. I am quite well studied and just can't understand this disease. I also tried using a stretching device but that was the worst advice in my opinion and stopped quickly afterwards. I have read studies, have read your book and am interested in what happens to younger men. No one seems to know. I am 1% of a sample size of 1% of the population – aren't I lucky. I am not giving up, your book makes a lot of sense which is why I started off with your mid plan and have now bought everything I can get my hands on. I do take pentoxyfilline at the same time though as I feel it does help blood flow although it doesn't fix anything.To summarize therefore, at the moment, I have changed my diet (as much as I can), now just started taking everything on your list (although I am still nervous about DMSO but it is a calculated risk) and pentoxyfiline.
Having said that, it is all slowly getting worse. I have days with intense pain and all the time I have some pain. I think your point about digestion is valid as I do struggle with digestion and find it hard to go to the toilet.
I would really like your help. Currently I have a very fibrous penis all throughout. Sometimes it feels better than others but it isn't good. I am a positive guy but I am at my limit. I have a beautiful girlfriend who doesn't mind and I am great at sex, but I can't climax. I don't actually have pain during intercourse but erections are getting harder.
My personal hypothesis is that Peyronie's is caused by a chemical that is released through damage. In my case it is a nerve at the tip of the penis. This chemical went everywhere due to the great trauma and now the scar tissue is just finding where the chemical is. If I can find the inhibitor, I might get my life back.
What are your thoughts? I may be barking up the wrong tree but I need hope. In short, forget my hypothesis, is there anything I should do. Should I change my treatment because I am younger? Should I take more of one thing and less of another? I am completely open to ideas. Like I say, I think it is beatable at any stage, you just have to find what works for you. I think there are many types of Peyronies caused by many types of things (which is why drug treatments are inconsistent).
Let me know what you think. I really appreciate your approach and thoughts.
Welcome to the large body of men who do not understand Peyronie's disease. PD is a mass of contradictions and irregularities and this accounts for the ongoing difficulty not only in making a diagnosis, but also treatment.
You ask for my thoughts. To begin with, several aspects of your story makes it sound like you have an extremely atypical, or not standard, case of Peyronie's disease.
Your 2nd and 3rd paragraphs are very interesting. Bear with me, but based upon the scenario of the development and progression of your problem as you present it, I can make a different interpretation of your problem. From a slightly different vantage point I interpret your report differently. I can see it is possible that your penile problem was not originally Peyronies. It is possible that you only developed later into Peyronies after the rigors of “a few operations on the skin“, plus a circumcision. Starting a penis problem by pulling the foreskin tightly down tightly during masturbation, a superficial and circular pattern of fibrosis at the tip of penis, and constant severe pain for 18 months are not at all typical of PD; fundamentally, Peyronies is a problem of the tunica albuginea located in the shaft, not in the tip of the penis. Your problem is not even in the usual location for it to be Peyronie's disease. Furthermore, you do not mention a deep nodule in the shaft and you do not mention penile distortion. Very little of your initial complaints during the first 18 months of your ordeal sound at all like Peyronie's disease. It is only later, after you were under medical care and had several penis surgeries for these unusual complaints, when you were probably catheterized several times or used Cialis several times, or were traumatized while using a mechanical penis stretcher, that you started to have complaints more consistent with Peyronies.
I mention this observation because it is important for you to explore the possibility that you are dealing with a complex problem that could actually be two or more different problems that are superimposed on top of each other. Perhaps I am incorrect in this regard, but based on what you have reported in your statement I think the case could be made that you initially had a superficial tissue abrasion or tearing that later developed into fibrosis, and only after receiving drug injections into the shaft during surgery or from catheterization after surgery did you develop PD. Something to think about.
You ask if you should change your plan because you are in your thirties, which you apparently consider to be younger than average to develop PD. Based on many years of experience, you are not young to have PD; many men I would with are in their 30s, and 20s; I deal with many sad cases of teenage boys with PD.
Regardless, whatever your age might be, age is not the reason to change your plan. You should change your plan because whatever you are doing is not working; if your current Peyronies treatment plan is not providing benefit or improvement, and you have not changed it by now, then you definitely should change what you are doing. You did not mention how you are using your medium size plan, or what your individual dosages are, so there is no way for me to suggest how to best modify your plan since I do not know what you are currently doing for yourself.
The best way to handle this is by working together in direct discussion during a telephone call. We can get a lot done in just 30 minutes or so if we put our heads together. Please go to the PDI website to arrange for a telephone call together so you and I can directly discuss your situation in detail. TRH
Have had PD for two years; mostly on the part of the penis below the outer wall of my abdomen and on the right hand side. Can feel a 3-5 inch long fibroid maybe 1/8 to 1/4 inch wide, again most of it inside my body. Penis bends to the right at about a 90 angle, but right at the base so I just “straighten it out” and still can have sex, albeit that I have lost maybe 1.5 inches in length. Urologist says every one of his PD patients cured by themselves in a “3-5″ year time frame??
1.Is he smoking something??
2. Have tired the “fibroid dissolving” Neprinol/Serracor/Senacor and Varapamil cream for months, kind of early on (8-18 months) ; all to no avail
3. What do you recommend?
4. What do you think of the European “needle puncture” technique to break up the plaque?
1. I cannot comment on the recreational smoking habits of your urologist. Perhaps the urologist is laboring under some old concepts and information that states most cases of Peyronie’s disease will eventually get better, or he has some very unusual patients. However, more recent studies indicate it is not true that all cases of PD eventually get better on their own. Current investigation states that at 5-10 years after onset of PD, approximately 10-15% of men with Peyronie’s disease will experience a variation of symptoms and even gradual resolution, while 40-45% will have continued progression or worsening, and about 50% will be stable or have no further worsening of their symptoms. Perhaps your urologist was simply trying to make you feel better since he has nothing to offer you in the way of treatment and just wanted you out of the office.
Actually, if you think about it, it is interesting to note that your urologist’s comment that “every one of his PD patients cured by themselves” goes right along with the PDI treatment concept that I have constantly preached since 2002. Your urologist confirms that it is his/her experience that men cure their own Peyronie’s disease in a certain number of cases. Even the current concept of 10-15% of men recovering spontaneously support the PDI treatment idea. All that the PDI concept of treatment of Peyronie’s disease attempts to do is to support, promote and increase that very same tendency to recover naturally from PD that your urologist told you about. This is really a simple and natural thing that PDI is attempting to do: make sure a man who wants to get rid of his Peyronie’s disease is equipped with everything he needs to function to the best of his ability to get eliminate his Peyronie’s scar. If all men – or 10-15% of men – get over their PD without any problem, what do you think you can do to get over yours? Well, PDI has worked on this problem for a long time and has some very good answers to that question. Read about it here.
2. Your use of systemic enzymes and Verapamil cream, in my opinion, and based on over 10 years of experience in working with men who have this problem, is not likely to be successful in eliminating your Peyronie’s disease. This narrow-base approach is far too limited to be successful against a problem as stubborn and complex as PD. Of course I am committed to the ideas and concept of treating Peyronie’s disease you find on the PDI website. In my experience it is far more effective to aggressively and faithfully use a wide variety of different Alternative Medicine therapies delivered all at the same time, over a long period of time, to increase and support your natural immune response to the foreign fibrous tissue in your penis.
3. I recommend that you use the largest and most aggressive PDI treatment plan you can sustain for 3-4 months while you attempt to support your natural ability to heal and eliminate the foreign fibrous tissue from the shaft of your penis. The PDI large plan tends to get the best results, while the PDI medium plan is the most popular; of course you can modify any of these plans any way that appeals to your understanding of your situation. Any of the model plans you see on the PDI website can be modified to be smaller or larger, or contain a therapy you prefer, based on your knowledge of your particular situation. If you need help in this area please let me know.
4.The European “needle puncture” technique to break up Peyronie’s plaque is called the Leriche technique or needle plication. Please see “Leriche Technique for Peyronie’s Surgery,” and “Does any Urologist Perform a Needle Aponeurotomy for Peyronie’s Disease?”
Lastly, your method of forcefully straightening a 90 degree bend so you can have intercourse should not be used. There is a good chance you are injuring yourself and causing the developing of additional scar formation by stretching your tissue in this way. I strongly suggest that you do not do this. Perhaps you could get some good information and helpful ideas from my book, “Peyronie’s Disease and Sex.” TRH
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I ran across comments on your site regarding the use of ultrasound therapy. Do you have a suggested protocol for intensity, frequency (1 vs 3.3) duration, etc?
There seems to be a rash of great interest lately in using ultrasound treatment for not only Peyronie’s disease but also Dupuytren’s contracture. I suppose this is the way the internet works.
Yes, I have a detailed protocol for using the ultrasound machine for the particular problems of Peyronie’s disease and Dupuytren’s contracture that is being sold on the PDI and DCI websites. This protocol is specific for this particular machine, and would not necessarily apply to other ultrasound units. Further, this set of treatment guidelines will probably change over time as our research with ultrasound continues. For these reasons I hesitate to share the specific ideas with others who do not have such a unit. They might not know how to adapt my protocol to their machine, and they would be outside of the loop when later changes are made to improve these treatment instructions.
I can tell you, however, that I strongly advise against the use of the 1MHz frequency ultrasound machines for treating PD and DC; the 3MHz is preferred.
There is a great difference of effects from ultrasound on living tissue when delivered at higher (3MHz) and lower (1MHz) frequencies. The reader might need to be reminded that 1MHz and 3MHz are not brand names or model numbers an ultrasound machine. Many companies make a 1MHz US machine, and a few that make a 3MHz US machine. These two terms, 1MHz and 3MHz, refer to frequency or rate of sound vibration that a particular US machine will produce. The terms mean that at 1 MHz, the sound is being produced at 1 million cycles or sound waves a second, and at 3MHz the sound is being produced at 3 million cycles or sound waves a second.
There is three times the amount of sound waves created in a 3MHz machine compared to a 1MHz machine. The higher number of sound waves get “jammed” as they enter living tissue. Thus, the higher rate of sound does not penetrate very deeply into the tissue, so they remain near the surface where they create heat, since they tend to be unable to penetrate deeper down. The greater the number of sounds waves of a 3MHz US machine is more powerful and faster, but this greater amount of sound also prevents the sound from going down into the tissue -which is exactly what we want to treat Peyronie’s disease or Dupuytren’s contracture.
Ultrasound therapy is just sound that is directed into the body to shake the cells at extremely fast speed that will heat them up. The sound produced at this high frequency cannot be heard, and it cannot travel through air; it can only travel through solids and liquids. Most therapeutic US machines are made to generate sound at 1MHz. These one million sound waves are created each second and can be driven deeply into the tissue (several inches) where they bounce around and create heat by producing friction between the cells the sound waves strike against. In addition to producing heat, this cellular vibration also increases metabolism of the cells, especially the healing process. That is how and why US therapy works.
So, what have been the results of the ultrasound therapy for Peyronie’s disease? Any breakdown in tissue? What is the protocol — daily, weekly? Does improvement happen over a certain period of time or “therapy” sessions? How long is each session?
Ultrasound has been heavily researched in the general area of how it affects living tissue. See these internet discussions http://cnx.org/content/m16192/latest/ and http://en.wikipedia.org/wiki/Therapeutic_ultrasound and http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1265028759369 (go down to page 34) to name just a few.
Since the initial research in the early 1940s there has been a growing body of good science that proves ultrasound has definite therapeutic tissue effects, especially the effect of tissue cavitation. But it is necessary to extrapolate this information to the problem of Peyronie’s disease, because no one has taken the time or spent the money to see if it applies to Peyronie’s disease. Having written that, I have had perhaps over the years had 6-8 people report to me at different times that they used US for their PD or DC and that they thought it was helpful. This is certainly not scientific, for sure. But if you and I waited for something truly scientific to be conducted by a drug company or the medical research department of a university concerning non-traditional treatment being used for Peyronie’s disease or Dupuytren’s contracture, we would spend a lot of time sitting on our hands while our conditions worsened. Because I have explored and rationalized so many of these different concepts through, especially the basic concept of synergy and applied it to PD and DC therapy, there are perhaps well over a thousand men and women whose problems have been eliminated or improved in various degrees. By being proactive and using common sense many people have been helped.
I am working now with an idea that the men and women who will be using ultrasound therapy for the PD and DC problems can be used to assemble raw data about the therapeutic effects they experience. Not exactly sure how I will eventually go about doing this, but perhaps I can make it happen.
The therapeutic effect of ultrasound is not to break any tissue down, but simply to increase metabolic activity of the tissue being treated so that natural healing and repair is accelerated. In so doing this, the net effect is often a breakdown of foreign and abnormal cells, and their eventual removal as part of the desired healing process.
Treatment with ultrasound at this time is advised to be done three times weekly, for ten minutes each session; this might change over time as our research and comparison of results gets started. The exact protocol we propose is provided with each ultrasound machine we sell on the PDI and DCI websites, so that each person is doing the therapy the same and in a safe and effective manner.For information about the unit we sell, see ultrasound treatment of Peyronie’s disease and ultrasound treatment of Dupuytren’s contracture.
Ultrasound treatment, following the standard PDI and DCI guidelines that directs all 14 therapies that we suggest, is not proposed as a stand-alone or solo therapy; ultrasound therapy is only one part of a large, diverse and balanced treatment protocol. Anyone who uses only ultrasound therapy to treat these two problems is not following the DCI and PDI concept. As such, when applied correctly the therapeutic benefits will typically develop gradually over time. TRH
I have been using the following and not seeing many changes. I’m wondering what I should increase.
Externally: Super CP Serum, Vitamin E then DMSO 3 x day
Internally: 2 Neprinol, 1 Quercetin/Bromelain and 1 Acetyl-L-Carnitine 3 times daily between meals
1 Ascorbplex 1000mg and 1 Unique E 400mg 2 times day with meals
I will also order the ultrasound unit to go with the treatment.
Thanks for your help.
You need to tell me when you are taking these products and if/how they are being used during the day. I can at least tell you that your plan is rather limited and light compared to those who get good results with their Peyronie’s disease treatment plans. I suggest that you set up an appointment to have a telephone discussion with me soon to get you on the right track. TRH
After some vigorous masturbation I felt like my penis had puffed up around the circumference so I stopped. That very day I noticed this had made a very soft and rubbery circle (and another half circle as well), encircling my penis, (prominent mostly on the sides) almost like I squeezed it too hard.
I’ve had no pain except for the discomfort that one time masturbating, all seems well now. And I have no curvature etc..
It is not noticeable when completely flaccid. but during a semi erection (when the penis is soft but still somewhat engorged) I can see a “ring” under the skin around the shaft. It is not movable with the veins
Anyways, I have had this for 2 weeks… I have no pain or erect curvature. Great erections… Just this thin soft/rubbery thin stringy thing that isn’t hard or obstructive.
Do I have Peyronies disease? Does it ever present this way early on?
No, not much of what you describe sounds to me like early Peyronies disease. It sounds like not much more than some inflamed and swollen tissue that should clear up in a short while. If it does not start clearing up soon, say in another two weeks, I suggest you have it looked at by a urologist.
However, let me put you on notice, my friend, that any masturbation technique that is aggressive enough to cause that kind of tissue swelling and inflammation two weeks later might just as easily have caused Peyronie’s disease. In this sense I think you were lucky this time. But, you might not be so lucky next time. I have a feeling that you masturbate with some frequency, and perhaps even with some degree of aggressiveness. This might be the reason your rubbery ring has persisted; I suspect you are continuing to masturbate even though you have this bruised tissue ring problem. While it is not my intention to tell you to stop masturbating, I definitely do want to caution you that you should reconsider how you are masturbating (and how often, since this gets back to the issue of being abusive to the delicate tissue of the penis shaft.
Please lighten up and enjoy a slower and more gentle experience. Peyronie’s disease is a terrible thing to happen to a guy. You do not want to be the man who brought it on himself in this way.
For additional information please see Is there a connection between masturbation and Peyronie’s disease? and Can masturbation cause Peyronie’s disease? and Is it beneficial to achieve erection and masturbate in the early stages of Peyronies disease? TRH
Hi Dr Herazy,
I have had Peyronies for 2 or 3 years now and visited a GP who said if does not interfere then leave it but things have changed lately
I have an upwards curvature and can have sex but the penis is not hard enough and I am not able to ejaculate easily – I have no pain
I am in Australia and want to order products. Because of freight I should get a sufficient supply- I notice you have packages but they do not contain Neprinol. I read about and would like to order Neprinol – could you recommend the best way to buy a range of products
Also can you give me your thoughts on the use of penis extenders to correct the curvature
Sorry to hear of your problem.
You were given the stock medical information: “If you have Peyronie’s disease and have a curved penis that does not interfere with sex, leave it alone until it is bad enough to bother you and we can talk about penis surgery.” In my opinion, this is bad advice because you have lost time and opportunity to do something to help yourself recover from PD. Your Peyronies problem has slowly worsened during that time so you will now have more work to do in order to recover.
The softness of your erection is due to the Peyronie’s scar preventing the valves in the penile veins from closing completely. When this happens the veins cannot trap blood in the penis to engorge it with blood, and insufficient hydraulic pressure is created to develop the usual hard erection to which you have been accustomed. The problem is not ED (please do not take ED drugs like Cialis and Viagra because they can make your Peyronie’s disease worse), but the problem is the presence of the PD scar. The scar is acting like a foot being put in the door way and preventing the door from closing. You need to reduce the size and density of the scar so your penile veins will be able to close once again.
Neprinol is a wonderful product. It contains serrapeptase, nattokinase, bromelain, co-enzyme Q and papain in a good ratio at a high concentration. By far, it is most popular systemic enzyme product we offer as part of any Peyronie’s disease treatment plan.
Most, if not all, of the information you will need to use Neprinol to reduce or eliminate the fibrous Peyronie’s plaque can be found at the Peyronie’s Disease Institute website. Please visit our website for additional information not only about Neprinol but diverse and synergistic group of valuable Peyronie’s therapies.
There are two reasons Neprinol has not been included in any of the three standard PDI therapy plans we offer. It was omitted from these entry level plans due to the rather the practical consideration of not starting treatment with a potent enzyme product like Neprinol. Some men cannot handle the dumping of tissue toxins that such a concentrated enzyme product sometimes produces. Also, there is the economic consideration. Neprinol comes in such a large bottle (300 capsules, compared to 100 capsules of Nattokinase or Fibrozym), and the ingredients in Neprinol has 6-8 times more concentrated “functional units” of enzymes. Therefore, it costs more initially but this is actually a better deal because of better results and the fact you would be taking fewer of them. If Neprinol was included in any of the standard Peyronie’s disease treatment plans the higher price might discourage some men from starting treatment. For these reasons the smaller and less concentrated Nattokinase and Fibrozym are included in the small, medium and large Peyronie’s treatment plans, to allow a man to acclimate his body to the changes these enzymes can create.
The best way to get a diverse range of products at the best price is to purchase any of plans you find on the PDI site. The most popular plan is the medium Peyronie’s treatment plan, but the one that gets best results is the large plan. You can modify any of the plans you see, either making them smaller or larger as you choose to do so, based on your current thinking. In your case you can also follow the basic format of the small, medium or large plan, but remove the Nattokinase and Fibrozym and replace both of them with a single bottle of Neprinol. Your choice.
Penis extenders can hurt you, as they have injured many men to whom I have spoken. Please read Penis Extender Claims and Peyronie’s Disease or Penis Stretchers: Big Problem as Peyronie’s Treatment. TRH
Do you think that acupuncture could help Peyronie’s disease? Did you ever hear about this?
If you go to the PDI at Acupuncture for Peyronies treatment you will see that I have always promoted the use of valuable treatment for this purpose.
When I started to advise people about Peyronie’s disease treatment I suggested that they go to an acupuncturist for treatment. Many could not afford the ongoing costs of treatment.
For this reason I searched for and found an economical option, the Genesen Acutouch pointer pens that allows a person to provide a sophisticated and affordable acupuncture treatment at home.
To read about this option go to Genesen Acutouch treatment.
Please let me know if I can help you in any other way.
From the time when I was 11, I used to masturbate, and several times after masturbation, I pulled my penis so hard that I heard a kind of sound from end of my penis.
Another bad habit I had was the wrong way of masturbation. I used to bring my legs closed to each other and then moving or inserting the erected penis between the two legs. After a short time I saw that my penis is curved, narrowing form its end where a kind of line like rupture and weakness is seen.
Now when I get erection, I lose it and get back soon, it can’t stand erect which makes me unable to achieve penetration. Although, I have erection, but it can not be maintained. While having intercourse it curves down from its end I mean the place where it is weak and narrowing. And also I think I ejaculate very quickly.
What should I do? I need your help!
In our area we don’t have experienced doctors, so please help me. Now I am 19 years old, the age when I lost self-confidence and seeking for help. I need your help, Please! Help me !!!!!!!!!
I am looking forward to hearing from you.
Yes, you do need help. You need more help than I can offer here to sort out what has happened to you over the years due to your rough masturbation practices. It is fairly common for Peyronie’s disease and masturbation to be related to each other simply due to repeated injury.
In your case, the first thing you need to do is to get a complete urological examination even if you have to go outside your area, so you and I can both be certain you have Peyronies. If you have not told your parents, or an adult in your family, about your problem you should do so now if you can do so comfortably and without concern for reprisal.
If you feel embarrassed talking to a family member about what is going on with you, then simply tell them, “I have pain in my private parts and I do not know why.” That story will protect your privacy, make you feel comfortable that you are not saying more than you want to say, yet it will also let an adult know you re in trouble and need medical care. If that adult wants to go into the exam room just tell them that you feel embarrassed and that you would prefer to go in alone. Once you get to the doctors office you can get a lot more specific and accurate so the doctor will know what to do with you.
There are very strict HIPPA laws in place today that will protect your privacy as an adult. This way no one from the family needs to know what is going on, but you can get the diagnosis you need.
You may or may not have Peyronie’s disease. I cannot tell you what is going on from the limited information you provided.
If it turns out that you do have Peyronie’s disease you must keep in mind that many boys and men have made the same mistake you have made by masturbating too aggressively; you are not alone in this problem. You need to learn how to achieve orgasm while using gentle and pleasant self stimulation. If you need help along this line, please let me know and I will guide you to appropriate resources.
Let me know how it goes for you. If your parents want to use Alternative Medicine to treat your problem, contact me again and we can work together. TRH
Bent penis usually means Peyronie’s disease later in life
A curved penis can be normal for some men, or it can indicate the presence of a problem for other men. Just because the penis is curved does not necessarily mean there is a problem.
For the most part, the fact that penile curvature exists at all in a man does not indicate a true abnormality or reason for concern; an abnormality is more so suggested if there is a change in the appearance and structure of the penis if it was previously straighter than it is now and only later became curved.
If a diagnosis of Peyronie’s disease has already been made to explain the bent penis you are asking about, you should consider using Alternative Medicine treatment to assist and support the body’s natural ability to heal and repair the Peyronie’s plaque that causes the curved penis and the various signs and symptoms that are a result. Click here to find a good place to start learning about non-surgical and non-drug Peyronie’s treatment.
When did the bent penis begin?
Usually the answer to the question, “When did the curved or bent penis begin?” will usually indicate if there is an actual problem to justify concern.
If your husband’s penis has been curved since childhood, or for as long as he can remember, then there is a very good chance that he has a normal variation of the shape of his penis. This is called a normal penis curvature and is often simply due to a variation of the size of the internal chambers that make up the body of the penis. In a congenital curve of the penis there is usually no pain associated with erection or intercourse.
Also, in regard to when the penis curvature occurred, it is not uncommon for Peyronie’s disease to develop after certain medical procedures or treatments:
- Use of Viagra, Cialis or Levitra (PDE5 inhibitor drugs) that have been known to cause damage to the internal tissue of the penis when an exaggerated or excessive erection occurs. For some men this can happen after just one use of these drugs, or for other men after multiple uses that previously did not cause any unusual reaction.
- Use of beta-blocker heart medications that are used for chest pain and arrhythmia to name a few. There are many beta-blockers used, but a few of the more popular are Lopressor LA, Sectral and Tenormin
- Use of some cholesterol lowering drugs (statin drug group) that have a long list of known side effects, but recently have been expanded to include Peyronie’s disease. There are statin drugs in this category, but a few of the more popular are Crestor, Lipitor, Lisinopril and Lovastatin
- Having been catheterized as part of surgical procedure, especially when done while under anesthesia while in a hospital setting. Many times greater force is used to pass the catheter tube through the urethra due to time constraints and urgency, resulting trauma to the penile tissue.
If your husband’s penis curvature started recently or sometime after his teen years when it had been previously straight, then this suggests a problem for which he should make an appointment with a urologist for an examination and diagnosis. The most common cause of a curved penis that appears after it was previously straight, by far, is Peyronie’s disease. Other less common causes can be:
- Trauma to the penis that causes simple swelling
- Trauma that causes penile fracture
- Penile cancer, although very rare
Diagnosis of Peyronie’s disease and the curved penis
Typically, in cases of an adult onset curved penis, there are three primary findings that usually have to be met in order to establish a diagnosis of Peyronie’s disease:
1. Presence of one or more nodules or areas of hardness located under the skin of the shaft. These localized nodules are not seen on the surface, but a felt by digital examination below the skin; some can be so large that the surface of the skin is elevated from below by the nodule.
2. Pain, from mild to severe, from occasional to constant, in some area of the penis while erect. A small percentage of men experience penile pain while flaccid (non-erect), and an even smaller percentage experience pain during both states.
3. Recent development of curved or bent penis, or some other similar distortion of the penis (bottleneck, hourglass, or indentation).
A diagnosis of Peyronie’s disease can still be made without one of the above findings, if the other two are dominant and reliable. Other findings of slightly less frequency and less importance seen during Peyronie’s disease, that are of some value in making a diagnosis are:
- Loss of penis size in terms length and circumference (girth or diameter).
- Reduced erectile ability in either the entire shaft or a localized area of it.
The important thing is to not ignore the penile curvature and to do whatever you can to avoid Peyronie’s surgery whenever possible since the side effects can be devastating.
A few months ago I noticed a slight curve/tilt in my penis to the left side. I figured it was due to the way I lay when I sleep, and I thought it would go away soon. But, now, it's months later and it hasn't gone away, and I'd say it's gotten a little worse. I'm thinking it's Peyronies Disease, but I'm not sure. I seem to have most of the symptoms: one part of my penis looks like it's pinched, there's an area of inflamed skin on the underside of it, and there's the curvature I mentioned. However, there's no pain (except lately I feel a very minor, dull pain near the inflamed area after ejaculating which lasts for a few minutes, and the curvature also gets worse for a few hours after ejaculating), and the curvature is only maybe 30 degrees to the left at its worst.
Considering there's no significant pain, and considering the curved penis isn't too major and my penis still works just as fine as it did before, is there a chance that it's maybe not Peyronie's Disease? Or maybe a mild form of it? I'm convinced it's from rough masturbation, and if it is, is it possible I can cure it naturally by maybe stopping masturbation and being more careful from now on?
The curvature seemed to show up overnight, but I recently remembered that I noticed the "pinched" area maybe a few months before the curve showed up. So, it seems that this happened gradually (if that makes a difference at all). I also realized that I started lifting weights around the time I noticed the pinch effect, and as I've continued to lift weights it seems like I'm seeing more and more symptoms of Peyronie's Disease. (I haven't physically damaged my penis with weight equipment at all, but I'm wondering if maybe the strain from lifting is stressing my tissue? Could that be a cause?)
Thank you very much, Dr. Herazy, and I'm really hoping I can fix this problem with your advice.
My first advice is to stop guessing and wondering, and make an appointment with a local urologist to have your problem formally diagnosed. The tissue inflammation and pain after ejaculation are not typical of Peyronie's disease and could indicate other problems.
Lastly, the strain of weight lifting would not cause Peyronie's disease; if you have it, rough masturbation is much more likely a cause. Please review the article in the PDI website, Peyronie's disease and masturbation.
If your condition is diagnosed as Peyronies then I suggest you consider putting yourself on a treatment plan to increase your natural ability to reduce and eliminate the foreign fibrous tissue of the PD plaque. Let me know if I can help you in any way. TRH
What does your natural vitamin C have in it? Why is it called natural? Thank Dave G
The vitamin C product from Douglas Laboratory is highly regarded for its quality and purity, and is the reason PDI has selected it as part of all Peyronie's disease treatment plans. It contains 1000 mg of ascorbic acid and the full bioflavinoid complex as is found in rose hips. The base of the rose is a powerful source of vitamin C as it occurs in nature. The vitamin C in this supplement is extracted from the hip of the rose plant (right below the base of the flower petals) and this is why it is called "natural". TRH
I have had Peyronie's disease for about a year now. I have been doing lots of research and plan to purchase your medium plan. I feel that will be a god starting point. I have seen some other options with success stories, in particular, Serracor-NK mixed with Serra RX 80. My question is can I add these supplements to your medium plan in hope to defeat the disease better. Is that healthy, or would that be too much? I read that the Serracor-NK has nattokinase in it which is one of your supplements in the medium plan, so would this be pointless or do you think that would be ok?
It seems most everyone makes changes and adds variations to the basic PDI-based treatment plan. I cannot comment on the products you mention because I have no direct experience with them. The problem with using these products is that I have been told that there is little information that has been made available about how to use these products.
The medium plan is already a well diversified way to increase your ability to reduce your Peyronie's disease. I suggest that you simply start with the medium plan and see what it can do for you as it is presented. If at a later time you think you might want to add some additional therapy you could always use the products you mentioned.
When you order your medium plan you will be impressed with the amount of information you will receive that describes in great detail how to use each component of the 10 items in that plan. No one says that they do not understand how to go about using their therapy products after reading the information that is given with each order.
Lastly, in my opinion Neprinol is a better fibrinolytic enzyme product than those you mention, based on the formulation and the feedback I receive from people who have used both. That is why we promote its use and not other enzyme products. The ultimate decision is always yours.
Let me know if I can help you in any way. TRH
Is anyone doing research on the possibility of Viagra causing Peyronie disease or any other type of medication causing this disease? Mine seems to have started after I took Viagra . Thank you, Floyd Mathis
Sorry to hear of your problem with Peyronie's disease.
Yes, there is growing evidence that Viagra, Cialis and Levitra (all the PDE5 inhibitor drugs) can cause Peyronie's disease in some men. I have reported this and written about this observation for many years now. You can read more about this topic in these posts from the PDI website: Viagra Peyronie's disease connection and Viagra, Cialis and Levitra Use with Peyronie’s Disease and Peyronie’s Disease Plaque, Viagra, Cialis, Levitra, and Blood Supply . There are more articles that are available but I think you will get the idea from these.
The basic way the injury happens that leads to the start of Peyronie's disease is from "over inflation" that damages the internal tissue of the penis called the tunica albuginea.
I was talking to a man the other day from Australia whose PD started from just a single use of one of these PDE5 drugs. He told me that he developed an erection that was so hard and large that he was scared what might happen to him. He said he thought he might explode. Obviously that was the last and only time he took any drug like that. About two months later he had three internal Peyronie's plaques and a curved penis of 45 degrees. Because he did not have any sexual activity for months before that event or after it he is positive it was the drug that injured him.
He went to his medical doctor who told him that this sometimes happens to men. You will notice that there is a caution on inside drug product information that warns that men with PD should not use these PDE5 drugs.
What strikes me as especially careless and inappropriate is that there are medical doctors who actually prescribe Viagra, Cialis and Levitra to men who already have Peyronie's disease to help them have an erection when they show signs of erectile dysfunction.
Yes, there are other drugs that are said to be associated with or to cause Peyronie's disease. The common list includes beta blockers used for heart problems and all of the statin drugs used to lower cholesterol.
I suggest that you review some of the Alternative Medicine treatment ideas on the PDI website to learn how you can use Peyronie's natural treatment to help yourself correct this problem. Please let me know if there is anything I can do to help you. TRH
I’m 31 and I have been diagnosed with Peyronie’s disease this year. I had trauma during sex in January and after about a month the scar appeared and I started to have pain in the beginning of the erection, and since that time pain varies. During sex I don’t have any pain.
I have changed 3 urologists because they have very very poor knowledge about Peyronies and they said there is no cure for it. One of them said that my body reacts to trauma by making an excessive amount of scar tissue. I mentioned to him that 5 years ago I had trauma on my ear and I had a keloid develop which was removed with an operation. They all want me to wait and see what will happen with the pain and penis curvature. In other words, no treatment until the scar stops growing and pain disappears. When that happens their solution is injection of Verapamil or operation, but I don’t want that especially now when I discovered your website. You already help me a lot in understanding Peyronie’s and I’m continuing reading everything I can on your site.
The scar is on the upward right side and its size was like the bean when I discovered it and after few month it was bigger, and last month my penis bend towards up for about 20 degree (I can send you pictures too). I started taking vitamine E 400mg per day from April, and last month I’m taking 600mg. Now I know that only Vitamin E isn’t enough (and it didn’t help me) and I want to buy some products from your PDI website. Can you help me to decide which program to buy? I’m from Croatia and I would like to order supplies for a few months including CDs and books too, so I don’t have to order every month and wait for it. I’m worry when I order something that I have problems on customs and I don’t get your products. Do you have some experience with that?
Based on what you have described I suggest that you consider getting the PDI medium size plan.
There is indeed a cure for Peyronie’s disease. The body cures and eliminates the Peyronie’s plaque in about half the men who develop this problem. That is a rather good success rate. What the MDs mean is that they do not have any method to help you, although it is obvious that the body generally does a good job of eliminating this problem when given the opportunity.
We have had some problems with Croatia customs. I suggest that if you have a friend in the U.S. or the UK that you have your friend receive your plan from PDI. Your friend could then send these products to you as a gift. I cannot send an order to you as a gift. This I believe is a legal thing to do and might help you receive what you want. TRH
I now take Neprinol 4 pills 3 times daily, vitamin E 2 pills 400iu 3 times daily, Sulfur 2 pills 3times daily, and Scar x 2 times daily, e oil, and Super CP Serum with DMSO. Sometimes progress seems very slow but have only been doing this dose for about a month. Have been about half this dose for about 7 months. Any advice?
What if I have had Peyronie's disease for a couple of years without any treatment?
Would hydro heat therapy benefit me in any way?
I do not currently have health benefits but will before the end of the year.
I would prefer to avoid surgeries and would be interested in learning more about viable lower cost treatments.
My urologist in MA said that as long as I can get and maintain en erection there is little else he can do.
I am in the Tampa area now. Perhaps a new doctor? I can still have sex with my wife, but the curve is making it more challenging to perform.
Since 2002, while working with men who have Peyronie's disease, some have had PD for 10 years and more; most are in the 18 month to three year range, but many have come to PDI for help without any treatment even though their problem has continued for many years. When most men who have had PD for many years follow an aggressive treatment plan and apply it faithfully and well, they seem to respond about as well as those who have had PD for a relatively short time. Age of the Peyronie's disease does not seem to influence treatment outcome. What seems to influence outcome of natural Peyronie's disease treatment the most is the diversity of the treatment plan and how well it is conducted.
Moist heat packs are always a good addition to any Peyronies treatment plan, but should not be considered a serious solo treatment for a problem as difficult and stubborn to treat as PD. For many years I have recommended men who follow a medium or large PDI treatment plan also use moist heat especially before using DMSO, manual stretching or Genesen Acutouch pointers in their treatment plans.
Yes, by all means do all that you can to avoid any surgery. Especially try to avoid Peyronie's disease surgery that has a poor record of post-surgical outcome, side effects and complications, and recurrence and worsening of the original problem. There are many men who rue the day they were cut on for their Peyronie's plaque because of significant worsening after surgery. The PDI website is estimated to have 2,000 pages of information about natural Alternative Medicine treatment of Peyronie's disease for you to read and learn how to get healthy without drugs or surgery.
If you have any specific questions about using Alternative Medicine to increase your ability to eliminate your PD plaque just ask and I will do the best I can to help you. TRH
Hello Dr Herazy. My peyronies is very mild it was done in a sex accident around 7 months ago. My penis is still straight when erect and hasn't really changed. I just noticed a little more bend in my penis when I went to urinate in the morning. My condition is stable and isn't really changing. My urologist said it was a traumatic form of peyronies. There is no real scaring but noticed when I did it a small line on the side of my penis more noticeable when erect. I was thinking of using your Unique vitamin E oil. Does it have the tocotrienol parts of vitamin E in it? Thanks for reading my question.
Yes, Unique-E oil has both all four members of the tocotrienol part of the vitamin E family, as well as all four members of the tocopherol part of the vitamin E family. I trust you need to know that in addition to using the topical vitamin E you should use PMD DMSO after the vitamin E is applied to the area so that the vitamin E can be taken deeply into the involved tissue.
Further, you should not assume that your Peyronie's disease will stay the way it is now. Peyronie's disease is not a static problem; it changes over time, sometimes slowly and sometimes rapidly, but it seldom stays the same for very long. Most people take the position that it is far better to use Alternative Medicine to treat the Peyronie's problem while it is still small and manageable to keep it that way. TRH
Can I cause more damage to my Peyronie’s disease due to difficult penetration during sex because of a partial erection?
Hi Dr. Herazy,
I started having some pain with erections about March 2012, seen family doctor, asked if penis was bent and when I self examined, and yes it was. He then told me I had Peyronie's Disease. I had about 30 degree bend to left and could still enjoy sex. Most pain has subsided, but about 2 weeks ago, found I could not make penetration with my wife. Upon self exam, I see I am not getting full erection, top of penis is soft while base is erect. I gather there must now be full blockage to the end of penis? I am thinking of trying your medium treatment plan. Also, can I do more damage if I try again with my wife? I was also thinking of trying CyberSkin Transformer, would that help? Like every other guy, this is a huge blow to me.
Your assumption that your poor erection quality is due to a "full blockage to the end of the penis" is not correct. Actually, the opposite is probably true.
In Peyronie's disease the reduction of erection strength is typically due to the Peyronie plaque preventing the closure of valves in the penis veins. When these valves cannot close the blood that is normally circulating within the penis simply is not trapped and collected to create the hydraulic effect known as a erection. Imagine what would happen if you attempted to blow up a balloon that had the other end cut off. Any amount of air you would blow into the balloon would not be trapped inside and the balloon would not swell and become firm with increased internal pressure caused by air being collected in an enclosed space. To say it another way, if you try to warm up your bathroom in the winter you must close the door so the heated air can collect inside the enclosed space. Opening the door allows the heated air to escape. In the soft area of your penis the blood is not being trapped because the scar prevents closure of the valves that trap blood. Your blood circulation in the penis is probably as good and uninterrupted as it has ever been, it is just not being collected to create the hydraulic pressure a good erection requires.
What is probably happening in your situation is that the fibrous material related to your Peyronie's disease has advanced now to the point that the internal Peyronie's scar or plaque material is getting larger and reducing the ability of the valves to close to trap blood and create a complete and normal erection. The solution involves reducing the size of scar, or even eliminating it. That is where the PDI treatment plans come in to help you heal them as they normally are healed in about half of the cases. The medium plan is a popular way to get started with Peyronies treatment.
Sexual penetration with a partial erection can be difficult and dangerous. It is dangerous in the sense that a partial erection can suddenly bend and buckle during intercourse and this can result in further damage to the tunica albuginea and make your PD worse than it is now. I suggest that you get the 2nd book I wrote, "Peyronie's Disease and Sex" that will explain in great detail how you can maintain your sexual activity in spite of having PD. It is a great book that has helped many couples in this vital area of life.
The Cyberskin Transformer series of products are effective in providing additional support to the penis to reduce – but not totally eliminate – the possibility of sudden bending during sexual activity that can further injure the penis. There are other products as well that PDI has available for this purpose like the Girth Prosthetic Rings, Invisi-rider Enhancer and the Reversible Sleeve. All of these can be found at the sex supports/aids section of the PDI store front.
Peyronie's disease can be a tremendous personal stress to everyone who is in a relationship who has to deal with the outlandish physical changes that can happen to a penis. The important thing is that you work to do all you can to reduce those changes by increasing and supporting the natural ability of your body to eliminate the internal fibrous scar tissue that causes the curved penis and weak erections of Peyronie's disease. Please let me know if I can help you in any way to correct your problem to the greatest extent possible. TRH
I am a young adult male from CA. I have been cursed with Peyronie's disease at a young age and it is destroying my youth. I am practically bed-ridden with depression and I can't even sleep right anymore. All I want is to fix my Peyronie's disease. My plaque doesn't even cause bending, it is in the base of the penis and is causing a severe narrowing of the tunica. My erection hangs low now and the deformation can be seen easily. You could call it "baseball bat" shaped. I lost my job due to my severe depression this has sunk me into an even deeper state of gloom. I can't afford to pay for anything on the site. Please Doctor Herazy you are the only person who I think can help me. Everything else is just suggesting thatcher's formula or surgery, but they think my penis is curved.
I eagerly await your reply.
I could write a 10,000 word response to your email, but I simply do not have the time or opportunity to reply to all the levels of the different problems that you express in your email.
The fact that you do not ask a question in your email suggests that you have not attempted to learn about how you might be able to help yourself out of this problem. You wish for me to fix your problem, and I cannot; only you can. The fact that you suggest I am the only one who can help you tells me that you are not taking any responsibility for your recovery but would rather put that burden on me. This is not the way that Peyronie's disease treatment works, and for that matter it is not the way that anything in life works. You need to re-evaluate this aspect of your personality and mindset to see how this has affected your response not only to Peyronie's disease but to other aspects of your life.
You are making your situation worse by wallowing in self pity and you amplifying how your condition is affecting you. You are the one allowing yourself to be bed-ridden with depression. You are telling yourself that your life is being destroyed and you are believing that voice as though it was the truth. You are making your problem worse than it is, you need to take control of yourself, and you need to correct these deeper and larger issues that bother you.
You say you are bothered by your observation that the baseball bat deformation can be easily seen. You are investing far too much worry and energy in the idea that someone else will look at your deformity and think less of you. This bothers you as much as it does because you already do not think much of yourself and have been bothered by low self-esteem for most of your life. I suggest that your poor self image is what is really at the base of why you feel that your youth is being destroyed.
I also suggest to you that you have always had many problems in life that have overwhelmed you, and Peyronie's disease is just the latest to flatten you out emotionally.
Please allow me to help you by telling your to seek professional help for your other problems. In the meant time, you should investigate a bit about Peyronies treatment and attitude. TRH
Hi Dr. Herazy -
My name is Chad, and I’ve had Peyronies about 4 years. I purchased some of your products to treat Peyronies about 3 years ago. I used them and saw great improvement (I only had a slight curve). Each year I seemed to be getting better until suddenly, about 2 weeks ago, I’ve started having much more difficulty getting and maintaining erections. Also, I’ve had some odd sensations throughout the day, and I seem to have a bit more of a curve. I’m feeling nervous that I may have agitated or reinjured it. Have you heard of this happening before?
Yes, it is possible to re-injure yourself again; if you did it once, you can do it twice.
I suggest that you begin treatment again because the odd sensations you mention and return of penile curvature could be due to aggravation due to a intercourse-related injury. It might also be wise for you to consider using some type of penile prosthesis or support that can work to provide an added level of protection during the rigors of intercourse. bear in mind that none of these devices is foolproof and re-injury while using one of the penis supports we offer at the PDI store is still possible. It is always necessary to use common sense and good judgement in regard to how you conduct yourself during intercourse.
It might also be a good idea to get “Peyronie’s Disease and Sex” that will provide considerable information about how to avoid doing this again.
Please let me know if you need some assistance in getting started this second time around. TRH
Hi Dr. Herazy,
I have been told by two urologists that I have Peyronie and told to come back in 4 or 6 months. I originally felt a tighter than usual erection and latter felt a lump inside my penis. I can feel this with my thumb and another finger, like a small ball inside the shaft close to the base. I am not sure how long I have has this for. I am not sure for how long a have had the curve upwards. It’s not big and I have asked my wife and she is not sure either. Looking closer I can feel where the bent is. I have had no major trauma etc.
I don’t have pain on erections but have been feeling some itchiness type pain when flaccid. And if I have been sitting for long time, I have felt really uncomfortable tightness beginning from under my scrotum to the top of the base of my penis. I get the sense that it’s where I felt the lump.
I have read that TRENTAL/PENTOX/OXPENTIFYLLINE has helped some people in combination with CoQ10 and have got a script from my GP. I took a test run today of TRENTAL 400 to check for side effects — none so far.
Should I continue with this?
I cannot comment whether you should take pentoxifylline (pentox) or not. That is a decision you must make for yourself in consideration with the advice offered by your treating doctor. Ultimately you have to feel confident with your treatment and know that it is right for you, and not just simply do what you are told to do.
It is good that you have not experienced any side effects to pentoxifylline, but the real question is if it will help your Peyronie’s disease or not.
I suggest that you consider using Alternative Medicine in the way that is described on the PDI website. Let me know if you have any questions in this regard. TRH
My husband will not see a doctor about his curved penis (we think it is Peyronie’s disease), what should I do?
Avoiding medical care for Peyronie’s disease is common
Refusal to see a doctor about a bent penis is an unwise but common reaction among men who find themselves dealing with the long-term negative prospects of Peyronie’s disease. The male tendency to be slow about seeking medical attention in general is compounded by the shock and utter disbelief of learning that there is actually a urological medical condition called Peyronie’s disease that undermines the ability to function as a sexual human being.
In Peyronie’s disease the development of fibrous plaque tissue below the surface of the shaft results in a curved penis or some other deformity that reduces or eliminates the ability to engage in sexual intercourse. Making matters worse it frequently reduces the length and girth of the shaft, as well as weakens the quality of erection.
Take advantage of the fact the body cures Peyronies disease half the time
When a woman looks for helpful information about Peyronie’s disease she can turn to the Peyronie’s Disease Institute woman-to-woman program for a telephone discussion during which our nurse will answer any questions about PD treatment, sexual dysfunction problems or anything that is of interest to a woman when her husband will not help himself.
The proposal that a man can move his status from someone who was not able to eliminate his own Peyronie’s disease to become a member of the 50% group who rid themselves of this affliction is a simple and easy one to understand. It is based on the observation that about half of the men naturally and spontaneously heal or correct their Peyronie’s disease within the first 12-18 months after onset.
When a man finds that he has not self-corrected or eliminated his Peyronies plaque he still has the option to promote his own recovery. This can be attempted by an aggressive plan to actively support or increase his natural healing ability using several different natural therapies identified by medical research to assist the removal of the offending fibrous plaque material. To find out more about this process go to “Start Peyronie’s treatment.”
Alternative Medicine offers natural treatment options to Peyronie’s surgery and drugs
Since 2002 the Peyronie’s Disease Institute has developed the concepts, as well as nutritional and external techniques, that proposes any man can follow a program of self-administered Alternative Medicine care in an effort to increase his ability to heal and repair the Peyronie’s plaque. By focusing multiple therapies to enhance healing potential many men find they can increase their immune response against the soft tissue changes that cause all the outward signs and symptoms that are so deeply disturbing and disruptive to normal male function.
This is good news for any man who realizes that there is indeed a cure for Peyronies disease; half of the time the body will naturally rid – or cure – itself of the internal scar or plaque material that causes all the problems of altered sexual structure and reduced sexual ability without any outside help or intervention. In other words many men just get rid of their own PD without any help. Using well placed and logical assistance that is guided by research done in this area for the last 40 years, the Peyronie’s Disease Institute finds that it is often worthwhile for a man to simply support his immune system to reduce the foreign fibrous material of Peyronie’s disease in order to support his tendency to eliminate his PD fibrous plaque as happens half of the time.
A woman can help her man in many ways
Probably as the two of you were going through information on the Internet your husband got stuck on the idea that there is nothing that can be done for PD except Peyronie’s surgery, which the Internet information also reports will be followed by recurrence of the same problem in a few years and the possibility of side effects that are sometimes worse than before the surgery (loss of all sensation, constant pain, impotence). With the negative atmosphere and bleak prospects for medical care associated with Peyronie’s disease many men feel a natural hesitancy to get started moving in that direction.
A great paradox commonly develops for a couple when they struggle to understand what is happening to them when they are first learn about Peyronie’s disease. The contradiction is that after getting the diagnosis and learning about the disease that neither of them knew existed, the man is typically motivated by embarrassment and fear of the future to be quiet and introspective while the woman instinctively wants to discuss the problem and explore her feelings with others. As time goes on and Peyronies exerts its negative influence on their lives, each will be driven deeper into their opposite direction, and each will not understand why their partner is behaving that way. This makes for increasing tension between the couple while they should be coming closer together to deal with their mutual problem.
The special relationship between a woman and a man is always tested greatly when Peyronies enters the scene. While not absolutely true, it has been my observation that most couples will find that the many trials and tribulations of Peyronie’s disease and women will cause whatever is good and strong in their relationship to increase and become better, and whatever is troubled and weak in their relationship to deteriorate further. Peyronie’s disease does not actually create new conflict within a relationship, but only increases and intensifies whatever strength or weakness was present before it arrived on the scene; it acts as a great reference point that amplifies whatever was going on between the couple before its arrival. It does not have to be that way, but it happens because people are not prepared for what lies ahead. They are caught so unprepared for the drama that becomes their lives together that the truth of their relationship is not only exposed but it is exaggerated by the emotions that emerge.
During countless talks with PD couples since 2002 it has been observed many times that either a couple is a naturally good problem-solving team, or it is not. When it is not, and the man and woman do not work together well, it is very difficult for them to develop and practice whatever new personal skills of good communication, tolerance, compassion, forgiveness or whatever assistance might be needed to help their situation. It takes extra effort and great patience to acquire the skills and ability needed to come together as a team, while at the same time dealing with the harsh realities of Peyronie’s disease. Just as it might be difficult to learn to swim while being swept away in a flood, it is just as difficult to develop those skills that lead to becoming a solid team if at the same time they are being tossed about while dealing with PD. Having presented that observation, it should bring comfort to know it is still possible to minimize and perhaps even overcome the negative and destructive forces that develop as a result of Peyronies disease if exceptional effort and honesty are applied.
You can begin to help your husband with his Peyronie’s disease by encouraging him with information that it might be possible to help himself correct his own PD problem as those 50% of men whose internal plaque are naturally eliminated. Offer this information to him, showing him that there are more options available to him than Peyronie’s surgery.
Thoughts on using pentoxifylline in conjunction with your program?
Thanks for the interesting question.
In several places on the PDI website I have laid out my thoughts about using pentoxifylline to treat Peyronie's disease, such as Pentoxifylline, Niacin and Peyronie’s Disease and Pentoxifylline and Peyronie's disease.
I have never taken a position to say that any person should not take a medication that has been prescribed by a treating physician. If that pentoxifylline has been prescribed to you, then by all means listen to your doctor and take what he or she has ordered.
However, it just happens to be my personal opinion that what pentoxifylline is supposed to do to help Peyronie's disease recovery is not indicated or especially helpful for the correction of the Peyronies scar. The purported benefit of pentoxy is that it increases blood flow in the lower half of the body. With this in mind, please know that no one has ever reported or suggested that the cause of Peyronie's disease is reduced blood flow. What pentoxifylline does is not related to what is wrong with the penis that has PD. On top of that also know that there are fewer MDs using pentoxifylline than several years ago; it seems to be losing its popularity for lack of clinical success.
Some men do take prescribed drugs in addition to following some type of Peyronie's disease therapy that comes from PDI. I cannot report how that usually works out for them because the results have never been shared with me.
Good luck to your.
If you want to work to increase and support the natural healing of your body, that has about a 50% success rate, please let me know how I can help you. TRH
My name is DJ and I am positive I have Peyronie’s disease. I have always had a slight curve downward and to the left but very slight. I did some jelqing to try to fix this on and off over the last two years. This was a terrible mistake as I was not careful and did it too hard. It ended up giving myself Peyronies and now my curve is much worse. I noticed big changes about 4 months ago where I started to get pain and the curve was getting worse. Now my curve is probably about 50 degrees to the left and downward. It is very painful and I every day I can feel the scar tissue on the bottom of my penis get harder.
This is destroying my life and as many people with this disease, I feel hopeless. I have been taking vitamin E for about a month as well as rubbing vitamin E oil on the scars but this has not done anything. I have decided that I need to take action immediately to stop this from getting worse. What do you suggest? Should I get your large plan and start doing that? I would greatly appreciate some suggestions as I am overwhelmed and do not know what I should do.
The first thing I suggest is that you have a urologist examine your problem to verify what you suspect about this being Peyronie’s disease. However, it is possible that by excessive jelqing you only traumatized the blood vessels of your penis shaft and it is not PD. Based on the information your provided it does make sense that your problem is Peyronie’s disease, but you should really get this examination done anyway so there is no doubt about it.
By no means are you alone. About once or twice a month I hear from someone who caused his Peyronie’s disease by jelqing. By its very nature when a man does jelqing he will create an excessive and often brutal amount of internal pressure within the penile shaft that it is not built to take. For this reason when you jelq you take the risk that you can easily injure the delicate deep tissue layers of the penis, especially when repeated over a two year span of time as you did.
Using a large PDI treatment plan is a good idea in a situation like this. The more aggressive and faithful your effort to support positive tissue changes the more likely you will be able to naturally reduce the Peyronie’s plaque that may be present. I always suggest that anyone thinking about using a PDI treatment plan should first read my book “Peyronie’s Disease Handbook” because there is a lot of good self-help treatment information that is not found anywhere else.
Dear Doctor Herazy
Almost 5 months ago i felt a slight pain at the base of my penis (on the underside), i was shocked and i ran to emergency and family doctor and they did all sorts of tests to rule out infection and prostate problems. everything came back negative. during all this time my anxiety has driven me crazy. i started rotating my penis once to the left and once to the right every day and night and taking pictures for whatever i see (which was actually nothing). for five months i have been abusing my penis by twisting and rotating to check it, besides the spot of pain which is much like a bulge at the base i developed more spots, one just close to the glans and the other on the shaft, it is like thickened areas underneath the skin. i have a history of dorsal vein thrombosis which has been there for years without causing any pain, and now those spots are so painful that i cannot even walk. walking is just terrible. i am not sure if those areas are plaque or they are swollen branches of the vein due to thrombosis, i have the hourglass shape at but only after masturbation, and i cannot see any curvature during erection. the pain is really bad and i wake up everyday with it, it is worse with walking. the pain is in flaccid as well as erected penis however erection worsens it. my penis is hard and very stiff at the flaccid state and the pain is changing its patterns from sensation of wound in the erectile tissue to a sensation of burning in the spots which i developed. but the best to describe it is a disabling pain as i cannot walk. i will have to wait for 3 more months to see a Urologist, knowing that i had an ultrasound on my penis which was non-specific (pretty much looking for cysts or anything unusual as the nurse said) and the nurse couldn’t see anything……anxiety is about to ruin my life…i appreciate your advice and support.
Based on the information you provided, it is my educated guess that your problem does not sound like Peyronie’s disease. Typically, the pain of Peyronies disease is not as intense nor of a burning nature. Also, the only penile distortion you report only occurs after masturbation, and this is not at all like what Peyronie’s disease would do to a man.
My advice for you is to attempt to get in soon for another evaluation since I suspect that you could be having an aggravation of your deep vein thrombosis. TRH
you said that pd scar heal it self in (12 -18) months, but i think that is possible if one prevents any sexual activities . I am saying that because i already have pd and i almost ordered the treatment from your site knowing that i don't have sexual activities and never had ,but a few days ago i notice that my pd scar has increased after my penis became erect while i am sleeping .Now i am scared that this scar will increase more and more and the treating process will be harder, so help me.
forgive me for my tedious question.
abduallah, 20 years
I am not sure I exactly understand what it is that you are trying to say.
As a general statement I can tell you that simply having, or not having, sexual relations will not help or hurt your recovery from Peyronie's disease or worsen your condition. The primary issue about sexual activity in regard to Peyronie's disease is any potential for abuse and injury that might occur during sexual activity. Further, what I mentioned about sexual activity when done gently, safely and while using reasonable judgement and restraint, will not necessarily aggravate Peyronie's disease, the same can be said about developing an erection. Erections do not cause and cannot aggravate the problem, except if there are extenuating circumstances associated with the erection. An example of this situation would be if there is not enough room for the erection to extend outward and so it becomes painfully restricted, and forced to remain bent even though it is erect.
For further information please see "Peyronie's disease and sex safety concerns."
If this explanation does not help you, please let me know. TRH
Is the Genesen Acutouch pointer applied directly to the the Peyronies scar? How is it used for the treatment of Peyronies disease?
The Genesen Acutouch pointer pens are applied directly to the skin the over, around and near the Peyronies scar. They cannot be applied directly to the PD scar because the scar is an internal structure that cannot be reached from the outside surface.
Each Genesen Acutouch pen set comes with a 260 page manual that explains how it can be used to deliver a very sophisticated level of acupuncture treatment to over 100 common health problems. In addition, as a Diplomate acupuncturist who taught acupuncture principles and technique for many years on the post-graduate level, I have written a seven page set of notes that explains how to use this wonderful instrument to improve treatment results for Peyronie's disease.
I will not discuss how to use the device as a Peyronie's treatment least you get the idea that it should be used by itself to assist recovery from PD. There is no therapy that I am aware of that is powerful enough or so complete that it can be used by itself to correct this problem. All therapies on the PDI are intended to be used in various combinations to treat Peyronie's disease. As great as the Genesen instruments are, they should only be used in combination with other therapies you see on this website to support your recovery from PD. TRH
I got Peyronie's disease about 5 years ago through intercourse with my wife. I saw an urologist who prescribed a 3 month dose of pills which failed to do anything so we tried it again. I was then told I could have surgery which made me go into denial. The curve has got worse over the last 2 years and I’m worried about having sex so it's become non existent between the two of us. I am now desperate and have been looking at the penis extender for Peyronies – is this a possible method along with your treatments, or is this the wrong move. I'd like to get started in the right direction.
You need to do a little bit of reading. There are many articles and posts I have written about using a mechanical penis stretcher, commonly called a penis extender. Here are a few links for you to read: Penis stretcher: Big problem as Peyronies treatment and Penis extender claims and Peyronie's disease and Peyronies treatment and the penis stretcher.
Peyronie's surgery is always something that is proposed when other medical treatment eventually fails. I would caution you to consider that if your penis has already demonstrated the ability to develop too much scar after a small injury, there is a stronger possibility of an even greater amount of scar occurring as a result of the surgical incisions associated with common penis surgery techniques. This is the reason that men find their PD worse after having surgery to correct their curved penis.
From my experience many couples who live with Peyronie's disease in their lives will limit or stop sexual intimacy when it is not necessary to do so. The problem often is that their medical doctor does not know about or does not take time time to explain, some basic information that would enable a couple to safely engage in intercourse. I can assure you that within a brief time you would feel a lot more comfortable about resuming sexual relations once a few things have been explained to you. My wife, who is an RN, and I have counseled with many hundreds of couples and helped them to regain that part of their lives by simply sharing some simple information. Contact me if you are interested in learning more. Additionally, you can get a book that wrote, "Peyronie's Disease and Sex" from the PDI website.
Getting Peyronie's treatment started in the right direction is easy if you are prepared to spend some time educating yourself on the PDI about Alternative Medicine methods to increase your ability to remove the PD scar naturally. I did it, and I get emails every week from men who are doing it. I have come to realize that when the average man – even after five years of dealing with Peyronies – if he uses a large and diverse program of care and works aggressively will see positive change in 2-4 months in about 80% of cases.
Let me know if I can help you in any way to get your life together. TRH
Painful sexual intercourse of Peyronie’s disease can often be eliminated or reduced
Painful sexual intercourse when due to medical or psychological causes is medically known as dyspareunia (dis-pair-oo-nee-uh). While this kind of pain is most often reported exclusively by women, it is also reported amongst men who have a curved penis due to Peyronie’s disease.
Assuming that your husband has a curved penis because of Peyronie’s disease, there are several different ways and areas of their life that a couple can work together to improve, and possibly eliminate, the pain they experience during sexual intercourse. While most people assume that the pain is the direct result of a curved penis, it has been shown it is necessary to consider the effects of the multiple factors that are unique to Peyronie’s disease and capable of affecting sexual function. To help a situation in which intercourse is painful because of the effects of Peyronie’s disease it is usually necessary to use more than one treatment approach.
Do not make a hasty assumption that the cause of your pain during intercourse is a crooked penis; you might be right, but then again you might be only partially correct.
The topic of pain during intercourse is so common and so important to couples who deal with Peyronie’s disease that the Peyronie’s Disease Institute offers two valuable methods to learn how often eradicate the problem, or at least minimize it greatly. The first is a special program in which our staff nurse will personally consult with and advise any woman who needs help in a program called “Woman to Woman.” Women can speak to our nurse to ask questions of any sort that deal Peyronie’s disease, from the anatomy and physiology of sexual intercourse to suggestions for intercourse positions and lubrication options, as well as help dealing with sexual difficulties. The second is a book written by Dr. Theodore Herazy titled, “Peyronie’s Disease and Sex,” that covers many of the diverse problems faced by couples who find intercourse painful or restricted by a curved penis or erectile dysfunction.
There are many different deformity patterns (bend, curve, indentation, rotation or twisting, hourglass and bottleneck, as well as combinations of these) plus different degrees of those penile distortions and curvatures that can contribute to different levels of pain experienced during intercourse. Even so, a bent penis is usually not the sole reason for painful intercourse for a couple dealing with Peyronie’s disease. Just like the difficulty of putting a square peg in a round hole, a curved penis will certainly get someone’s attention and be the natural assumption for the cause of painful intercourse.
However, the amount of pain and even the absence of pain during intercourse that is due to a curved penis often presents a surprisingly inconsistent and unexpected pattern; it is difficult to predict the failure or success of intercourse, or even if pain will or will not occur, based solely on the external appearance of the man’s penis. It is not possible to say that a couple will experience pain or failure to complete entry for sexual intercourse only based on how much or where the penis is bent or distorted.
Women get help with painful sexual intercourse related to Peyronie's disease
The Peyronie’s Disease Institute nurse has advised and counseled many men and women who had not been able to engage in sexual intercourse because of pain for several years, even though the penile distortion involved sometimes is not great, less than 10 degrees. Conversely, she has encountered a large number of happy couples, who in spite of having to deal with penile curvature approaching 90 degrees, were still able to engage in satisfying sexual intercourse without pain.
Based on these observations, there must be something else going on that explains why one couple will have problems with a small Peyronie’s curve and another couple will not have any apparent problems with a large Peyronie’s curve.
From our experience it is common for other seemingly small and less obvious factors to turn out to be the sole reason for pain during sex, or at least the primary contributor, rather than the more obvious curved penis. Nevertheless, to find a solution for painful intercourse that is part of the Peyronie’s experience it is important to consider all possible factors and not the just obvious. Unless all the issues that contribute to painful sex are identified and addressed, pain will likely continue to be a problem, often getting worse over time since interpersonal problems tend to escalate.
The most common cause of pain during sexual intercourse is a simple lack of vaginal lubrication that normally is secreted during arousal to make penetration easier and reduce friction and irritation during coitus. Some common reasons a woman would experience a lack of lubrication are:
Menopause – reduced progesterone and estrogen hormone production after age 50
causes many changes in the ability of the reproductive system to operate in a way that favors reproduction. Thinning of the vaginal walls, less natural lubricant production and pain during sex are common signs of menopause.
Lack of foreplay – hurried sex does not allow for adequate time for natural secretions to be produced.
Disinterest or emotional issues about sex – a variety of past and current issues can be at play to reduce sexual interest in either partner
Vaginismus – an involuntary spasm or tightness of the muscles surrounding the vagina, especially at the opening, making penetration difficult, painful or impossible. This tightening and subsequent pain while attempting entry can have several possible causes: past sexual trauma or abuse, a history of discomfort with sexual intercourse, and at times no cause can be found. Psychological factors related to Peyronie’s disease are commonly found to be at the heart of vaginismus often develops because of anxiety regarding sexual intercourse, such as remembering the traumatic event that happened during intercourse that caused the Peyronie’s disease injury in the first place, the guilt and anxiety about causing his Peyronie’s disease, the anger about being in a relationship that is marred by a curved penis, the fear another accident might happen making his PD even worse. Vaginismus treatment involves education and counseling for the couple, behavioral exercises, and vaginal dilation exercises using plastic dilators. This type of therapy should be done under the direction of a sex therapist or other health care provider experienced in this area of sexual dysfunction.
A wide range of emotional issues that are rooted in Peyronie’s disease result in pain during sex because they cause of variable degrees of vaginismus and reduced sexual lubrication:
Anger and frustration about being in a relationship without normal sex
Fear of making his Peyronie’s worse during sex with another accident
Fear that the Peyronie’s disease is contagious – and it is not – and could result in problems for the female partner
Fear that the deformed penis will injure the vagina
Guilt since she was one who caused sex accident
Low expectation to gain entry since penis does not look like it would be able to fit
If you are a woman experiencing pain during intercourse while also dealing with Peyronie’s disease, contact the PDI nurse via to get help identifying and eliminating all issues that might be involved.
I have peyronies a year and a half now with a 45 degree bend when erect.i have consulted my doctor.i have seen a surgeon and I am not satisfied with his straightening method.he just wants to put a slit in it and sew it back.i don't believe this would would work.i need a second opinion.i am on medical card and live in county roscommon in the west region of Ireland. i need a surgeon who is prepared to carry out the full and proper treatment I would be very thankful for your assistance doctor and advice.i am only 39 and this is ruining my relationships and I am depressed. please help me.
Are you sure you heard and understood everything that was told to you about this penis surgery?
I cannot directly comment about what your surgeon explained about the Peyronie's surgery he or she proposed because I was not there to hear the explanation you were given, and you were. However, as I understand penis surgery to correct a penile curvature caused by PD, the typical procedure is much more complex than simply putting a slit in the shaft and closing it up.
If you are positive you were given this exact explanation, I suggest you contact another urology surgeon who will take your case more seriously for a second opinion. Using the information that follows I propose that this next time around you be prepared to ask many questions and demand answers. You should fully understand what is being proposed to you so you can make an intelligent and informed decision. I also suggest that you spend some time on the Peyronie's Disease Institute website to learn about the possibility of using non-drug and non-surgical treatment to increase your ability to eliminate the Peyronie's plaque naturally.
I am sensitive to what you are asking and I understand your concern about penis surgery. However, I have no way to know what is the full and proper surgical treatment for your particular problem, and frankly neither do you. Something as vitally important and final as surgery requires a great deal of trust in the skill and competence of the surgeon in an area that a layperson does not have enough knowledge or skill to judge what needs to be done. Having said that, I think you might be correct to want to talk to another surgeon if only because it is not correct or proper that you were allowed to leave that office without a better understanding of the proposed surgery. In my opinion, a half-hearted explanation is no explanation, and does not bode well for the kind of surgery that a doctor like that would provide.
There is always the possibility you misunderstood what was explained to you, but it is still the responsibility of the doctor to make sure you do fully understand so you can give informed consent to a surgical procedure. There is also the possibility the doctor did not want to give you all the (somewhat gruesome) details of the surgery, since it might scare off someone with a squeamish stomach. Another possibility is that the doctor simply did not want to take the time from a busy office schedule to explain what would happen in the proposed surgery. It has been my observation that many times a surgeon will greatly limit or modify the truth about some aspect of a proposed surgery (risks, chances for recurrence, changes for failure, degree or frequency of complications or side effects) so that the patient is more inclined to accept the idea of the surgery, and agree to have the surgery done. It is somewhat of a "selling job" that is done. It is not appropriate, it is not correct, and it is not legal, but it is done. Perhaps something like this happened in your case. Whatever was the reason that you thought the doctor was going to "put a slit in it and sew it back," it is the fault of the doctor for that notion and possible misunderstanding to remain.
More than likely, and I could be completely wrong since I was not there, the doctor proposed to do a Nesbit procedure for your curved penis.
I have an erectile dysfunction that I have since teenager and now I am 46 years old. year of 2001 and I went to see the urologist in Framingham, Mass when I used to work in Framingham, Massachusetts and he got me on x-ray and ultrasounds he found that I have a very good blood flows in my penis, good blood vessels but the blood vessels do not hold the blood in and that is why i have problem of getting of erection, and that is why I have an impotence. also I noticed I have an inability keep an erection premature.
I am very healthy I do not smoke, good heart beat, and that does not make any difference. during that time the doctor suggest me to take Viagra. but it causes me headaches and it works. then years later to use Calais that is even better and no headaches. But they cost me lot of money. I am wondering can my erectile dysfunction can be fixed? I am tired of this problem. I am not in depression or anything so I hope you could make some suggestion of what I shall do to fix my an impotence problem.
I am frustrated because many women left me due of this problems and wondering if you could help me with this?
Now I live in Ontario, Canada. I am a Canadian. I worked in USA with NAFTA Visa at that time. Many thanks for your help.
Since this website is focused on Peyronie's disease, I only get involved in the erectile dysfunction that is related to Peyronie's disease; it is a very special and unusual kind of ED because of the way that the Peyronie's plaque or scar interferes with how an erection occurs. It would appear that your erectile dysfunction is related to a blood vessel problem. What I do would not help your kind of ED.
I suggest you contact a urologist either in Canada or the US who works specifically in this area as a specialty. You would call the office you are interested in visiting, and ask to speak to the doctor's nurse. Explain to her what you mentioned in your email about the blood vessels not holding the blood in to create an erection. She will know if that doctor works with men with this kind of problem. Don't be satisfied talking only to the receptionist who answers the phone; you want to talk to the nurse who works directly with the doctor. If she says her doctor does not do this kind of work, then ask her for the name of someone who does do this kind of work, so you can get the kind of help you need.
However, if I missed something and you also have Peyronies, we can discuss how you might want to try to help both problems.
Please let me know how it goes for you. TRH
I've been diagnosed with fibrosis of the Corpus spongiosum. Have you heard of any relief of this with the topical Super CP Serum and/or Vitamin E spray? Any other possibilities?
The corpus spongiosum is cylindrical mass of tissue in the penis through which the urethra passes, located in the bottom half of the penis below the two corpora cavernosae. There are irregular cases of Peyronie's disease that start as fibrosis in the corpus spongiosum and later extend toward and into the tunica albuginea layer that surrounds the corpora cavernosae. At this point the fibrosis becomes Peyronie's disease.
When you ask about using topical Super CP Serum and Vitamin E oil you are forgetting about the most important component of the topical applications, and that is PMD DMSO. Using Super CP Serum and Vitamin E oil by themselves is fairly useless since they lack the ability to penetrate the tissue to get down to where the fibrosis problem is located. So please be sure to include DMSO in this topical treatment, always applying the DMSO last. When you order from PDI you will be instructed how to use all of these products for greatest effectiveness.
For about a month and a half I have been taking 2 tabs of nattokinase 3xdaily and 3 tabs of fibrozym 3x daily. In this time I have to urinate more frequently including getting up 2x at night from sleeping.(not experienced before) Coincidence or do these pills cause more frequent urination? No extra liquid has been consumed. Thank you
The explanation for the increased urination is that your body is pulling out additional fluid from your tissue to dilute the toxins that are being produced as the Nattokinase and Fibrozym breaks down the fibrous tissue in your system, especially the Peyronies scar. Some men have more fibrous tissue than others, hence they experience more frequent urination. This can be seen as a good thing since it shows you that the systemic enzymes you are taking are working for you.
Please keep me informed of your progress. TRH
Hello Dr. H,
What is the best way to get rid of Peyronie's disease?
Wendell from Ohio
The very best way to eliminate your Peyronie's disease is to do it exactly the way that half the men with PD get over theirs. It goes away by itself. With the PDI method we attempt to increase your natural ability to heal and correct PD like it should have happened in the first place. Peyronies heals naturally and spontaneously in about half the cases, the same way that a broken bone or a throat infection heals.
We tend to forget that the body can and does correct the problem of Peyronie's disease in a high percent of cases. There is a very good reason that the standard medical approach to managing a case of Peyronie's disease is to do nothing for the first 12-18 months after the condition starts. The idea to initially do nothing is based on the absence of any actual medical treatment that works to correct PD. During this waiting period the body is given time to heal or eliminate the problem naturally. In this way the medical profession admits that a natural healing process for recovery from PD does exist and that it actively happens in a high percent of cases.
When I developed Peyronie's disease in 2001 I immediately understood the great potential for my body to cure itself of this problem if I could determine what therapies might support or improve my natural healing ability. After doing considerable research I found a large group of natural therapy items (vitamin E, acetyl-L-carnitine, etc.) that were abandoned after initial getting positive research findings as a potential Peyronies treatment. I have always assumed that they were not subjected to additional research because the large pharmaceutical companies did not want to advance the idea that inexpensive and readily available nutritional products might be helpful against PD. Regardless, I started to use all the vitamins, minerals and enzymes I read good things about, and started to take them together and in slowly greater and greater dosages. Eventually over time I began to see my four PD scars slowly get smaller, softer and more difficult to find.
There is much that medical science knows about the healing process of the body in general – what cells are involved, what hormones and chemical messengers are produced, the different chemical equations that must happen, the minerals and enzymes that must be present for certain reactions to occur. However, there there is still much that remains unknown about what the body does to recover from illness and disease. This is especially true in the case of Peyronie's disease where far more remains unknown than known. However, it is still possible to work to improve the odds for recovery from Peyronie's disease. All that must be done is to present to the body a wide list of known vitamins, minerals and enzymes that
Promoting the natural healing of Peyronie's disease is not a simple or even easy thing to do, but by taking this route to recovery it is possible to eliminate the Peyronie's plaque and the curved penis it causes without exposing yourself to the risk of drug side effects or surgical failure.
I suggest that anyone with Peyronie's disease should go to the Peyronie's Disease Institute website to learn more about what needs to be done to stimulate and support the natural healing process against Peyronie's disease. TRH