Do you think I should try the enzyme supplement Neprinol for my Peyronies?

My question is really more confusion over the past year of having Peyronie's disease while using Topical Verapamil cream. My urologist wants me to keep using it and I have lost faith. I would ask your patience, and for you to read my experience because I do not know if the "new" curvature I have now is just due to active Peyronie's fibrosis or if it was somehow affected by the Verapamil.

If you envision what a moderate erection of a normal penis would look held down by clothing and "worn" to the left of the testicles, when my penis was erect it maintained a similar curvature. I assumed this was my "curse" for being aroused so often every day from the ages of 8 to 18. The curve never caused me pain or any sexual issues, and though would have wished it straight, it was nothing I would have sought treatment for. If not for pain that developed during erection under the left side of my glans, I would never have heard of Peyronie's Disease.

My Urologist is not a proponent of surgery except in extreme cases, so he prescribed me Topical Verapamil 15% (PD Labs). The confusion I have is that he wants me to keep using is and I think it is a waste of money.

During the first 90 days of use, my penis' curvature changed drastically. At first I thought that this was due to the Verapamil therapy, but now that it is clear that it was not becoming straight, but rather just curving even more drastically to the left from a different point. The downward curve is gone (a good thing I suppose) but replaced with this almost 90 degree curve to the left about 2.5 inches from the tip.

My Urologist wants me to keep using the Topical Verapamil, but I think that it is a waste of time and money and if it DID effect me, it only facilitated a worsening of the curve. I now have to have "help" to have intercourse with my wife of 27 years! By now we should know where things go and how to put them there, but this has messed that all up! I have minor to no pain, but it is emotionally screwing with me. She thinks it's no big deal, but I'm sorry. It is to me.

Do you think I should try the enzyme supplement Neprinol?



Sorry to hear of your problem, not only with having Peyronie's disease but for your experience of worsening while taking Verapamil. 

When I developed Peyronies back in 2002 I also used topical Verapamil.  I used it for six months and my condition slowly worsened,  just as you report.  I assumed then, just as I do now, that the Verapamil was not responsible for the worsening but was totally ineffective to reduce the scar structure and allowed my distortion to increase while taking it. 

I cannot comment on the appropriateness of topical Verapamil treatment in your case.  That is a discussion you should have with the treating doctor who prescribed it for you.   Perhaps his insistence in continuing this drug is more so based on his lack of having anything else he feels he can offer you in good conscience, rather than an overwhelming confidence and belief that it will eventually assist you. One of the articles about Verapamil from the PDI website that might give you helpful information is "Peyronie's Disease and Verapamil."

You ask if you should "try" Neprinol as a possible treatment for your Peyronies problem.  

Neprinol is definitely the most popular enzyme we sell in our  Alternative Medicine lineup, but we never – ever –  suggest it should be used alone to treat Peyronie's disease simply because the problem is too difficult and stubborn.   As good as Neprinol is as a systemic enzyme, from my experience it is almost always necessary to use a few other therapies in addition to Neprinol to create the desired tissue changes.   Neprinol works best used when it is an essential part of a good therapy plan.  When I was actively treating my Peyronie's disease many years ago I took Neprinol, along with Nattokinase and Fibrozym (but with greater emphasis on Neprinol) as the systemic enzyme part of my larger treatment plan.   I do not think you must do it this way to be successful, I did it just to cover my bases and to keep my tissue as saturated as possible with these enzymes.

I think Neprinol is so important for a successful Peyronie's treatment plan that I have a large and detailed discussion of this important subject in my book, "Peyronie's Disease Handbook".

While Neprinol might be a great systemic enzyme, the men I counsel about their PD who get the best results use more have many other things going for them than just Neprinol.   It is most important to approach your problem from as many different directions at the same time as possible to create synergy.

Some men report just OK results with just one therapy used against PD, but more men report better results when they take multiple therapies.  That is what the whole therapy concept of synergy is all about:  the more you do, the larger your plan, the greater the likelihood of promoting a favorable change in your metabolism that enables you to reduce the Peyronie's plaque that causes the cured penis that is at the heart of PD.    The idea is not to “treat the scar” as a medical doctor would do, but to “treat the man who has the scar” so that his body can heal what is wrong with it.   This is a basic idea that is fundamental to Alternative Medicine that presents a major shift in thinking for most medically indoctrinated people.   For this reason, as good a single therapy as Neprinol might be,  I do not recommend for  anyone who desires  good Peyronie's treatment results to use just Neprinol – or just any one product – but several therapies to create the desired synergistic effect. 

There are several special techniques I have worked out over the years for taking Neprinol to increase its potential benefit; it does not work to its maximum benefit if you take it like a vitamin.  After working with thousands of men about their Neprinol usage these special techniques for using systemic enzymes make them more available to you so they will do you the most good.   All of this information is provided when you receive you order from PDI.

PD is a tough and terrible thing to happen to a man.  It takes dedication and persistence to overcome it.   Good luck to you.  Let me know if I can help you in any way.  TRH


Can Neprinol be used in my Peyronie’s treatment plan if I am sensative to soy?

Hello Doctor,

I was reading about soy free Neprinol AFD on the PDI website.  The statement "soy free" caught my attention.  For some time I have been taking a soy-based energizing protein supplement.  Is there some connection between PD and soy?

About a year ago I began to mix the soy protein with a whey protein in a 1:2 ratio.

Thank you for a very informative web-site.




Greetings Bill,

There is no statistical or clinical evidence to suggest that Peyronie's disease is related to soy intake. That information about Neprinol being soy-free is based on the need of many people to avoid soy in their diet; it is mentioned to let those know who are sensitive to soy that Neprinol can be used for their Peyronie's treatment.  TRH

Where can I get the diet for treatment of Peyronie’s disease?

Where can I get the diet that you recommend for treatment of Peyronie's disease?


That diet is available and is explained in detail in Chapter 5 of "Peyronie's Disease Handbook."  

You must remember that PDI recommends a broad base of treatment for PD, using a variety of combined external and internal therapies, with your food intake and how you eat as being a very important part of your overall therapy plan.  The PDI diet for Peyronie's disease is only a part of the overall effort to increase your natural ability to recover from PD.  This suggests that you not rely on any one type of treatment but that you employ them all for best results.    TRH

Is Neprinol is a better Peyronie’s treatment option than Fibrozym and Nattokinase?

If I order Neprinol how much should I lower my present dose of Fibrozym and Nattokinase 1500 dosage to?    I am currently on 7 pills Fibrozym and 5 pills of Nattokinase 1500.  Also do I discontinue fundamental sulfur or continue while on Neprinol?   Do you believe that Neprinol is a better option than Fibrozym and Nattokinase 1500 overall?


Neprinol is a more concentrated form of the systemic enzymes that are found in Fibrozym (serrapeptase) and Nattokinase 1500 (nattokinase).   Neprinol has a higher enzyme activity rating than these two other products.   However, it is not always true that stronger is better or more effective Peyronies treatment.  

My suggestion is that you work with Neprinol to see how you will respond to it compared to Nattokinase and Fibrozym.   You could start taking a total of 4-5 Neprinol daily to determine if changes occur in the size, shape, density or surface features of your scar.   If you determine that there is a positive change in your scar, then you maintain that  same 4-5 Neprinol dosage until your scars disappear.   If at that dosage there are no positive changes in the scar, then you can increase your Neprinol intake until you see reduction of the scar size, shape, density or surface features.  It always comes down to what your tissue requires to make the changes you want.

Many men take all three enzyme products with Neprinol being the primary or lead therapy, but also keep a few Nattokinase 1500 and Fibrozym in their plans as secondary or minor sources of systemic enzymes.






Does Lexapro cause Peyronie’s disease?

i have been taking lexapro for about 7 months now – a side effect was diminished sex drive – so, as a result, my partner and I have had sex perhaps twice in those 8 months, ad that was nearly 6 months ago. I have been trying to stimulate myself so we can regain our sex life, modest as it is a this age and, of the last three occasions, i was able to get an strong erection but noticed now my penis is significantly curved upward – needless to say, i feel a bit freakish, and a conflicted between wanting to get aroused but not wanting to see my bent penis. Is it possible to Lexapro had this affect? I am 55 and now feel a "hate" relationship with my penis and not wanting to tell my partner or even have him see it. Basically, i am miserable about this and wanted to know if there is something i can do to help to "straighten out "my boy" and get back to more normal life (also looking to get off the lexapro but my Dr. said not till next year.


There are many side effects of Lexapro.  The most common are:   Constipation; decreased sexual desire or ability; diarrhea; dizziness; drowsiness; dry mouth; headache; increased sweating; light-headedness when you stand or sit up; loss of appetite; nausea; stomach upset; tiredness; trouble sleeping. 

There is no report in the literature of Lexapro causing or leading to development of Peyronie's disease

Before you go off in the wrong direction I advise that you have a medical examination to determine if you have Peyronie's disease.   If it turns out that you do indeed have Peyronies that your problem started in a more traditional manner of trauma.  A more likely scenario is that while taking Lexapro, or even before starting to take Lexapro,  you sustained injury during sexual activity that resulted in damage to the shaft of the penis.   Please review the information found on this site about Alternative Medicine treatment of Peyronie's disease.  TRH

Peyronie’s treatment diet questions

Diet questions
1. is rice milk an acceptable alternate?
2. why no bananas?


Yes, rice milk is an acceptable alternative drink, and so is almond milk. 

Bananas are to be avoided while doing self-treatment of Peyronies disease for reasons related to ancient oriental principles of yin-yang theory.   As I mentioned in “Peyronie’s Disease Handbook,” if you really want to completely understand why bananas should be avoided you will have to read several acupuncture text books to develop an Eastern insight into this way of looking at things.  The answer is not a simple Western explanation.    TRH  


How do you find the Peyronie’s plaque or scar

Dr. H – how does one gauge the presence/size of the plaque on the dorsal side of the penis ? Frankly, I do have the curvature but am not able to “feel?” the area that has been compromised.  Thanks



Location of the Peyronie’s plaque or scar is essential for effective and efficient Peyronies treatment.  For this reason an entire chapter was devoted in my first book, “Peyronie’s Disease Handbook” to help men locate and know how to gauge the size, shape, density and surface features of the plaque or scar within the shaft.

If you have a penis curvature you must have a plaque or scar that is causing it, even if you are at this time unsure how to locate it.

I suggest you get a copy of this important book to learn how to go about finding and defining the scar.   You will use the information of the size, shape, density and surface features of your scar to determine if changes are being made while you undergo Peyronie’s treatment. Without this information you are merely guessing about self-care and this is not a good thing to do.  TRH  

Any institute located in India that provides treatment of Peyronies disease?

Hello Doctor,

I wish to know that is there any institute located in India which gives treatment for Peyronie.

With regards,


Greetings Rajan,

I am not aware of any formal group or effort in India to treat Peyronie's disease

The Peyronie's Disease Institute is the only online effort to educate, treat and research this problem.   You can read and learn about Peyronie's disease treatment online and in the two books I have written and undergo an active self-directed treatment plan based on the information and ideas found on this website.   If you have questions or concerns during the course of your treatment you are able to write me emails so I can share with you my experience and suggestions for help.   Usually men are very pleased and satisfied with this arrangement since they have come to learn that their own effort and interest is far better than what they receive from the average medical institution.  TRH

Why isn’t Neprinol included in the medium Peyronies treatment plan?


I have started using the medium plan.   I noticed, however, from your response to a question about Neprinol that you thought that Neprinol was more focused than Fibrozym and Nattokinase.  If this is so, why isn't Neprinol included in the medium plan?

Thank you for your response.



There always seems to be some question about Neprinol when used in Peyronie's treatment.   Here is something that I copied from the PDI website that you might have missed along the way that will explain my thinking about Neprinol in the initial plan usage:


"Hey, wait a minute!  I do not see NEPRINOL in any of these plans!  Why do you have Fibrozym and Nattokinase 1500 in these plans and not Neprinol?"   

"Neprinol is not included in the PDI Small, Medium or Large Plans for two reasons:

     "1.  Neprinol is more powerful than Fibrozym and Nattokinase 1500.  It contains the same enzymes as Fibrozym and Nattokinase 1500 – at perhaps 10-12 times greater bioactive activity.  It also contains different kinds of enzymes that are not found in Fibrozym and Nattokinase 1500.  So, Neprinol is more concentrated and has a greater variety of enzymes than these other products.  Therefore, based on my experience since 2002 with men who are treating their Peyronie's bent penis, we have learned it is better to start treatment with the less intense and concentrated enzymes of Fibrozym and Nattokinase 1500 to get accustomed to the action of these enzymes; it is easier on the body and men have less diarrhea this way.   When you re-order the 1st or 2nd time you can then slowly introduce Neprinol into your treatment plan.

     "2.  Cost.  Because the bottle of Neprinol contains 300 capsules of more powerful and concentrated enzymes, as compared to 100 capsules in the other products, Neprinol costs more.  Therefore, after almost seven years experience working with men who are treating their Peyronies disease, we have found that men feel more comfortable keeping costs down when getting started.  The first order is the most expensive, and this is appreciated by men just starting who want to see how the suggested PDI plans work."

I will usually suggest to men that after being on your plan for a few weeks or few months, or whenever you are comfortable adding Neprinol to your plan, that you do so.  Many men will later use Neprinol as the primary source of systemic enzymes in their plan, but also keep a few Nattokinase 1500 and Fibrozym in their plans as secondary or minor sources of systemic enzymes. 

When I was actively treating my Peyronies I took all three products, but with a greater emphasis on the Neprinol.  I do not think you must necessarily do it this way for you to be successful; I did it just to cover my bases and to keep my tissue as saturated as possible with the enzymes.

Peyronie's disease is a tough and terrible thing to happen to a man.  It takes dedication and persistence to overcome it.   It is never easy to overcome, but always worthwhile.  

The biggest advantage in ordering your therapy products from PDI is that we provide a high level of service and background information specific to the problem of PD that you will not receive from anyone else.   Each product you order from PDI comes with all the information you will need to you it correctly to treat your Peyronie's disease. You cannot expect that kind of vital information from any other source.   TRH







Information about vitamin E and Peyronie’s treatment

Dear Dr Herazy,

I am a GP in the UK.   I have a patient with Peyronies, who has been following your advice (through your publications and web site) for some time. He is very happy with your advice and his results.  He asked if I could ask you some specific questions?

He has been using vitamin E for some time, and feels it does benefit him, however given the recent data from the SELECT trial, he is concerned if he should continue, he wondered what your advice might be.   Also, he wanted to know if you had any position on the use of fish oils ( omega 6-3) and activated vit D ( cholecalciferol) in the management of PD.

I have been trying to guide him through the available data. He would have contacted you directly but asked if I would do so, partly because I suspect he feels it is more 'official' through me and partly because I understand he does not have internet access at the moment.

I'd be grateful for any advice you can offer.

I would prefer that you do not use my name when you reply to this email, for confidentiality reasons.  

Best wishes.

Hurley Clinic


Greetings Dr. SXXXXX,

Of course.   Many people have been concerned about the findings of the SELECT trial of vitamin E, although if they knew a few details of that report they would be far less concerned.    They would understand that the conclusions they cite are misguided and based on several false premises that alter the conclusions that should be drawn.

Since this important topic bears a detailed explanation that I have already answered at length, allow me to direct you to my article, "Peyronie's Disease Treatment and Vitamin E." 

In regard to omega 3, 6 and 9 oils, we have always taken the stand that they are very helpful to Peyronie's treatment, especially in the early stages to reduce and control the inflammatory process that often causes pain.  Please refer to the discussion of Omega T and the essential fatty acids.   TRH