Is there a connection between using Cialis and Peyronies disease?

Is there a connection between using Cialis and Peyronies disease? The reason being is because I had no signs of the disease developing. I woke up one morning to find the scar/plaque on my penis when I went to the bathroom. Overall I took about 13 pills over 6-7 weeks, only taking one at a time. My doctor examined me and confirmed that I have it but did not offer anything solutions or why it happened. He did say he was surprised that it just came on as fast as it did which was like overnight for me.  I know my body and I was completely surprised.


Cialis is a member of group of drugs called PDE5 inhibitors, used to treat symptoms of erectile dysfunction (ED). Other members are Viagra and Levitra.

Yes, there definitely appears to be a connection between using Cialis and Peyronies disease.   Over the years I have encountered many men whose Peyronie's disease started after using just one dose of a PDE5 inhibitor.  There are many lawsuits pending in this regard.

Here are a few of the posts I have written about this subject over the years: Peyronie's disease plaque, Viagra, Cialis, Levitra and blood supply, and Peyronie's disease treatment and Viagra, Cialis and Levitra; there are others if you look further on the website.  TRH

Starting to lose hope about Peyronie’s disease

Hello Dr. I'm inspired to read through these posts that your actually spend time with the people on this site. I'm wondering how I go about getting a phone consult with you? I am 46 years old and have experienced a curved penis and diagnosed with Peyronies about 2 years ago. It seems to be getting worse by adding pain and trouble keeping hard during sex. Orgasms are not nearly as intense and I'm not able to 'adapt' for my wife like i could even 6 months ago.

I'm skeptical like many of the men on this forum, but they seem very satisfied that you take the time and attention, and I'm starting to lose hope so i thought i'd reach out.

Thank you

Franklin, TN


Greetings Don,

I remember what it was like when I had Peyronie's disease, so it is easy for me to want to help. 

Your skepticism is related to the medical sites who do not know anything about natural Peyronie's disease treatment, have never used it, have never tried to learn anything about it, and yet say it cannot be done.  All we are attempting to do is to increase the odds for natural  healing of PD as it occurs in half of the men who develop this problem.  We are not trying to make pigs fly.  It happens for half of the men who get PD, with a little help why not you?

If you want to schedule some time on the phone to discuss your situation, just scroll down a short distance to look for the picture of me holding a telephone and purchase a small block of telephone time.  I will email you to arrange for a time to discuss your situation.   TRH

How many units of vitamin E should I take for my Peyronies?


After reading much of the literature on Vitamin E treatment I find it hard to conclude how many IU’s of the vitamin one needs to take on daily basis ??



Greetings Dave,

With the naturally occurring and full spectrum vitamin E that is available on the PDI website there is much less cause for concern than when the synthetic forms of vitamin E are used.  All the nasty reports of bad reactions to vitamin E involved the use of synthetic vitamin E.

It is best to keep your daily dosage down to around 1200 IU of vitamin E when used in conjunction with a larger plan of diversified therapies.   When you place your order with PDI for any therapy products you will be given complete and detailed information how to use whatever you order.  TRH

What is your recommendation for a Peyronie’s disease treatment?

I have had Peyronies for about 1 1/2 years. It has now progressed to the point where my penis bends down from the base at a 60 degree angle when erect. My sex life has essentially come to a screeching halt.  I would like a recommendation of treatments that I should incorporate.


Greetings Bruce,

The PDI website is loaded with information about how you can go about using Alternative Medicine to increase your ability to heal and repair your Peyronie's disease; all you have to do is look and read.  I suggest you begin reading at Start Peyronies Disease Treatment.

I also suggest that start with the largest and most aggressive plan you can sustain for about three months to determine if your Peyronie's problem will respond to this form of treatment.  Sample plans are shown on the Peyronie's Disease Institute storefront. 

Sex problems are common when a curved penis prevents entry.   You should look at this book for help, "Peyronie's Disease and Sex."   TRH

More questions about Peyronie’s disease and a congenitally curved penis

Hello Dr Herazy,

I posted the congenital vs Peyronies curvature question that you recently answered. Thank you for your in depth answer but I have a couple follow ups regarding one of your response.

You said you've had a number of congenitally curved men that have improved with the manual stretching + enzymes… if there is no scar tissue in the congenital penis curve, and it is instead caused by two differing sizes of the corpora cavernosa chambers, then how do these stretching + enzymes work? What are those therapies actually doing to help straighten the penis? Since they're obviously not helping to break down any scar tissue as there's none there in the first place as with a congenital curve.

The whole pd vs congenital thing is still quite confusing & nebulous to me. Yes, I can recall a curve even as a young child, which points to congenital. A downward curve, like mine, seems to be fairly common among congenital as well. But at the same time my erections have firmed up due to the manual stretching and the curve seems to improve almost daily with the PDI method of penis stretching. Which seems more related to Peyronie's disease. I'm not sure how that would happen if it were congenital unless I'm somehow stretching not scar tissue but the actual corpora cavernosa chambers.

Also, the congenital improvements reported to you. Are the improvements they report mild, small? Is improvement common, rare? Comparable to the more successful PD responses that seem to be quite common with the PDI therapies? And it's that you simply haven't had a large enough sample of men with a congenitally curved penis to use the treatments to say definitively whether they work for them or not as a whole? Any indication they show more difficult to correct than a PD distortion?

Lots of questions, I know. But I think it's important that people in my position have as much info as they can.

Thank you.



Greetings again A,

Thank you for your thoughtful follow up questions.

Living tissue (animal or plant) is rather plastic, meaning its shape can be changed within certain limits – the tree that grows around and engulfs the barbed wire fence, African native women who compress their shoulders by forcing them down with brass rings around her neck, young Japanese girls whose feet are compressed by tight binding, ancient Mongolian warriors whose foreheads were flattened to look fierce and warlike, the contortionist whose joints are made preternaturally flexible, even I suppose the old joke about the cowboy whose legs eventually become bow-legged in response to years of riding a horse.  We see around us evidence that otherwise normal tissue can and does change its shape when gentle force is applied over a long time.

It does not take a great amount of imagination to envision also altering and equalizing the small size discrepancy that exists between the right and left corpora cavernosae in men with a simple congenital penile curvature, making it straighter by reducing the internal asymmetry.   Time, persistence and a light touch that does not provoke innate resistance to change is all that are needed.  These changes take place using the PDI process of using gentle manual stretching simply because the method is based on so many examples that occur in nature around us.

My theory is that the systemic enzymes assist the tissue remodeling that occurs during the gentle penis stretching process.  The manual stretching initiates a signal to the brain to change the tissue in question on a cellular level.   The fibrinolytic enzymes on the PDI website would assist that process by remodeling the fibrin of the soft tissue layers as they are being gently stretched.    Keep in mind that tissue remodeling goes on after each and every wound and injury you sustain.  The body is engineered to remodel tissue as part of the healing process.  All you are doing with the PDI technique I present is to gently focus that process to your curved penis.

You ask about “small’ or “mild” curves.  What exactly is your definition of a small curve?  Any man who tells me his curve is small or large, mild or severe, is taken with a grain of salt because what do these terms mean?   What would be a small curve to one man could easily be a large curve to another.  This is part of the difficulty in communicating with people through the written word.  Trying to be as accurate and objective as possible, I usually ask the men I work with for a description of their congenital curve this way: Is your penis curved less than, more than, or about the same as, the average banana?   The answer I am given provides a fairly good idea of what we are dealing with.  For your information, the great majority of men who I work with say their congenitally curved penis is about like a banana.  A few say less, rarely more.

Men do not offer reports frequently or well, offering very limited information about their condition or progress.  I spend a lot of time giving information to men, and receiving only a small amount of information from them in return.   The reports I receive back could be called seldom or rare, and are often limited to “my curve is gone,” "it’s really a lot better,” or “after a few weeks my bend is maybe half gone.”  The terms are almost always broad, general, and not as detailed as I would like them to be.  When I ask for further clarification or details, I seldom receive a reply.  Most of the time when I hear back from a man to whom I provide help, it is to say that there has been improvement; rarely do I hear that the problem did not improve at least to some degree.  Women will tell you that men do not discuss this problem of a bent penis very much; I know this is true.  I think that when a man gets this problem, shall we say “straightened out,” he wants to forget about it and put it far behind him.  The last thing he wants to do is discuss his previous deformity in detail.  TRH

How can I tell the difference between Peyronie’s disease and a congenitally curved penis?

Dr Herazy,

I do not know if I my curvature is PD related or congenital. What are some of the signs that point to a congenital curve versus a PD distortion? It's frustrating because my condition seems to exhibit signs of both congenital and PD. I'm sure seeing a urologist is required to say for sure but even then apparently some will misdiagnose simply because they can't find the scar tissue present in PD. So, even that avenue doesn't seem to be a sure fire way of knowing 100%.

We know that PD is caused by an excess of scar tissue buildup in the tunica albuginea due to physical trauma to that area. But what causes the distortion in the congenital curvature? Is it an excess of scar tissue one is "born with"? If not, what would cause a penis to curve in dramatic fashion (35º- 45º downward) w/o scar buildup? To me that would seem to be an exceedingly rare condition to be born with. I could see a 5º, even 10º curve but 45º is a heck of a curve to be born with. If a congenital curve has no scar tissue, how do the PDI therapies treat it in that case since there would be no scar tissue to heal?

Secondly, if one does have a congenital curve, does the treatment for it change in any way from that of a PD distortion? How successful are your PD therapies at treating congenital curvature and do you even intend on doing a full study on this?

As you can tell, not knowing for certain whether my curvature is PD or congenital, I have quite a few questions regarding the both of them. Please help me make sense of the differences and their subsequent treatment.

Thank you.



Thank you for the great question. 

Probably the answer to your question is found with the easiest and most fundamental observation that you can make.   The basic difference between a penis that is bent due to Peyronie's disease and one that is congenitally curved penis is time.  When did you first notice that your penis is not straight?  

If you have always noticed, even as a young boy, that your erect penis is bent then you probably have a congenital curvature of the penis

If you have only recently noticed that your previously straight (or almost straight) erect penis is suddenly curved or distorted in some way, then you probably have a bent penis due to Peyronie's plaque that has altered the ability of penis to expand fully.

Usually, a congenital penis curvature is not accompanied by pain, while a recent case of Peyronie's disease can be painful.   Further, a congenital penis curvature is not accompanied by a palpable nodule or mass of fibrous tissue, while a recent case of Peyronie's disease will demonstrate plaque formation.  This plaque formation is not always easily located, so it can be deceptive to make a diagnosis of PD based solely on the ability to locate this foreign tissue.

In congenital curvature there is no scar material in the shaft.  The curvature in this case is simply due to corpora cavernosa chambers that are not of equal size or dimensions.   Just like you might have ears that are not the same size or shape, or large toes, or thumbs, the body is not always symmetrical.   

I do not have a lot of information about congenital curvature responding to the PDI treatment protocol because men simply do not report this kind of information back to me.  I can tell you that over the years I have a number of men say that the gentle manual penis stretching technique coupled with a good dose of systemic enzymes like Neprinol made a difference with their congenitally bent penis.  TRH

How does jelqing work on Peyronies disease plaque?

How does jelqing exercise work on peyronies disease plaque?  Does this exercise soften the plaque or harden it?


Jelqing can injure the penis because it is not so much an exercise, but a series of aggressive penis stretching and maneuvers that force blood under great pressure into penile tissue.  It cannot soften the Peyronies disease plaque, but can easily cause more plaque to develop because the tremendous squeezing and stretching force that are required in jelqing will literally tear the internal tissue of the penis like the delicate tunica albuginea.  This repeated and forceful stretching of tissue by jelqing goes beyond the normal tissue limit and causes the delicate tissues to become damaged far more than it causes it to actually stretch.

Overall, jelqing is a bad idea because it is dangerous.   The trauma to the delicate tunica of the penis caused by jelqing is probably enough in some men to start the injury that results in the excessive scarring that is known as Peyronie's disease.  Over the years I have spoken to many men who are convinced their Peyronie's disease started after just one session of jelqing.

One of the most common reasons that men say they do jelqing when they have Peyronies disease – besides their effort to enlarge the penis – is to increase the blood circulation.   Do you jelq your hands if they are cold, trying to make more blood to enter?  Do you jelq your arms too?  How about jelqing your feet when they do not have enough blood.  No, no one does that.   The body does not need to be jelqed to increase circulation.  Before touching your penis to jelq it, is it cold, is it blue?  No.   Then the circulation going into the penis is not the problem in Peyronies disease.   The problem is that the blood is not being trapped by the corporal veins to create the greater fluid pressure that results in an erection.  The problem of a weak erection in Peyronie's disease is caused by veins that do not trap blood and this happens because of the presence of the Peyronies plaque.   That is where you need to concentrate your effort.   You need to improve the ability of your veins to close by eliminating the PD scar or plaque.   Jelqing does not do this – and probably injures that ability since you are using such great forces that the valves can be damaged.  Proceed at your own risk.