Can Verapamil and Neprinol be used in combination?

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

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Should I use lysine to treat Peyronie's disease?

Hello Dr

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.


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Greetings Jeff,

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, and what are the risks of treatment?

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.


Greetings Brenda,

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.

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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.


Painful erection caused by Peyronie's disease or someting else?

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.

T. K.

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.

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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


Is Peyronie disease natural treatment safe and effective?

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.


Greetings Brian,

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.
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  • 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.


What can I do for a jelqing penis stretching injury?

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. 

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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


How does your Peyronies treatment idea work?

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.

Thank you,

Jose T.

Greetings Jose,

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

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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


Would a penis extender help my curved penis?

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?

Harold Bridges

Greetings Harold,

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

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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

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Peyronies treatment using ultrasound therapy along with hydrocortisone

Hello Dr,

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,


Greetings Mike,

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.   

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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


Will my Peyronie's disease continue to get progressively worse if I do not have an operation?

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.

Alexander S.

Greetings Alexander,

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. 

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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