Different way to look at Peyronie's disease and blood supply
Peyronie’s disease is all about the Peyronies plaque, because the Peyronie’s plaque causes all the problems we normally associate with this condition. To back this idea up, and to show you are doing something that is potentially dangerous to your Peyronie’s disease by using erection enhancing drugs, let’s review some interesting research that took place about 15 years ago.
First, some background. According to two Peyronies disease researchers, Drs. J. A. Lopez and J. P. Jarrow, from the Department of Urology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, North Carolina, most of the erectile dysfunction that is associated with Peyronies disease is probably not due to reduced blood supply coming into the penis. Hence, taking Viagra, Cialis, Levitra, or any erection producing drugs, is often not effective and when it is it could be dangerous when someone with PD takes any erection producing drug.
Let’s get through the technical material first and then I will put it all together as it relates to using these drugs because you have Peyronies.
In the study done by Lopez and Jarrow, they did a penile vascular (blood flow) evaluation; they tested the penis arteries (to determine blood flow coming into the penis), and they tested the penis veins (to determine the blood flow leaving the penis).
They tested 95 consecutive men who came to them for evaluation or treatment of Peyronie's disease; of these 95 men, 19 were potent (able to become erect) and 76 were impotent (not able to become erect). They also did the very same kind of penile vascular (blood flow) evaluation on 100 consecutive impotent men who did not have Peyronie's disease so they could compare the condition of their blood vessels as it relates to erections and erectile dysfunction.
Potent men with Peyronie’s disease
After testing the 19 potent men who had Peyronie's disease, they found only one (5%) of the 19 potent patients had abnormal arterial blood flow coming into the penis, and none (95%) had evidence of abnormal venous blood supply leaving the penis.
Impotent men with Peyronie’s disease
After testing the 76 impotent men who had Peyronie's disease, they found that 27 men (36%) had abnormal arterial blood flow coming into the penis, and 44 men (59%) had evidence of abnormal venous blood supply leaving the penis.
Potent and Impotent men who did not have Peyronie’s disease
There was no significant difference in historical risk factors for impotence between the impotent men with or without Peyronie's disease and the control population of impotent patients.
After testing the 100 men who did not have Peyronie’s disease they found they had about the same percent of abnormal arterial blood flow coming into the penis. However, they found these same men had significantly less (16%) abnormal venous blood supply leaving the penis.
So the big difference was that the impotent men (59%) with Peyronie’s disease had a whole lot more abnormal venous blood supply leaving the penis, than the impotent men (16%) who did not have Peyronie’s disease.
This means that although men with Peyronie's disease may suffer some impotence due to artery blood flow problems, the research proves that the primary and overwhelming cause of impotence in men with Peyronie’s disease is abnormal venous blood supply leaving the penis.
So you ask, “What could be wrong with my venous blood flow leaving my penis?” Answer: your Peyronie’s plaque.
Peyronie’s plaque causes impotency
It is the Peyronie’s plaque that causes the veins of the penis to not close properly. Click here to understand a bit about Peyronie's disease and erection.
There are special valves within the veins of the penis that close off at special times, to trap the blood inside the penis – to create an erection. If the veins do not trap the blood, no erection. The presence of the plaque or scar material is the problem that causes the valves of the veins to not trap blood, hence a poor or absent erection. Yes, there are surely many emotional reasons a man with Peyronies will develop impotency, but this vein problem is by far the primary physical reason for this erection problem that we all are interested in.
Imagine that you want to close a door to trap warm or cold air inside a room. You try to close the door, but you cannot because there is something causing the door to not close all the way – perhaps the door is warped, or maybe there is something lying across the doorway like a doorstop and the door will not seal the room shut. If the door cannot be closed fully, it will be difficult or impossible to close the door, and you cannot trap the air in that room. It is the same in Peyronie’s disease. If the valves of the veins cannot be closed fully, it will be difficult or impossible to close them, and you cannot trap the blood to create the erection.
The presence of one or more Peyronie’s disease plaques or scars can and will cause physical interference with the normal closing of the valves inside the penis veins and one or more areas of the penis stay soft, preventing intercourse. It is as simple as that.
So your medical doctor, hearing that you are having a problem with impotence along with your Peyronie’s disease says to you, “Do not fear. I have my magic prescription pad here. I will happily write a prescription for Viagra, Cialis, or Levitra and you will get an erection that will amaze and delight the woman you love, and amaze all your family, friends and neighbors. Please pay the nurse at the front desk as you leave.”
Elsewhere I will write more about the potential dangers of erection producing drugs like Viagra, Cialis, and Levitra in relation specifically to Peyronies. For this discussion it is sufficient to state that Viagra, Cialis, and Levitra only bring more blood into the penis. The do not and cannot help you to trap it there to create an erection. This is why they may or may not work for you, and in fact, could potentially make your Peyronie’s disease worse.
For more information about the safe and effective treatment of Peyronie’s disease with Alternative Medicine, go to the Peyronie's Disease Institute website.
I would like to know more about the potential dangers of Peyronie’s disease. In his book, “Understanding Peyronie’s Disease” Dr. Laurence Levine writes –
“The key point to remember is that if you have Peyronie’s Disease and you use Viagra or another oral erection drug to enhance your erections, it is possible that you could reinjure your penis during sex. It is therefore wise to be careful about your sexual activity in order to reduce the likelihood of recurrent trauma and reactivations of the Peyronie’s process”.
So ok, this seems like a reasonable concern, but this is assuming Viagra, etc is causing a full erection. Is your concern if it doens’t? Dr. Levine also writes –
“When you have compromised erections, you can injure your penis while trying to have intercourse with a soft erection. It may be the buckling that occurs with a less rigid penis results in microtrauma…”
Are these the dangers you’re concerned with, or are their other additional problems/risks with Peyronie’s disease we should be aware of?
I just discovered your blog. Thank you so much. I’m surprised you’re not getting more comments.
Greetings icarus,
Dr. Levine is a good man who knows a lot about Peyronie’s disease. He is commenting on the potential problem of using any erection-enhancing drug from the standpoint of a mishap because of a partial erection. I am commenting on the very real danger of using any erection-enhancing drug from the standpoint of a mishap because of a full erection. But problems can happen either way, partial or full erection.
Since you have read my commentary, above, post #262 “Peyronie’s disease plaque, Viagra, Cialis, Levitra, and blood supply,” you understand that the increased internal pressure created by these drugs can tissue injury that causes or aggravates Peyronie’s disease.
My concern is that with Peyronie’s disease you can be injured both ways – either way – with a partial erection as well as a full erection. I say the greater injury and greater likelihood for making your PD worse is if you develop a monster erection with these drugs that cause tissue damage to the internal membranes of the penis.
To make this point from a different direction, let’s for a moment think about anyone with a blood vessel aneurysm. An aneurysm is a weakening of the wall of an artery that causes it to bulge out. This bulging can be so severe that one day it can “pop,” potentially killing you from internal bleeding. Doing anything to increase internal pressure within the blood vessel (chronic hypertension or high blood pressure, shoveling snow, engaging in sex, get angry or excited, etc.) can cause the weakened wall of the aneurysm to fail under the strain.
In the local area of the penis, while under the chemical influence of any of the erection-producing drugs, greater internal pressure is also created. You see, the penis is built to comfortably take internal pressure changes as blood is normally trapped to create an erection. The penis is built to become erect periodically, that is one of the reasons it is there. In my book, “Peyronie’s Disease & Sex” I write that the penis has only three functions: erection, elimination of urine, and getting caught in zippers. But anyway, back to erections.
I am not saying that these erection-producing drugs will cause an aneurysm. No. I am saying that normal or slightly greater than normal blood pressure can damage penis tissue that is weak and diseased. And I am saying that much greater than normal pressures inside the normal and the Peyronie’s disease penis from an erection-producing drug can cause tissue injury when the situation is just right for such damage to occur.
I know men are being injured by these drugs when they don’t work as well as they should, as well as when they work too well. It seems that these drugs can be a real problem either way. I say, stay away. To assist men who are having erectile dysfunction, the PDI website and its sister website, Natural Complementary Medicine Products, has an assortment of much safer and natural erection producing herbal products available, http://www.natural-complementary-medicine.com/index.asp?PageAction=VIEWCATS&Category=9
These products do not have the ability to create monster erections the way the drugs can, but are good to enhance and support erectile problems. I have worked with these for years with patients in my practice and have great confidence in them. Each order comes with instructions for use.
There are a few reasons that men do not make comments or participate more in this Peyronie’s disease blog. First, there is the difficulty of men to participate on any level with anything related to Peyronie’s disease. You see, many men are in denial about it at all levels. They just cannot think or act on it, frozen by their fear and loathing of the problem. Also, they do not like to expose themselves even in this anonymous way, because many feel shame and embarrassment about having a problem “down there” that is known to make the penis smaller. Lastly, the entire PD community of men is beat down and negative as a group.
Just visit any Peyronie’s disease forum and read the crap they have there. If anyone asks a simple question about treatment you read nothing but negativity – anyone who answers a question seems to be delighted to be the first to announce to the world how they are all doomed and hopeless. A poor guy who is just diagnosed with Peyronie’s disease will write into a Peyronie’s disease forum to ask a simple question about his problem. The writers will practically fall over themselves to be the first to tell the unsuspecting guy that nothing helps. They all seem to be self-proclaimed experts of medical propaganda.
That is why there is never any commentary or conversation on these Peyronie’s disease forums. That is why so many PD forums dry up. After you hear over and over again, “no cause, no cure,” what is there to say? So they eventually have nothing to say. This is the hopeless state of mind of the average man who reads and subscribes to the medical way of treating Peyronie’s disease.
For as few comments as you might read here, we get a lot more than other PD forums. Over time, I know we will have more activity. I am grateful for yours. Of course, when you consider that this website is only about two months old at this point, and has only slightly more than a hundred Peyronie’s disease members, I think we are going pretty well. Merry Christmas and Happy New Year to you. TRH