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My husband will not see a doctor about his curved penis (we think it is Peyronie’s disease), what should I do?

Posted on by Dr.Herazy

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.

Sex hurts because my husband’s penis is crooked, can we get help?

Posted on by Dr.Herazy

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.

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My husband has Peyronie’s disease, how can I help him?

Posted on by Dr.Herazy

How women can help men deal with Peyronies disease

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There is a wide range of unique problems that can develop based on the dynamics of special situations within a relationship, especially concerning sex. Even so, there unfortunately also tends to be a list of common problems and pitfalls that most couples must deal with in order to keep their relationship strong and working together well for his eventual recovery.  From this reason the Peyronie’s Disease Institute has a special program in which our staff nurse will 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, physiology and pathology of PD, to personal relations questions, as well as help in dealing with sexual difficulties.

There are many ways, obvious and not so obvious, a woman can help a man deal with his Peyronie’s disease on a personal basis, in addition to helping with those issues that threaten their life together as a social and sexual couple.  Here are a few ideas that will get you started in the right direction.

It is not just the man with the obvious physical problem that is affected, but Peyronie’s disease and women who deal these men on a daily basis are also distressed and are an integral part of any solution he might need. To really help him requires that his partner does her best to try to understand the strange and stressful thing he is going through with Peyronie’s disease, and forgive him if his behavior and personality have deteriorated under the weight of his burden. More than anything else, much of what is required to help him right now is in the form of emotional support and great acts of kindness by letting go of the hurt feelings that will probably arise.

If a woman really wants to help her man deal with his problem, and wants to protect the bonds of their family unit, she can:

  1. Make a special effort to understand and forgive his moodiness and embarrassment since he has been diagnosed with Peyronie’s disease.  Women commonly notice that a man who previously was confident and eager for sexual contact will suddenly refuse sexual activity, and even hide his body rather than exposing himself to his mate. These temperament changes are usually based on a powerful sense of low self-esteem and deep lack of self-confidence that arises from his lost sense of masculinity.  Many women comment that their husband’s personality has changed so much that he is like a different man.For many men this change is a reflection of how he thinks of himself since the most masculine part of his body has been so flawed that he thinks of it as being taken away from him. He might easily act out in fits of child-like anger.  It is valuable that his mate attempts to be as tolerant of these outbursts, just as she would a child; at these times he is functioning at very primitive and instinctive level of emotional development as a child would.Above all else, he will require more patience and understanding than ever before. This is not to say a man with PD should be given license to be abusive and use ugly behavior, but only that any tolerance that can be afforded to him should be used since it will help to prove to him that he is not being rejected by his mate.  As discussed below, fear of rejection and fear of loss are two of the primary driving forces that most deeply trouble the man with Peyronies.His thinking about the subject of PD is often overridden by his strong emotions, so do not count on him to be logical or mature about this subject.  Think of him as a scared child having a temper tantrum and you will not be too far off; treat him with that same compassion and forgiveness as you would a child when necessary.  You can help him deal with his Peyronie’s disease, but it will most especially help you to understand and deal with him effectively.
  2. Be prepared for him to be down on himself, and to not accept or believe you when you say that his Peyronie’s disease, curved penis and reduced sexual ability are something that you can learn to live with. Be prepared to be rejected when you say that you still love him in spite of his distorted penis.Many men cannot make themselves believe it is true no matter how many times they are told that their physical distortion does not matter, regardless of the sincerity and emotion that is used.  They see themselves as so pathetic and unworthy that they cannot believe any woman could accept them in their reduced state.  Men will push women away in anger when she only reaffirms her love and acceptance.  The more she insists she is not affected by his loss, the more aggravated and lost in denial he can become.  It makes for some very emotionally charged moments.Do not take his anger personally; it is delivered to you because you are standing in front of him, but is really a reflection of his despair and anger with himself.
  3. Over and over, in small and large ways, offer direct and indirect assurance he is still acceptable and attractive to you. His confidence and self-worth can easily be taken to at an all-time low because of the humiliating effects of Peyronie’s disease.  His reduced penis size, erectile dysfunction and penile curvature can cause a man to think less of himself, and he will assume you do the same.  While the physical change of his genitals can be shocking, do your best to respond to him in a way that is as positive and normal as before his Peyronie’s disease started.  The majority of men disbelieve that their spouse is willing to stand by  during his difficult time.  Calm repetition of your acceptance and love is your best ally.

In my work helping men who have Peyronie’s disease I frequently encounter those whose lives have been ruined not just by the emotional effects of a curved penis, but by the women who abandoned them.  Often these problems are avoidable if someone would explain to these women why their men behave in such a bad way, and how little it takes to not only help these men but also help the women to protect what is an otherwise good relationship and keep their families together.

In the case of the women who deal with Peyronie’s disease, trying to understand he is just a scared little boy who is behaving badly because he is scared of losing you.  Treating him with a little compassion can go a long way toward protecting your little boy and your relationship with him.

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Is there anything I can do to help my husband recover from Peyronie’s disease?

Posted on by Dr.Herazy

Any woman can help and support his effort to reduce Peyronies disease in several ways

There obvious and not so obvious, direct and indirect, ways a woman can help the man in her life to deal with his problems of Peyronie’s disease not only on a personal treatment basis, but also by supporting and assisting with those personal matters that threaten their relationship as a social and sexual couple.

It goes without saying that the obvious physical problems of a curved penis, reduced length and girth, and erectile dysfunction that are part of Peyronie’s disease directly affect the man who has this condition.  But the woman in a relationship with such a man is in a critical position because of their personal relationship to help him deal with the many negative aspects of Peyronie’s disease, and so can provide an integral part of any solution he might need.  Her role begins by understanding and accepting that he is going through a strange and stressful event for which no man is ever prepared.  Throughout a woman’s life, even before her teen years, she is talked to and prepared for changes in her reproductive system; she discusses these events that affect her genital area with her mother and perhaps her sisters and girlfriends who also experience these changes; she even goes to a special kind of doctor, a gynecologist, who specializes just in the female reproductive system; each month she is reminded that her pelvic region does unusual things; if she becomes pregnant she soon overcomes her modesty and privacy about this area of her body.  A man does not ever experience anything remotely like that.  His genitals are his prized masculine region, but they are private.  For the most part his reproductive area is uneventful and is not discussed much – except if he develops Peyronie’s disease.

For these reasons he has been completely unprepared by his past experiences to deal with  suddenly learning that there is a problem he has never heard of before, called Peyronie’s disease, that jeopardizes his ability to engage in sexual intercourse and denies him the act that defines manhood to him.   For a man Peyronie’s disease is perhaps not so much experienced as a health problem in which fibrous plaque material develops internally within the penis, but more so it is felt to be a loss of what makes him a man.  The woman who must deal with her man’s Peyronies problem must see this condition as a great emotional issue for him and be prepared to forgive him if his temperament and mood suffers while he comes to grips with his curved penis that no longer works as it once did.

He will benefit greatly from his mate’s emotional support and patience, and her ability to forgive him while he wrestles with the fears that are connected to Peyronie’s disease. Probably his biggest fear is the losing you because of his reduced sexual ability; no longer being able to provide you the pleasure of sexual intercourse, that you will leave him for someone else. He fears that he will never experience regain the pleasure of traditional sexual satisfaction. He fears that if you do leave him he will never be able to develop a relationship with another woman, and he will be alone in life. He fears being pitied and ridiculed as the man with the deformed and shrunken penis. He fears feeling like less of a man.  It is not really the physical aspects of Peyronie’s disease that drives a man into despair, it is being unprepared for the emotional isolation he feels.  More than ever he needs you but he feels ashamed and embarrassed to be with you, adding to the torment he feels.

From the combination of physical, emotional and sexual problems related to Peyronie’s disease comes a list of common problems and pitfalls that happen to most couples. Since the man with Peyronie’s disease will often shut down emotionally and a state of denial, totally ignoring his problem, the burden to actively learn about and reach out for help will fall to the woman in that relationship. From this reason the Peyronie’s Disease Institute has developed  a special program in which our staff nurse can consult with and advise a woman who needs help dealing with any aspect of Peyronie’s disease.  During a friendly phone call our nurse will answer questions of any sort about Peyronie’s disease (male and female anatomy, sexual difficulties, personal relationship problems, treatment options, or anything else that is on her mind).

Here are a few ideas to consider to help him deal with his penile problems and to protect the bonds of your family:

  1. Continue your usual sex life if at all possible, limiting traditional intercourse only to the extent that his curved penis prevents it.  In case you believe that you cannot any longer engage in intercourse, please know that there are many techniques and ideas that can help you allow entry and increase your ability for traditional sexual intercourse. Few couples are as limited in their ability to engage in intercourse as they assume; usually all they need are some basic ideas and simple instruction. This is such an important topic; please refer to my second book that covers many aspects of this topic at great detail and length, “Peyronie’s Disease and Sex.”
  2. An important aspect of Alternative Medicine treatment of PD is the PDI diet to assist recovery from Peyronies.   This subject is covered in detail in chapter 5 of “Peyronie’s Disease Handbook.”  You can assist his recovery greatly if you can coach him through these dietary ideas, and make it easier to follow if you incorporate these principles into your lifestyle for the time being.
  3. Moral support at this time is crucial.  You will help him, and help yourself as well, if you can offer him encouragement and praise during these rough times.  You will prove your loyalty and earn his admiration and respect when you demonstrate you are not a fair weather friend.  Men commonly refer to their time dealing with Peyronie’s disease as the lowest point of their lives, feeling alone and depressed, offering them all the excuse needed to behave badly.  Just because a man is acting like a jerk does not mean he does not know he is acting like a jerk; he knows his behavior is bad; he just does not care to control his primitive emotions of the moment. This is the time a man needs a friend to offer support and a trusting heart.  Even though he might push you away out of embarrassment and self-consciousness for his reduced physical state, he will soon recognize your acts of steadfast friendship and tolerance as proof you are not going to reject him.  Once he is confident you are not going to run away because of his sexual problems, your man will come around to his old self (and probably better) because you will have proven your love for him to an even greater level than he knew before.  This is how your relationship will grow under the adversity of Peyronie’s disease, by showing your strength and loyalty to him no matter what happens.
  4. Be tolerant and understanding about his reduced sexual interest and flawed sexual ability.  Both of you are afraid of what will happen in the future regarding your sex life together.  The way to make our fears become a reality is to place a lot of pressure on his sexual performance.  Easy does it.  As discussed at length in “Peyronie’s Disease and Sex,” we find that most couples can actually engage in sexual intercourse for a far longer time than they imagine, but stop only because the do not know how to solve get around some of the difficulties of gaining entry with a bent penis; this book explains how to be successful with sex using a curved penis than you could imagine.  In the early stages of Peyronies it is most valuable to continue traditional intercourse for as long as possible.  It is not necessary to stop sexual activity as long as no pain occurs for either partner.  Engaging in sexual activity is good for the physical and emotional health of both partners, as well as beneficial for your personal relationship.  Sex can be the all-important emotional glue that keeps you together, so use sex liberally since PD is really all about sex when you think about it.  If you reduce sexual activity at this time it will only confirm his worse fear that you are no longer interested in him as a sexual person. If traditional sexual intercourse turns out to not be possible due to his curved penis it is necessary to explore, expand and use a greater variety non-intercourse sexual activities and techniques, with the hands, lips and whatever else is mutually agreeable to you as a couple.  Your previous thinking and attitude about sexual activity might have to change to satisfy your unfulfilled physical needs for intimacy.  With an open and honest dialogue you can work these things out.  Again, your helpful and willing approach to sexual problem solving and cooperation only proves your place in his heart as the best possible partner he can have.

Many of the conflicts and stresses a couple goes through when Peyronie’s disease enters their lives are avoidable.  A little understanding, a few suggestions about altered sex techniques, the man having the woman’s side explained to him, the woman having the man’s side explained to her, reading the positive and informative books that are available from the Peyronie’s Disease Institute, and starting an aggressive Alternative Medicine treatment plan to increase his ability to heal and repair the Peyronies plaque can do wonders to reduce stress and misunderstanding between people dealing with Peyronie’s disease.

If the woman would keep in mind that her man with Peyronie’s disease is very much like a scared little boy who is behaving badly because he is scared of losing you, and treat him accordingly, things would improve greatly. With understanding, love and a little compassion you can help that little boy know you are not going to leave him and you will protect your relationship with him.

How do you treat a penis "waist" or hourglass deformity?

Posted on by Dr.Herazy

Dr. Herazy,

Are you familiar with what Urologists call a “waste” in the penis? If so, how do go about treating it?

Greetings,

I believe you are mistaken. There is no urological term “waste” that refers to the penis. I am not aware of any; all medical text I reviewed did not contain that term; a Google search of the Internet for variations of “penis waste” did not bring up anything.

You are probably referring to a “waist” formation around the penile shaft that is just another way of describing an hourglass deformity. This penis “waist” occurs in Peyronie's disease as an indentation around part or all of the circumference of the shaft that resembles a narrow waist formation.

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Like any other penile deformity, an hourglass formation is treated by attempting to eliminate the cause of it – the Peyronie's plaque. The hourglass form is created when the plaque either pulls from inside the shaft causing a depression on the surface, or if it keeps the local veins of the area open and thus prevents blood from being trapped in the penis and the local area does not fill with blood. Treatment is to eliminate the plaque as described in the PDI website. TRH

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Peyronie’s disease and pain in the penis

Posted on by Dr.Herazy

Penis injury during sex common cause of Peyronie’s disease 

Nothing will get a man’s attention more than when his penis hurts.

There are typically two ways in which a painful penis can develop:  after direct penis injury, or as a result of some type of medical health problem or sickness affecting the urinary system.  When the penis hurts because of suspected disease of the prostate gland, bladder or urethra there are few clear cut answers to penis pain with the exact location, duration, and quality of penis pain different from case to case, without good explanation.   You will notice that some men with prostatitis have pain at the base of the penis, while other men with the same diagnosis have pain at the tip of the penis, and other men no penis pain at all.  Men who have a painful penis are often surprised that their condition is never given a definite diagnosis to explain its cause.

This discussion will focus primarily on a particular type of painful traumatic event peculiar to Peyronie’s disease that can either cause or worsen an existing penile problem, as with an injury during intercourse.

Peyronie’s treatment

Regardless of how Peyronie’s disease starts, surgery and drugs are not always needed to reduce the pain and penile distortion it causes. Since 2002 the Peyronie’s Disease Institute has worked with people from around the world to use natural Alternative Medicine methods to help their body reverse the Peyronie’s scar naturally. While surgery is always an option, most people prefer to first use non-surgical treatment to possibly avoid the inherent risks of surgery.

Learn more about Peyronie’s disease treatment with Alternative Medicine. Another good source of information is the Peyronie’s Disease Handbook.

Medical conditions that can cause penis pain

It is important to know that several common disease conditions not related to penile injury can also cause dull and sharp pain in the penis and should not be ignored, especially if you have other unexplained symptoms related to the pelvis or urinary system:

  • Peyronie's disease
  • Bladder stone
  • Cancer of the penis
  • Inflammation of the prostate gland (prostatitis)
  • Reiter syndrome
  • Sickle cell anemia
  • Erection that does not go away (priapism) after 4 hours – medical emergency
  • Genital herpes
  • Syphilis
  • Urethra inflammation caused by chlamydia or gonorrhea
  • Infected or defective penile prosthesis
  • Infection under the foreskin of uncircumcised men (balanitis)
  • Pimples or insect bites on the head or shaft of the penis

Because any of these conditions can cause a deeply hurt penis, it is always best to rule out disease of the urinary system by going to your family doctor for a complete examination with any type of pains in the penis.  If you do not have a medical health problem, then a painful penis is usually explained by past trauma to the genitals or pelvis.  Even minor trauma can at times cause significant penile injury with varying degrees of pain and other symptoms.  One of the reasons that traumatic penis damage is often not suspected as the cause of genital pain is that there is sometimes a delayed response between the time of injury and when the penis pain begins.  It is rather common for a man to discover that a penis injury during sex that started his Peyronies disease might not cause discomfort until several weeks or months afterward.  Probably the single-most common way for PD to start is from a forcefully bent penis during sex.

Penile fracture or broken penis syndrome – Common way to hurt penis during sex

Even though there are no bones in the penis, penile fracture and broken penis syndrome are legitimate medical terms.  Both refer to a sudden and forceful bending injury of the erect penis, resulting in torn or ruptured internal tissue.  Many times a penile fracture will occur as a result of injury during sex activity when an erection is suddenly and forcefully impacted at the tip of the penis, almost like being punched in the nose.  When the force is sudden and unexpected the vulnerable shaft can painfully sustain a sharp bend, “breaking” the inner layer of penile tissue called the tunica albuginea membrane, as well as other tissues.  The forceful impact that causes a penile fracture most commonly happens during heightened sexual activity with the female partner in the superior position; other sexual positions allow for this to happen but this is the classic situation that results in a penile fracture.  Within just a second of time she will pull back too far, lose contact with the male, and then continue back down on top of the erection impacting the penis head with her pubic, inguinal or inner thigh area.  The initial immediate pain can be very mild or severe, depending on many variables, yet sufficient to tear the tunica when it is stretched tight during an erection.

The tunica albuginea surrounds the two corpora cavernosa chambers, specialized elongated masses of spongy tissue of the penis that fill with blood to create an erection.  In a penile fracture, because the torn tunica albuginea can no longer trap blood inside the penile chambers, blood that is normally confined within the penile chambers can freely leak out to surrounding tissue often resulting significant bruising and swelling, in addition to varying degrees of pain in the penis.

About half of men who undergo penis injury similar to the above, or even compression injury during a work-, sports- or auto-related accidents, will self-heal and repair the problem with the tunica albuginea without developing Peyronie’s disease.   The other half of cases will not heal, and it will slowly and gradually worsen as Peyronie’s disease develops over time.

Pain in tip of penis

Men with Peyronie’s disease sometimes have pain in the tip of the penis, although this is somewhat unusual because the pain of PD is usually located along the shaft or even base of the penis.  Although pain in the penile tip could be related to Peyronies, it is more likely due to reflex from the prostate gland; prostatitis often will refer pain to the tip of the penis.  As a point of differentiation, prostatitis will often increase urinary frequency, reduce the force and volume of urine, burning in the penile tip unrelated to voiding, reduced erectile ability, blood in the urine and semen, and aching pain is possible in the penis, testicles, rectum, perineum, groin and lower abdomen and low back.  Prostatitis can be precipitated by too frequent or too infrequent ejaculation, sexual arousal without ejaculation, withdrawal at the time of ejaculation, aggressive bike or horseback riding, excessive spicy foods, alcohol, and caffeine, as well as prolonged sitting especially in an automobile.

A similar complaint is burning at the tip of the penis.  When this occurs it suggests the possibility of an STD (sexually transmitted disease) or an infection of the urinary tract.   Generally, an STD is associated with a change of sexual partners, and can be variable from few a few subtle symptoms to marked genital pain during intercourse, discharge, itching and pain burning pain in the penis tip during urination.  STDs are serious problems that demand prompt and aggressive medical diagnosis and care.   A common urinary infection is suspected if you feel the need for frequent urination or notice that you need to urinate again within a few minutes.

Pain at base of penis

Pain at the base of the penis is perhaps most often explained as originating from a chronic bacterial infection of the prostate (chronic bacterial prostatitis).  This problem often comes and goes over time without apparent reason.   During a flare-up the penis pain can be dull or sharp, and extend to the testicles and anus as well as the pubic bone in front or the low back.  Bowel movements may be painful at this time.  It is also common to note frequent urgency of urination, pain when urinating or during ejaculation. While these symptoms are similar to an acute bacterial prostatitis, men who have a flare-up of chronic bacterial prostatitis tend to be less run down, feverish and ill-feeling than with acute prostatitis.

If he discontinues drug use would his penis eventually return to “normal”?

Posted on by Dr.Herazy

My husband’s penis has become increasingly curved/bent (now about 45 degrees when erect) over the last 8 months. He has been on an antidepressant for about 5 years. He is a traumatic head injury survivor and is on the antidepressant to control outbursts of anger. However, the antidepressant has decreased his sexual function dramatically and the bending of the penis decreases his function further. If he discontinued use, would his penis eventually return to “normal?” He is also on medication for seizures.

Greetings,

You have not stated that your husband has been diagnosed with Peyronie’s disease or not. I ask not only because of the curvature you mention, but also because there is an anti-seizure medication, phenytoin, that has been said to cause Peyronie’s disease.

If in fact your husband does have Peyronie’s disease it will not help him to discontinue any drug that might have caused it. He would still have to undergo Alternative Medicine treatment of the PD in an attempt to have his body correct this curvature problem caused by the internal Peyronie’s scar material.

As an aside, I have communicated with several men with Peyronie’s disease who say that their Peyronie’s disease started with an injury to the penis that occurred during an epileptic seizure that happened while they were erect. You might keep this in mind when you consider another possibility how his PD started.

All patients should check with their doctor before discontinuing any prescribed drug. TRH

Can Peyronie’s disease cause a “back-flow” that maintains an erection?

Posted on by Dr.Herazy

Dear Dr Herazy,

I recently had a cystocopy and developed approximately 2 weeks later hardness in the perineal area of corpus carvernosum. The shaft is still unaffected. However because of the hardness that probably reminds of of a reverse bottleneck I have had trouble getting the penis down after an erection. This is particularly problematic during the night where I wake up from the erections and then have to get out of bed to get it down.

My urologist said that I could have developed developed peyronies disease in the perineal area but I have searched the Internet and have not seen any similar cases. The area covered is around 2 inches. Have you heard about something similar including the decreased "back-flow" following the erections?

I am also worried I could develop a priapism from this condition that would make things a lot worse. Can you make an advice as how to move on?

Thank you very much in advance.

Kind regards

C

 

Greetings C,

First of all, I think a few people who read your email about an erection if you have Peyronie's disease would have some questions of their own about some of the medical and anatomical terms you used.  So, here is a bit of information about these terms to help understand your email a little better:

1. Cystoscopy – a medical procedure in which a long tube or probe is inserted up into the urinary passage (urethra) of the penis for the purpose of looking into the urinary bladder or the urinary passage, itself.   It sometimes happens that when this is done that the urethra and tissue of the shaft of the penis can become injured, resulting in Peyronie's disease.

2. Perineal area – the region of the very lower part of the pelvis in men that is found between the back part of the scrotum and the anus, and in women between the back end of the vulva or outer lips and the anus.

3. Corpus cavernosum – or corpora cavernosae – one of the two long cylinder shaped masses of tissue that make up the bulk of the penile shaft.  Each corpora cavernosa is covered by a thin tough layer of fibrous tissue called the tunica albuginea that when injured becomes scarred and leads to Peyronie's disease.

4. Back-flow – release of blood that was trapped in the two corpora cavernosa during an erection that creates the hydraulic pressure within the penis to make it expand and hard.

5. Priapism – this is a persistent, and often painful, erection that is considered a medical emergency when it lasts longer than four hours and develops without sexual stimulation.  Priapism occurs when blood in the penis becomes trapped and not able to drain as it normally does. 

OK, now that we have that out of the way, allow me to address a few points you made:

1.  The penis is attached to the front part of the pubic bone in the area directly behind the pubic hair.  If you are an average size male, there is probably 4-5 inches between the point where the penis ends and where the perineal area begins.  These two structures are not connected or related. There is no perineal area of the corpora cavernosa.  Any hardness, mass formation, swelling or abnormality of the perineal area is not related to the penis and is not related to Peyronie's disease. If you truly have a hard mass or lump between the base of your scrotum and the anus I suggest you get it checked out immediately.

2. I know what a bottleneck deformity is in relation to Peyronie's disease, but I have no idea what you mean by a reverse bottleneck.  Please explain.

3. The reason you could not find any reference to Peyronie's disease in the perineal area is that it does not happen that way and it is not possible. 

4.  Your decreased back flow causing persistence of an erection could be related to the mass in your perineal area; for that reason you should see a doctor immediately.

5.  Pripism can occur as a result from many different situations, but not Peyronie's disease:

  • Sickle cell anemia
  • Medications, like Thorzine and Desyrel
  • Illicit drugs (marijuana and cocaine)
  • Trauma delivered to the lower pelvis or spine, or something in that same area causing reduced blood flow 
  • Black widow spider bites
  • Carbon monoxide poisoning

6.   I assume that your doctor did not give you much of the information you have shared here because it is mistaken.  To move forward I suggest you stop trying to figure these things out for yourself and immediately get yourself examined by a competent urologist.  TRH

Advice about penis spitting whitish yellow drops

Posted on by Dr.Herazy

HELLO DOC,

I am having this problem and i am very conscious about my penis being disturbed. I have research a lot on your website and concluded that i am suffering from Peyronie's disease with slight left penile curvature without any constrictive ring or hourglass. 

My penis is spitting whitish yellow drops whether i am awake or sleeping and I am helpless to do anything.  I started throwing all my underpants and pajamas.   I used to masturbate a lot before 3 to 4 months, and used to grab my dick head to stop wasting the sperm, until one day it hurt me very bad.  But ignoring that day i slept  and after a couple of days i started feeling heavy pain that I used to hold my piss for a whole day or even 2 sometimes getting afraid of the pain.  Then gradually it decreased, and now again i am feeling pain with every piss.   My penis is curved slightly left and spitting drops very often.  I have postponed my wedding due to this, and really is very dishearted of the situation.

Please help me out.  I will always pray for you and your family in good or bad times.  A detailed and prompt answer would be highly appreciated

Best regards,  Umair

 

Greetings Umair,

Based on your description it is possible that you injured your urethra by your practice of masturbating but pressing on the head of the penis to prevent complete ejaculation.  I think it is not likely you have Peyronie's disease, even though you do have a penile curvature.

I strongly encourage you to go to your local medical doctor and explain your problem to him for prompt medical attention.  

Good luck to you.  TRH

Erections and Peyronie’s Disease

Posted on by Dr.Herazy

Erections can be difficult to develop on demand while in a sexual situation.  Paradoxically, erections can be difficult to stop or inhibit at certain times, especially during sleep.  All of this is important to Peyronie’s disease treatment since erections during sleep can have an adverse affect on progress of care.

A nocturnal, or nighttime, erection occurs because it is important for the basic health of the deep tissue, known as the corpora cavernosa, of the penis.  These deep tissues of the shaft fill with blood and trap it within the corpora cavernosa to create the erect state. If this term, corpora cavernosa, sounds familiar it is because the tunica albuginea is a thin and tough layer of tissue that covers the corpora cavernosa and the tunica albuginea is where the Peyronie’s scar is located. A nocturnal erection can be thought of as type of stretching exercise that takes place during the night when there is little other activity going on, to make sure the penile tissue is stretched and used in this unique way to keep the tissue healthy.

The problem during a nocturnal erection when Peyronie’s disease is present is that restriction and binding of the already-bent erection can be sustained against the penis for a long period of time.  Also, it is important to keep in mind that this added pressure poses a risk of additional injury top the man who already has PD.  For this reason it is important to be careful with an erection when the penis has no comfortable or safe direction to extend itself.   Since it is not possible to stop an erection while asleep, it is smart to not wear tight or limiting underwear or pants while sleeping if you have Peyronie’s disease. It might be even smarter to wear nothing at all while you sleep since this avoids a great potential for binding and restriction.

For the most part, a normally occurring erection th

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at can simply “stand on its own” with no pressure against it, is not going to bind or incorrectly stretch out the penile tissue in a way that is detrimental to the penis.  Problems occur during a drug-induced (Viagra, Cialis, Levitra) or artificial erection, during which an abnormally great amount of blood is drawn into the penis by more soft tissue relaxation than normal.   For this reason it is understood that a naturally occurring erection is safer than an artificially created erection.

Drug induced erections can start Peyronie’s disease

Over the years I have communicated with many men whose PD started after a drug induced erection that stressed the penile tissues by greatly increased internal pressure.  This process would not be much different than taking a car tire that is meant to go no higher than 40-50 pounds per square inch during normal use, and over-inflating it to 100-150 pounds per square inch.  Because it is not built to take that kind of pressure, you could expect some problems to develop in using a tire that way.  Not much different with the penis.

Sexual activity is NOT to be avoided if you have Peyronies, but rough, aggressive, hard sex can be dangerous and really injure the already damaged tissue further. Developing and using a natural erection is not to be avoided either in Peyronie’s disease.  However, it is important to keep your wits about you and do not go wild during sex.  The emphasis should be on an easy, smooth and gentle sexual encounter.  Any sexual activity or posture that causes pain should be avoided.

Many important related topics about taking care of yourself, avoiding injury, doing nothing to set your progress back while you are attempting to heal your problem, are covered in my book, “Peyronie’s Disease and Sex.”  You will enjoy learning more about what you can and should do to take care of this nasty problem.

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