How much total loss of size can happen as a result of Peyronie's disease?

HI Doc,

I think my injury was about 2 years ago. I did not notice anything right away except for black and blue on the lower part of my shaft. After about 1 and 1/2 years i noticed i was having a harder time getting and maintaining erections. I thought it was because i was a diabetic. About a month ago i noticed that i had a dent on the lower left side of my penis causing it to bend slightly to the left. I also have pain while erect and soft. my urologist appointment is not for 2 more months. I was wondering if this was early stages or later? I have also lost some length and girth. I am very scared and nervous. I want to start your best plan as soon as possible, i don't want to waist 2 months of your treatments if i don't have to. Do you know what the total loss of size could happen as a result of having Peyronie's disease? When i order your large plan should i add anything else to it to get the best results? Thank you in advance.

Scared 50 year old

Greetings Scared,

We are all scared when we first come to realize how bad Peyronie's disease can be. Try to take some of that energy you now waste on feeling scared and put it to positive use by reading and learning how to help yourself with this problem so you can instead feel confident and in control of yourself.

A dent (also called a ding, nick, divot or hinge deformity) such as you describe is common. Sometimes there is only one, and other times they are numerous. Sometimes these persist, and other times they slowly or rapidly evolve into other deformities such as a bottleneck, hourglass or simple curve or bend.

Pain can and does occur in Peyronie's disease while both erect and flaccid; however, some men experience pain only while erect, or only during sexual activity; I only had pain while flaccid. As you will soon learn there are very few things about Peyronies that are not variable.

A common and consistent finding of PD is loss of penis size. It seems that the larger the penis, the more size that can be lost. While most men speak in general terms of getting smaller, not too often will actual numbers be mentioned; just like you most men do not give a number. It seems like admitting to the actual reduced size is too embarrassing or uncomfortable to reveal that kind of detail. When the actual size loss is mentioned it seems that 1 to 1 3/4 inches of lost length, and about the same for lost girth or circumference is what I am told commonly. Occasionally I am told the loss will go up to 2 inches or more. One poor devil told me that his 8 inch erection was now just slightly more than 4 inches. I have never heard of anyone losing only length or only girth, but always both; I suppose it could happen, but I have not heard of it.

I always encourage men to start Peyronies treatment proactively when there is strong evidence of the diagnosis, as in your case. It seems logical that treatment should start the sooner the better, while the fibrous tissue changes are less well developed.

The large plan is a smart way to start. Do not add anything to it initially although you could if you feel compelled to do so. A good therapy to consider adding, if that is your intention, is the gentle manual penis stretching program since it is so unique compared to the rest of the items in that plan. It is also comparatively inexpensive and it never has to be replenished, making it a good buy for a whole new range of treatment that you are able to use.

The best results come from two separate factors: 1. Being faithful and aggressively applying whatever plan you select to start with. 2. Spending the time and effort to learn the exact size, shape, density and surface features of each of the internal scars that are present in the shaft. This information is critical to use as a valuable referencer point to determine if your plan is or is not working. If you cannot accurately and in detail the physical structure of your internal scars you will not know if and when change occurs. Without this valuable knowledge you are forced to guess about your plan, and this is obviously to be avoided. Go to different parts of the PDI website to learn more about how to do this. You can also read about it in chapter 4 of the “Peyronie's Disease Handbook.”

Let me know if I can help you in any way as you work toward your eventual recovery. TRH



Do I need the Peyronie's Disease Handbook if the only treatment method left to try is the penis stretching?

Hi there, so i came across your site a while back and have been reading into it

I appreciate the work that has been put into the project as a whole but im sure there is a lot of skepticism out there still.
My question to you is regarding options.

If i may say so, i already take vitamin E, acetyl-L-carnitine, glucosamine, fish oils, and other supplements for my body building.
I saw that you sell a book “Peyronie’s Disease Handbook” and then have “Manual Penis Stretching Method” CD

My PD developed about 5 years ago but is only gradual but enough to cause discomfort !

do i need the handbook if the only treatment method left to try is the stretching?

some clarification would be greatly appreciated

Kind Regards


Greetings Colin,

Your basic question, as shown in the title, indicates you do not understand what the PDI protocol is about. You are not remotely correct that the only other method left to try is the PDI gentle manual penis stretching technique. It seems to me you are seeing only a part of the process, but assume you see the whole.

As a body builder I am sure you are keenly aware that technique is of utmost importance. Your question would be similar if I asked you, “I already do a lot of heavy lifting. I work delivering refrigerators all day long, so I think I am doing all that I should for a body like Arnold Schwarzenegger. Do you think I really need to lift weights the way that Arnold Schwarzenegger did to get the kind of body he had? Why I can't I just do it my way, and not do all the other stuff? By the way, I will judge your ideas and methods based on the results I get, but I will not follow your methods.”

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While you may have been reading the PDI site for some time, it seems that you may have missed a key point related to how this process works to assist the recovery from Peyronie's disease. It is not enough to “take” some of the various nutritional supplements, but they must be taken in the correct dosage and combination while assessing for changes in the size, shape, density and surface features of your PD plaque fibrous material. If the dosage you are following is not causing the desired changes, then you must increase the intake until you notice reduction of the plaque beginning to occur. Popping a few pills is not what this natural Peyronies treatment process is about.

Further, we do not advocate using only internal therapies, meaning supplements taken orally intended for internal systemic distribution as the sole method of treatment for Peyronie's disease. Diverse external therapies, of which manual penis stretching is only a small part, are also needed to support recovery from PD. There is far more to the PDI treatment protocol than the use of the stretching method that was developed by PDI.

I think the reason you need this clarification is that you have not looked around the site sufficiently or considered all the information it has to offer. TRH


Do the medium and large Peyronie’s treatment kits come with instructions?

Product Question- do the medium and large kits come with instructions?

They do not seem to include a book. Would the book give instructions on what supplements to take?



Greetings BH,

All products you order from PDI come with full detailed instructions how to use what you ordered.  No one ever complains about the lack of information and instruction how to use what you order.   By my estimation the PDI Large Plan for Peyronie's disease comes with 17 pages of information, the Medium with a few less.   

To know what is in the "Peyronie's Disease Handbook" you only have to scroll down a bit and read the information that we have presented to you.   TRH  

Can I take these other vitamins with my Peyronies treatment plan?

My husband has just started the medium plan and is working on the diet modifications. I am joining him on taking the Vitamins A and C for the health benefits. We want to know if you know of any adverse interactions that are likely to happen with our current additional use of Magnesium Citrate, Krill Oil, CoQ10, and Niacin along with the products in the medium Peyronies treatment plan.

We have been pouring over the Peyronies Disease Handbook and really appreciate all the detail there.



As long as you take the PDI directed plan as suggested there should be no adverse reaction wit the various nutrients that you list here. 

Thank you for the kind comments about "Peyronies Disease Handbook."    People always find the book extremely helpful and are surprised at the depth of information, especially after being told by most people that there is little that can be done to help this condition.   TRH

“Peyronie’s Disease Handbook” is the real deal

Hi Dr. Herazy,

I am writing this message to tell everyone how much helpful information I found in your book "Peyronie's Disease Handbook." I resisted buying it because I thought I could figure out a lot of the treatment ideas on my own. When I kept on reading you mention about how important it is to use the size, shape, density and surface features of the PD scars to determine if my plan was actually working, I thought I also could figure that out by myself. And when I read what you said about diet and PD I thought you were just talking about losing weight. I was wrong about all that.

After wasting 8 months without making much progress at all I finally got your book. Your book is the real deal, no nonsense and has a load of useful information. It has made all the difference in the world and helped me finally get some measurable results, not only reducing my scars but regaining lost size and decreasing a bad 90 degree curvature.

Your book is worth every penny. It will help anyone who wants to get better results.

Thank you for all the work you.

E. Taylor
Dallas TX

Is it adviseable to needle the penis directly?

Dr. Herazy,

I am an acupuncturist treating a patient with Peyronie's disease.  I bought your "Peyronie's Disease Handbook,"  hoping you had included specifics on the use of acupuncture, especially whether or not you think it's advisable to needle the penis directly?  I know you advise to not cause additional injury to the penis, but needling near scar tissue on other parts of the body is not contra-indicated, but actually beneficial.

What are your thoughts on this please? My patient is willing to try anything.

Greetings Doctor, 

Yes, needling a superficial scar on other parts of the body is very often beneficial, but the penis is a different part of the body. I would not needle the penis for concern of puncturing the tunica albuginea and further extending his Peyronies problem.  My concept is never to puncture the tunica in an attempt to help this problem. 

However, local treatment has always been an important part of my acupuncture practice, such as the famous Circle the Dragon technique, and that is why I advocate heavy use of the Genesen Acutouch pens to treat the PD lesion in this particular way because it will not risk injuring the patient by avoiding compromise to the tunica.

If you feel required to needle, distal points are always advisable. I do not treat a lot based on Five Elements theory, but I believe you would likely benefit your patient by evaluating for an Excess Wood situation.  Bear in mind that the “Peyronie’s “scar” is not a scar in the traditional sense of being a superficially located skin lesion; it is below the subdermis and within the tunica so the standard methods of needling a scar – that I have done daily for over 35 years – does not apply to PD.  At least, that is how I understand it based on my concept and methodology in guiding Peyronie's treatment.

If you feel obligated to needle, distal points are always advisable such as SP3, SP6, K3, GB34, the master points of the Conception Vessel, Sedation points for the Wood element and and Stimulation points for the Fire element. as well as appropriate Eight Extraordinary Meridian points (Du Mai, Chong mai, Yin Wei mai, etc.)    TRH  


Can you tell me how long the PDI middle plan will last?

Hello Dr. H,

My husband is considering the middle plan for his Peyronie's. Can you tell me how long it will last him?

Thank you!

Karen A.

Greetings Karen A.,

Many people want to get an understanding about rate of product usage, so yours’ is a common concern.

Each person approaches his Peyronie's disease treatment plan a little differently, not only in regard to size of treatment plan and overall direction of therapy, but especially in terms of dosage.  Some men take all their PD therapies in a very conservative way, some men take all their PD therapies in a very aggressive way, some men take 1-2 of their therapies conservatively and a few very aggressively, other men do not follow their plans very faithfully and so forget to do what they should do.

Because of this, each bottle and each therapy plan will last for a variable length of time.  In other words, not all men who get a Medium Plan use it in the same way or at the same rate.  So, how long individual bottles of any therapy plan will last is a personal and variable issue for which I can only give you approximations based on what I see others doing.

Based on my experience with others who use a PDI Medium Plan, the average person re-supplies the DMSO and Super CP Serum close to once every 3 months, while the Factor 400/400 and Maxi-Gamma E, C, Scar-X and MSM about every 4-6 weeks, and the systemic enzymes every 4 weeks.  Of course, the Massage and Exercise video CD is never replaced.  based on many years of experience working with men who use all of these plans, the average man will spend about $75-100 monthly to replenish the Medium Plan, after he makes his initial purchase which will be the greatest expense.  To state it another way, the Medium Plan costs around $210 to start, and about $75-100 per month to continue.     

In addition to the usual information that comes with your plan, I would suggest that you really should get the book I wrote about PD, “Peyronie’s Disease Handbook.”   In chapter 4 of this book you will learn the essential skill of how to determine the size, shape, density and surface features of your scar so that you will know exactly how to regulate your intake of therapy in your plan.  In addition, the book also gives a wealth of practical information that you can easily use every day to make life with PD easier and less stressful.  This popular book gives treatment suggestions and a dietary approach to PD that are not found on the PDI website; actually, the book is most helpful and valuable in treating PD, but in a much different way than what is found on the PDI website.  Check it out.   

Good luck to you and your husband.  Let me know if I can help in any way. TRH



Do I need your book or a doctor?

Thanks Doctor, I'm 64 and do a lot of heavy exercise. Yesterday I got a hard-on ….and for the first time time there was a break (left bend in the bottom third of my penis). Do I need your book or a doctor? Thanks. Mike Adler

Greetings Mike,

What you really need is to know for sure what is going on with that bent penis. The best way to do that should be to go to a doctor for an examination and diagnosis. The problem is often that the doctor does not know, does not want to take the time, or does not seem to care about dealing with Peyronie's disease. Even after a medical examination it is common for a man to still be unsure if he has a correct diagnosis.

I suggest that you get a very good medical examination or at least in some way come to a point where you are confident with the condition going on below your belt. It is not always easy, however, so be prepared.

If you wish to learn more about treating PD I urge that you start with the book I wrote, “Peyronie's Disease Handbook.” It will ground you so you know how to deal with PD from a physical and mental standpoint, treatment concepts, how to develop the essential skill of determining the size, shape, density and surface features of your Peyronie's plaque, and how to avoid doing things that can cause additional injury to yourself.

Let me know if I can help you in any way. Good luck. TRH

Change Peyronies Treatment Dosage

How to change Peyronie’s treatment

Starting Peyronies treatment dosage can be easy if you start by taking therapy products at the manufacturer’s suggested rate – perhaps for the first 14-21 days.  If this dosage causes a change in the size, shape, density and surface qualities of your scar(s), then that simple and small dosage is adequate to provide you with the help you need to eliminate your Peyronie’s disease scar formation.  

This is a list of all therapy products available through Peyronie’s Disease Institute and Natural Health Education LLC with the manufacturers’ suggested dosage:

1.   Vitamin E Factor 400/400 (60) – 1 or 2/day – with food
Maxi-Gamma E (60) – 1/day – with food
Unique E (180) – 1 or 2/day – with food
Natural C 1 gram (100) or (250) – 1 or 2/day – with food
Ascorbplex (90) or (180) – 1 or 2/day – with food
Fundamental Sulfur (100) – 3/day, taken between meals, or if upset occurs, – with meals
Acetyl-L-carnitine (60) – 1/day – with food
PABA (100) – 1 or 2 daily – 1/day – with food
Quercetin Bromelain ((100) – 1-8/day – between meals
Fibrozym (100) or (200) – 2 tablets, three times a day – between meals
Nattokinase 1500 (120) – 2 tablets, two times a day – between meals
Neprinol (90) or (300) – 1-4 capsules with 8 0z of water – between meals
Scar-X  (1 oz) – 10 drops three time a day – between meals
PMD DMSO Gel (4 oz) – 1-3 times a day, depending on skin tolerance
Super CD Serum (1 oz) – applied to skin before PMD DMSO
Unique-E Vitamin E oil (1 oz) – applied to skin before PMD DMSO
HJG and KBG Honso herbs – 1-3/day
Genesen Pointers – used 15 minutes or longer, daily if desired
Massage and Exercise instructions – performed 2-4 times a week
20.Gentle Manual Penis Stretching Method © instructions – used 15 minutes or longer, daily if desired
21. Prosta-Support (120) – 4/day – with meals
22. color: black;”>Omega T – 1 or 2 daily – with meals

Peyronie’s treatment dosage example
Let us say that you decide you will take PABA at a dose of 2/day. After doing this for a reasonable time – maybe 10-14 days – you do not notice any change in your plaque or scar at the 2/day dose. In this case you probably should consider increasing dosage until your scar responds to your therapy.  The usual method is to simply increase the dosage by one capsule or pill to the total every few weeks until you notice change in the size, shape, density or surface features of the scar.  

The process is made more complicated by the fact that you should be taking multiple therapies, but that is necessary to achieve results.

Peyronies dosage determined by scar response

To know exactly how to modify your dosage it is necessary to compare the size, shape, density and surface features of your scar from the onset of treatment. This critical information enables you to recognize positive changes when they occur. If you do not know how to determine and record the size, shape, density and surface features of your scar you will have to refer to chapter 4 of the “Peyronie’s Disease Handbook” to learn about scar measurement.   

All dosage increase is done slowly and carefully over a period of time to allow the body the opportunity to respond to a favorable change in therapy. If the dosage is changed too rapidly or too often it will not be possible to determine what factor caused a favorable response.  If you develop any unusual symptoms or change in body behavior or appearance while increasing dosage, simply stop taking the product for 48 hours after that problem/symptom disappears. Restart after 48 hours or when the new symptoms clear up, using the next lower dose.  From this point forward, once again begin the process of increasing dosage to promote favorable scar change. After reaching a higher dose at which changes are noted in the scar, remain at that dosage level for a few weeks.  Your correct dose is discovered by accompanying improvement in scar size, shape, density or surface quality.

Discuss your PD therapy plan with your family doctor or urologist so he/she is fully aware of what natural Peyronie’s treatment you are following.  You should consider this discussion about dosage strategy after getting final approval from your doctor. 

Poor Peyronie’s Disease Treatment Results

Every few months I will receive a telephone call from someone who asks why he has not had any improvement after using his Peyronie’s treatment for a while.

Usually the first and last question I ask is, “What is the size, shape, density and surface texture of your scar?” The typical response I receive is at first silence, and then the caller will admit he does not know the answer to the question. At that point I will explain that if he does not know the current size, shape, density and surface qualities of his scar and he did not have that information when he started his treatment, there is no way to know for a fact that he did not progress.

Basically, these men are comparing minimal information to minimal information, and conclude that nothing has changed.

Further, I also get emails and calls from men who complain that they have not made enough progress to justify continuing with their treatment plan. My line of questioning goes like this:

1. What products and therapies are you using now?

2. What is your dosage for each?

3. Honestly, how faithful are you to your plan; how often do you forget to do what you are supposed to do?

4. What kind of change to your PD therapy plan have you made recently?

5. What was the size, shape, density and surface quality of your PD scar before treatment started and what is it now?

As you can imagine I usually learn they have not been following the PDI plan, but picking and choosing to do a few things that suit their fancy.

Most often the men who do not respond well are those who use no more than 1-3 different therapies. Sometimes the products they use are not from PDI but they use something recommended by someone at a local vitamin store. Compliance on a day to day basis for taking their products is “not great”. I learn they have not read the book I wrote but were trying to base all their therapy on the information only from the website. Along the way I might also learn they have been using Viagra while following their modified PDI plan or that they have received a series of Verapamil injections within the past few years. These men also seem to naturally eat all wrong for PD based on the suggested diet in “Peyronie’s Disease Handbook.” In short, they are their own worst enemy.

If any of this describes how you approach your Peyronies treatment, please consider changing your ways if you wish to get good results.

Please take your problem seriously, and take your treatment even more seriously. The more you do the better your results should be.

Click here for information about Peyronie’s disease treatment.

Stay focused to your plan, and do not become discouraged.