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

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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?

Thanks
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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What is the maximum "safe" daily dosage of Vitamin E for treatment of Peyronie's disease?

What is the maximum “safe” daily dosage of Vitamin E (for example, Unique E) in IU that is recommended for treatment of Peyronie's disease. I have read that daily doses in excess of 1500 IU of d-alpha tocopherol can be potentially toxic. I am planning on taking Vitamin E, with Nattokinase 200mg 2x/day, and PABA 1000mg 3x/day. Any comments on this regimen are appreciated.

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Greetings,

Please search this website for many articles I have written about safety of taking vitamin E within a Peyronie's disease treatment plan.  For example: Peyronie's disease treatment and vitamin E  and  Peyronie's disease vitamin E therapy.

To answer your question directly, I usually recommend that a man takes 800-1200IU of Unique E daily in a Peyronies plan.

Concerning the brief plan that you have outlined, above, I suggest that you consider adding some external therapies to this plan (DMSO with related copper peptides and vitamin E as topical applications, gentle manual penis stretching, ultrasound, etc.).  Your plan as you describe it is not fully developed.  I suggest that you look at the small, medium or large PDI plans to get an idea of what a well rounded plan looks like.

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How to help my Peyronies disease that started after using Propecia for 14 years?

Dr Herazy,  I appreciate the work with Peyronies disease you have done and are doing. I have read your newsletters with great interest over the past year or so. I would love to get your opinion when you have time.

I have Peyronie's disease or what has been diagnosed as Peyronies disease due to the upward curve. However, mine appeared rather spontaneously. I had no injury. I have no pain. The curve does not seem to be changing (for the better or worse).

I read somewhere on the internet there appears to be a link between Propecia & Peyronies. I suspect mine might be similarly related as I took Propecia daily from '97? (or whenever it was approved as a “hair loss” preventive measure) until 2012 when I read of the possible connection.

Have you heard of this? If so, would Peyronie's treatment be the same?

I can feel a mass about the size of a dime—it feels like it does not go very deep—I mentally picture something as thick as a nickle although that may not be correct.

Things I've done:
Called my Doc May/June 2011 (as soon as I noticed)—referred me to a urologist
Saw the urologist—referred me to a specialist in VA Beach
Saw the Peyronies specialist in Nov 2011—prescribed Potaba, Vitamin E, L-Carnitine, & Cialis

Still taking all but the Potaba

May/June 2012 –Saw a specialist @ Johns Hopkins—-had not heard of any connection between Propecia & Peyronie's disease — said to come back whenever it reached the point of preventing intercourse & they would be glad to do surgery

August 2012–Saw a Peyronies specialist @ Mayo (liked him much more)—he said there wasn't much that could be done differently than I was doing except maybe try a vacuum pump—-I've tried but w/ no success

Any suggestions for what I can do to help my Peyronie's disease would be appreciated.

Thanks

Jim

Greetings Jim,

The Peyronie's disease specialist who was unaware of a connection between Propecia and Peyronies is either sadly unaware if what is going on in the world, or just did not want to spend the time to talk to you about the mounting evidence against Propecia in regard to Peyronie's disease and several other health problems.  For information that might be of interest to you please read Another case of Propecia and Peyronie’s disease.  In the absence of known trauma and known genetic predisposition, Propecia (finasteride) causation is an interesting possibility to consider.

If you do indeed have a case of Peyronies disease caused by Propecia the natural treatment would be essentially the same as for cases caused by trauma or other chemical causation. 

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I suggest that you consider trying to increase your natural ability to heal and correct the damage done to you that resulted in a Peyronies scar.  From my experience the more aggressive and consistent the treatment, when guided by the response of the scar structure to your therapy plan, the more likely you will help your body to heal.   A good place to start reading is How to start Peyronie's disease treatment.  TRH

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I continued jelqing for months even though my penile curvature was getting worse and now I might have Peyronie's disease

Dr. Herazy,   Firstly, I would like to thank you and this community for even being here to help those who suffer with penile curvature.  Finding information online regarding Peyronie's disease has been very tricky and even an anxious affair due to the condition's unnecessarily embarrassing nature. Anyway, a little background: I am a 23-year-old male who has had a healthy sex life for the last seven years. While dating my previous girlfriend, we had some bouts with sexual difficulty, mostly on her end due to numerous urinary tract infections and her mental condition; she has been on anti-anxiety and antidepressants for some years now. This made her very self-conscious during sex and, admittedly, other factors like privacy created tension. I have never experienced this before and thought something was wrong with me, and for some stupid reason, I wondered if my penis was somehow inadequate. So, I looked into enhancement options and discovered the murky world of jelqing and stretching.

I followed the exercise regiment very closely, with my workouts beginning in February of 2012 and ending at the end of October of 2012. I made sure to warm up every time with a hot wrap and never pushed myself too far, or so I thought. I discovered that my penis grew in length and girth, going from about 5.5 inches erect to 6.5 inches; flaccid, my penis has always been about one inch, no joke. Now, it is usually two but often three inches in length when totally flaccid. My ex at the time noticed it and was shocked I managed to change the size and shape of my penis. I was taking L-Arginine, L-Lysine, and Zinc on my workout days, including Pygeum Africanum, Lecithin, Flaxseed Oil, Fish Oil, Super B Complex, and a solid Multivitamin. But during the last week of October, after we had broken up, I think I went too hard and stretched too far, feeling an uneasy sensation in my penis. It's important to note that I had noticed the progression of a curve for months preceding this but with no pain. It is also important to note that I have always had a slight curve to the left, as several photos taken years ago prove.

Anyway, after this weird feeling from stretching, I finished my workout and decided to take some days off. But the pain got worse and I noticed a small bruise/discoloration and what appeared to be a reddish stretch mark running about two inches on my penis. So, I scheduled an appointment to see a urologist. I saw him and he said I essentially “sprained” something or caused a microtear near the glans of my penis. He told me to abstain from sexual activity for six to eight weeks. He didn't feel any plaque and said that he couldn't diagnosis Peyronie's because there wasn't significant curvature or plaque. While I didn't exactly abstain as much as I should have, I did mostly stop masturbating for weeks on end.

The pain is now completely gone but the discoloration and stretch mark (maybe inflamed vein) are still there, though they seem to have faded a bit. I am now living in Chicago and have scheduled an appointment with Dr. Levine for March 1st. I need some kind of closure on this; I need to know if I have to start treatment or maybe I just have a congenital curvature. The curve hasn't increased since my injury and, as stated above, I noticed the enhanced penile curvature while flaccid months before my injury. While erect, there's not much of a difference between the way my penis looks now and a few years ago when I was sixteen. The only difference is the discoloration/bruise, stretch mark/inflamed vein, and a bigger, more curved flaccid penis.

I am currently taking a Multivitamin, L-Arginine, CoQ-10, Acetyl L-Carnitine, and Vitamin E. I also was using Bio-Oil and Cocoa Butter, but have cut back significantly; I liked how smooth it made my unit feel. I have continued sexual activity with no pain and no loss of erectile function. Based on what you all know and what I have told you, can you point me in the right direction? Can you give me advice? My current girlfriend and ex have been very supportive through all of this, including my brother, best friend, and mother. I just want some kind of pointers and opinions; it can be quite suffocating with everyone telling you “you're going to be fine” or “you're overreacting.” This is a serious condition and I am not sure where to turn. Dr. Levine has me scheduled for an ultrasound the morning of our appointment so he can check it out before meeting with me. I seriously hope there is no scar tissue or, if there is, it is something I can deal with. I have grown fond of my curved flaccid penis and don't mind it; life is too short to dwell and panic about these things as long as I can have a functional sex life. Please. And thanks in advance for reading my story and any opinions. It means a lot!

Greetings,

Thank you for your detailed report and  insightful commentary concerning your experience with jelqing and penis stretching.

In many posts I have written about the dangers of forced penis stretching: for example please see I think I have Peyronie’s disease from jelqing. What should I do?  Too many men take a cavalier attitude about remodeling their penis to Adonis proportions.  The websites that sell the books and tapes attempt to support the idea that all problems of low self-esteem and difficulty with female relationships will simply disappear with a sausage-like member tucked in below the belt.  Life is perfect for men who have an unusually large penis.  They do not discuss the many problems and tragedies that occur with these strategies of forced stretching.  The jelqing websites try to create the idea that the penis can be squeezed and molded like a slab of clay can be tugged and strangled into an exaggerated size to please a lady or gratify a weak ego.  When penis tissue is taken forcefully and repeatedly beyond a certain point of limitation it will suddenly fail.

At this point you can only be certain that you have a bruise or micro-tear of the external tissue of the shaft.  You might be one of the luckiest guys in the world to only have a superficial injury, and not a deeper problem in the shaft at the level of the tunica albuginea; if it turns out that you have injured the tunica you are perhaps a step closer to having a case of Peyronie's disease.  Even so, with injury to the tunica and an early case of Peyronies to deal with, about half of these cases repair or reverse on their own without outside intervention – spontaneous recovery is the medical term for self healing. This is mentioned so that you can appreciate the gravity of what you have done and the position you are in at the moment.  

When you wrote that you “…  never pushed myself too far, or so I thought,”  you made a critical point about jelqing that gets to the heart of the craziness about this brutal practice. Did you ever watch a movie in which the bomb squad is called for help to defuse or take apart a complicated explosive device?  The tension and drama of those scenes where the bomb wires are being cut is based on the person never knowing if he is cutting the correct wire or in the correct sequence until it is too late.  The trick of taking apart the bomb is that you can be doing it correctly when everything is going well, until the moment you make a mistake and the bomb and you blow up.  Jelqing is not much different.  You can think you are doing it correctly and safely, until you make a mistake and injure your penis to cause a problem like Peyronie's disease.  Who knows how far to go until after you have gone too far?  Who knows how hard to squeeze and stretch, until after you have squeezed and stretched too much?  Everything can go well until after everything does badly, when the whole jelqing idea blows up in your face.

Based upon what you have written, I suspect that you have injured yourself enough to have caused Peyronie's disease.  I am lead to this conclusion by your statement, “… I had noticed the progression of a curve for months preceding this but with no pain. “  By this you say that for months your penis was becoming curved and yet you continued to jelq for months.   Since I have not examined you I can only speculate, although you will learn in time if I am correct or not.  I further suspect that you do not have at this time a curved penis when erect only because your condition is still too early and you are in the stage where the plaque has not yet formed the telltale Peyronie's scar that is far more capable of causing penile curvature.  Further based upon what you have written, “While I didn't exactly abstain as much as I should have, I did mostly stop masturbating for weeks on end, ” even when the doctor told you to abstain from sexual activity you did not.  Not only did you not stop having intercourse, you only reduced masturbating. You need to read a bit about the subject of hedonism.   

If you do not develop Peyronie's disease as a result of your immaturity and lack of self-respect, and I hope you do not, it will be a miracle.  Please try to use this experience as a way to learn something not only to learn about the dangers of jelqing and Peyronie's disease, but more so to learn about yourself and what aspects of your personality are in need of growth and maturity.

If it does turn out that you have an incipient case of Peyronie's disease, please consider that there is much you can do to assist your body to heal and repair the problem.  If half of the men who develop Peyronie's disease eventually heal it on their own without assistance and their penile curvature goes away on its own, there is the possibility you can assist your recovery over Peyronie's disease  by using information found on the PDI website.

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Good luck to you, sir.

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Will the drug finasteride (Proscar) (Propicia) affect my Peyornie's disease in any way?

Dr. Herazy,

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My urologist prescribed finasteride (PROSCAR) to shrink my enlarged prostate and lower my PSA level.  Will this affect my Peyronies in any way?

Thanks,

Lou

Greetings Lou,

Finasteride (prescribed under different names depending how it is being used) is used to treat enlarged prostate and prostate cancer,  (under the name Proscar), and it is used to treat hair loss and male pattern baldness (under the name Propecia).  Initially when finasteride was first given approval by the FDA (Food and Drug Administration) the known side effects of  fatigue, dizziness, weakness, breathing difficulty and reduced blood pressure were thought to be acceptable because they were mild.  Since approval by the FDA and greater usage in the general population more disturbing side effects have been associated with finasteride use.

In mid 2012 the FDA announced that finasteride use can increase the risk of a very serious form of prostate cancer, even though it is sometimes used to treat symptoms of a mild form of prostate cancer.

My first thought when reading your email was, “I wonder if Lou told his urologist that he has Peyronie's disease?”  But being your urologist, I assume you have gone to this doctor in the past simply because you have Peyronie's disease, right?  If so, it appears to me that you probably have gone to this urologist for your PD and now your enlarged prostate, and the doctor prescribed the finasteride for you anyway.

You see, there are currently several lawsuits being litigated against against Merk & Co., the maker of finasteride, about the many apparent side effects of this drug, including complaints related to the urogenital system:  Peyronie's disease, reduced semen volume, reduction of the size of the penis, genital numbness and lowered sex drive.  Unlike many drug side effects that stop once a drug is discontinued, the side effects of finasteride that affect the male reproductive system appear to be permanent and do not go away after the drug no longer is taken.  In addition, there are other categories of lawsuits being processed due to the mounting evidence that it also causes depression, anxiety, “brain fog”, memory problems, comprehension issues, reduced exercise tolerance, weight gain, and muscle and joint aches.

The FDA (Food and Drug Administration) has ordered Merck & Co. to revise its labeling of Propecia in recognition of the growing body of complaints that the side effects of this drug appear to cause permanent sexual dysfunction long after it is no longer being taken.  Most disturbing it seems is that the FDA acknowledges that new side effects and complaints against finasteride are being reported over time, creating a new medical condition now called the Post-Finasteride Syndrome.

Please see, Another case of Propecia and Peyronie’s disease.

Your urologist was not negligent or wrong in prescribing Proscar for your prostate enlargement because the FDA has not officially stated that finasteride causes Peyronie's disease or aggravates established cases of PD.  All of these claims are being studied and evaluated to determine if the association between the drug and the side effect are real or merely coincidence.  While the FDA might take perhaps a few years to reach an official conclusion, and your urologist can still prescribe this medication, you must decide if you wish to take it.

Just a few weeks ago I worked with a man in his late-40s who took Propecia (finasteride) for his thinning hair problem.   He was on it for perhaps a few months when he developed many unusual problems of skin eruptions, anxiety, forgetfulness and weight gain.  A few months later he developed severe erectile dysfunction (ED) and a curved penis.  His doctor denied any connection or association between his patient taking finasteride and these health problems that started after taking the drug.   In the face of all the information and evidence that is developing about this drug, I told him that his MD was not being honest because he was trying to protect himself from a possible law suit.  You must assume that an MD who prescribes a drug knows about its growing history of drug side effects.  The MD must make a decision:  Do I prescribe this drug knowing that it is getting a lot of bad reports of side effects and the drug maker is drowning in law suits, or do I continue to use it because the FDA has not pulled it from the market?  It seems to me that MDs play with fire, but it is their patients who get burned while the MD is protected by a good lawyer!

The problem this 40 year old fellow was having as he worked to reduce his Peyronie's scar, was that his response was very irregular and very slow.  Some days the scar was softer and smaller, and other days it would return to its previous density and size; some days the curved penis was straighter and other days it was not.  He was getting very discouraged.  I later learned that he was also taking a beta-blocker drug for high blood pressure, long known to cause PD.  Apparently this double-whammy of two drugs that cause Peyronie's disease was the basis of his slow and unusual response to his aggressive PDI treatment plan.   

Perhaps you should consider that some of the other drugs you are currently taking for different health issues might also contribute negatively against your Peyronie's disease.  For information along this line, please see Could these drugs be the cause of my Peyronie’s disease?  

I cannot answer your question if Proscar will affect your Peyronie's disease in any way.  My guess is that if it is possible for  finasteride to cause Peyronies disease, it would be possible to make an existing case of PD a bit worse and it might also be possible for it to make recovery all the more difficult as I work to reverse the problem with a PDI plan. 

To my way of thinking, being a very conservative person in these areas related to health and well being, I would talk to my urologist.  I would  learn if there are options to explore;  if there is an enlarged prostate drug that does not carry the possible side effect of causing all these different urinary symptoms that could be used as a substitute for Proscar.  If I had an enlarged prostate and I had Peyronie's disease, I would not take Proscar.  I strongly advise that you should do what you and your urologist decide to do.  TRH

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My Peyronie's disease started after I tried to straighten my curved penis with a penis stretcher, should I use another one?

Winter 2010 I used a penis extender for around 1.5 months (4-6 hours each day or less), where I probably made an injury on the left side (too hard penis with too hard stretch), just below the glans.

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I realize now that I probably have had congenital curved penis all my life.

When my penis is rock hard, it curves 30-40 degrees to the left. I think it was less before Winter 2010 when I started using the penis extender.

I wonder if it could have been possible that I didn't injure the penis, but bigger curve at the glans is due to longer extension on the right side compared to the left side (because of scar tissue on the left side) ?

Seriously, I didn't think so much about the curve before, so the curve might only have been congenital before this likely injury. I went to an urologist in May and he indicated that I maybe have had a little injury on the tunica albuginea (which makes the overall curve bigger).

In December I started to use an extender again, with the use of  XXXXXX, said to work specifically for PD. I stopped after 34 total effective days (9 h each day) as I have read some studies where they have used Verapamil injections before usage of an extender. In one study the curvature went from 30 to 0 and lengthened with 1.5 cm 🙂   I stopped using the extender 10 days ago.

Is this something you recommend? To remove the plaque first and then start using the extender after the plaque has been removed? Because it is speculated that some of the reasons the lengthening is shorter with PD, is because of the plaque. I have just started to use DMSO and SSKI (both topical), and will start to use Serrapeptase and Nattokinase as well. I see on this site that you also recommend Neprinol and some copper + +.

I have another question, so I may have to call you for more clearance; when the plaque diminished, will it leave an empty area in the flesh, maybe making the curvature worse and the penis shortened?

Peyronies disease is not just having plaque, but also having one side shorter than the other. It is then vital to use an extender so the shortest side can catch up the longest side, right?

I`m 31, which package do you recommend to me?

Greetings,

First of all, I removed the name of the penis stretcher product from your email because I think all of them are dangerous, as you have already shown us by reporting you injured yourself with one.  I wish to not promote these contraptions in any way.  The name of your particular device is not important because none of them are different from the others in any important or meaningful way.   All cars are fundamentally the same because all have a motor, seats, windows, wheels and a steering wheel; in that sense they are all identical in their basic design.  The same can be said of penis stretchers.  They all have a clamping device that holds the penis at or near the head, a base that is held against the pubic region, a pair of extendable threaded rods that lengthen the device while it is worn on the penis, a book of instructions that tells you what to do if you develop blisters and skin erosion while using the extender, and surgical wool and antibiotic ointment to keep you from hurting yourself further.

You are a rare man.  I have communicated with very few men who are able to wear a penis extender device for more than a short while; some could not wear one for even 10 minutes.  I have worked with many men who told me they could only put it on only one time and threw it away because of pain and apparent injury.   Many of those men who persisted in spite of the pain and superficial tissue erosion caused by these stretchers soon developed Peyronie's disease.  Some men put a penis stretcher on only one time for 30-60 minutes and then never again because they next day they have signs of early penis injury, and later demonstrate full blown Peyronie's disease.

It seems the prolonged pressure from the head clamp  causes local tissue anoxia (oxygen starvation) deep within the penis tissue; this is probably what happened to you.  When there is a lack of blood circulation in the penis caused by smashing it down with the clamp of the penis extender, blood circulation is cut off and a lack of oxygen occurs where the head is compressed.  This is very much like what happens when a tourniquet is worn too tight or for too long – the lack of oxygen caused by poor blood flow will kill tissue.  Any good boy scout or soldier learns that even if your arm or leg is severely cut you must periodically release the tourniquet – even if hemorrhaging starts again – so that fresh blood can deliver oxygen into the injured limb.  If this is not done the entire limb can become damaged and gangrene can develop.   But you report in one area of your email that you wore yours for 4-6 hours daily for six weeks, and you state later you wore another penis stretcher for nine hours daily for 34 days.  That is incredible.  If you were a boy scout you would have flunked the first aid class for leaving the “tourniquet” on for far too long.  No wonder you developed PD.

You state your congenital penis curvature is now worse than it was before you started using your first penis stretcher; your bent penis now curves 30-40 degrees to the left, more than before using the stretcher.  You think that the solution to the problem caused by the first penis stretcher is to use a second penis stretcher.  I do not agree with your thinking, and I will explain why later.

Please think about this statement I am about to make because it is very important in helping you to understand why you have injured your penis, and why I feel you are going about treatment in a totally wrong way:  If you have Peyronie disease, your problem is not that your penis is bent, dented or otherwise distorted; your problem is that you have dense scar tissue within the tunica albuginea layer of  the penis that as a secondary factor is causing your penis to be curved, dented or otherwise distorted.

Think of it this way.   If you cut yourself shaving, what is the actual problem?  Is your problem the blood running down your chin?  Or is the  problem the hole in your skin that as a secondary factor is allowing blood to leak out of the blood vessels and run down your chin? Certainly the blood gets your attention, but it is not the problem.  If you did not have the hole in your skin the blood would not be running down your chin.  If I was to offer you a way to wipe your face clean, it would not address the real problem which is the hole in your skin.   If I was to offer you something that would help you heal the hole in your skin rapidly you would not have to worry about the blood running down your chin.  Certainly when your penis is bent it gets your attention, but it is not the problem.

I emphasize this point because I believe you are seeing Peyronie's disease as being a curved penis, when it is not.  Peyronie's disease is a soft tissue condition of the penis in which a fibrous plaque of scar tissue develops excessively for some reason (congenital predisposition, nutritional deficiency, trauma, chemical or hormonal imbalance, drug side-effect, or a combination of some or all these) in the tunica albuginea, which in turn prevents the even and symmetrical expansion of the erection and a few other nasty symptoms.

You ask, “Is this something you recommend? To remove the plaque first and then start using the extender after the plaque has been removed?”   The answer is simple:  No.  If you did something to remove the plaque first, you would not need to use an extender because you would not have Peyronie's disease.  With no plaque in the tunica albuginea you would not have a curved penis and there would be no point in using the penis extender unless you are one of those men who believes stretching on the penis will make it bigger – and that is an entirely different topic.

You also ask, “…when the plaque diminished, will it leave an empty area in the flesh, maybe making the curvature worse and the penis shortened?”   The short answer is again, no.   As a longer explanation:  When a pregnant woman delivers a baby, does her abdomen stay stretched out?  When a weight lifter stops exercising, does he develop empty areas and voids where the larger muscle tissue used to be?  When you over-eat and your stomach and abdomen expand and bulge out, does it stay that way permanently?  No, to all of that.  All our body tissues are elastic (even bone to a very minimal degree), allowing the removal of unneeded or foreign tissue cells that are eliminated and healed over in the best way the body can accomplish under the circumstance.   The body always attempts to return to the most efficient and normal state it can whenever and however possible.  In the case of Peyronie's disease the body will attempt to reabsorb the strands of fibrous tissue and heals the tunica albuginea to the best of its ability.  In about half of the men who develop Peyronie's disease this attempt at self-repair and self-healing is successful.  In the approximate other half, the condition is not healed and becomes more or less permanent.

This tendency of the body to always attempt to return to normal (homeostatis), or self-heal, is the basis of the PDI concept for eliminating the Peyronies disease scar. By presenting to the tissue a wide variety of helpful and supporting vitamins, minerals, enzymes, and naturopathic modalities like moist heat applications, DMSO, gentle manual penis stretching (which is vastly different from your mechanical penis stretching concept), ultrasound and acupuncture therapy, we attempt to support, promote, stimulate and accelerate that ability of the body to eliminate the Peyronie's scar that works in 50% of men and fails in the other 50%.  What PDI attempts to do is really not so far fetched or bizarre.  We only attempt to assist and  promote a natural process that is successful in 50% of men when they eliminate their PD scar without any help from anyone.  We are not trying to make pigs fly.  The PDI concept of helping PD correction is one of working with the man who has PD so he can do a better job of what he failed to do in the first place.

Another question you pose is,  “PD is not just having plaque, but also having one side shorter than the other. Ii is then vital to use an extender so the shortest side can catch up the longest side, right?”   You ask that question as though having plaque and having a shortened side of the penis are two separate and distinct problems.  I get the impression you believe that the shortened concave side of penis curvature happens independent of the plaque, when that is not the case.   It is the presence of the dense fibrous scar that shortens the side of the penis in which it is located, and not the other way around.

To solve the problem of Peyronie's disease the body must eliminate the mass of dense fibrous scar in the tunica albuginea.  You cannot eliminate that tissue by stretching or pulling on it.  How do I know that?   Simple laws of physics governing our universe explains why stretching a penis with a PD scar will not influence that mass of inelastic tissue. 

We all have heard the expression many times, “A chain will break at its weakest link.”  We all intuitively understand what that means.   When a stretching or traction force is applied to a series in which there are stronger or stiffer areas as well as weaker or more flexible areas, the weaker or flexible parts or areas will give way, break down, fail or somehow give  up before the stronger parts or stronger areas.   In war: when the enemy attacks, the weaker part of a battle line will give in before the stronger part of a battle line.  Toilet paper and postage stamps: when the paper is pulled the area of paper that has been weakened by the small perforation holes will tear before the non-perforated paper has a chance to tear.  Tires on a car:  the softer the tire, the more it will absorb the vibration energy of a rough ride, and the harder the tire the more it will pass the energy of a rough road to your body.  There are countless examples of the idea that a weaker, thinner or more flexible area will absorb energy before a stronger, thicker or more rigid part is able to do so.  This is why a chain will break at its weakest link.  What does this have to do with Peyronie’s disease?

The PD scar is thicker and stronger than normal skin and corpora cavernosa tissue of a penis. When a traction force is applied to the penis, the normal elastic corpora cavernosa and skin tissue will absorb the energy of the traction force as it stretches out before the inelastic scar tissue has a chance to stretch – the scar will not get a chance to get stretched because the healthy penis tissue will absorb the energy as it stretches first.  Don’t believe me?  Do this experiment.  Find  three rubber bands– two that are thin and stretchy and one that is thicker and heavier than the two thin rubber bands.  Loop these three rubber bands together in a series, placing the two thin stretchy rubber bands at the ends and the thick heavy one in the middle.  Now hold this series of rubber bands at the two ends and pull on it so you are stretching the whole thing out to make them all longer.  Notice that all movement and stretch  is coming from the two thin stretchy rubber bands that are at the ends, and no movement or stretch is taking place in the thick rubber band in the middle.  Only when you stretch so far that the two thin rubber bands are near their breaking point and are ready to snap, will the thick rubber band in the middle begin to move a little.  If you continue to pull, one of the thin bands will break before the thick band has stretched only a small amount.  This will happen every time.  Thus, when you pull on a flaccid penis that has Peyronie’s disease you cannot stretch the thick fibrous scar tissue because the normal elastic skin and deeper corpora cavernosa tissue will absorb the traction force to do all the stretching just like the thick and thin rubber bands looped together.  

In Peyronie's disease any apparent inequality of length is caused by unequal expansion of the corpora cavernosa due to the presence of the dense fibrous scar material within the tunica albuginea. The dense and inelastic scar prevents full expansion of the erect penis, and perhaps only a minor amount of actual contraction of the tunica albuginea.  When I work with men who have been successful in reducing or eliminating the their PD scar material their curved penis returns partially or completely back to normal depending on how much scar elimination occurs.  I am told for some the scar elimination is complete and for others only partial; when I treated my own Peyronie's disease in 2002 it was complete elimination of the PD scar.  No mechanical penis stretching is done and no mechanical penis stretching is needed.  In 2006 a research project was undertaken during which we devised and perfected a gentle manual penis stretching method that works completely unlike and contrary to the concepts presented in the mechanical penis stretchers.  Additionally, I find that lost penis length and girth that occurs is a result of fibrous infiltration of the tunica albuginea and this often improves to the degree the body is successful in its attempt to remove this foreign fibrous tissue, owing to the natural tendency of the body to heal itself when given the opportunity.

Your last question about what Peyronie's treatment plan I recommend for you is the most difficult and also easiest one to answer.   Since I am not your treating doctor I can only advise you as I advise all other men who come looking for help in starting self-treatment.  I suggest you use the largest and most aggressive plan of treatment that you can sustain for at least 3-4months while you follow the PDI concepts of Peyronie's treatment that supports and encourages your body to eliminate this terrible scar material.  If you decide to do so, you might use the gentle manual penis stretching technique as part of that effort.

I appreciate your hard work, earnest effort and sincere desire to rid yourself of your Peyronie's disease.   You are like many men I deal with daily.  I commend you for not accepting your problem and encourage you do all you can to heal your problem.  If I can help you in any way, please let me know.  TRH

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Am I doing the right things for my Peyronie's disease at this point?

Hello,

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My first sign of Peyronies was just 5 weeks ago, a small indentation on side below mid-shaft. A week later I noticed a slight bend in the  same area. Last week the bend was even a bit worse and I did masturbate, not rough though. Since that time I have almost no ability to get a full erection. I believe some of this is mental as I had no problem before and am quite upset mentally about this problem. Injury can be seen (not felt) below the skin when nearly erect. Looks flat elongated and possibly a bit larger recently. So I am now nearing 6 weeks since first signs.

Believe I hurt myself originally during aggressive sex with a slip and bend.

Daily I have been taking since day one 1800mg fish oil, 3- 100mg doses of ubiquinol, 3- 500 mg doses of ALC, 3- 500mg doses of Arginine, 4- 100 mg doses of vitamin E. Daily vitamin B, C and Zinc (30mg). I have no pain with exception of occasional burning sensation at base of penis and above that area.

My question is am I doing the right things at this point? Also, I have heard from many and read that traction often works over time. Is this something I should consider? My case is very new and I saw it almost Immediately.  Is  it too early to begin massaging the scar?some. I workout daily and am in reasonably good shape. Not overweight and have a near impeccable diet. I am severely stressed by this.

Thank you.

Greetings,

First of all, you do not know for a fact that you have Peyronie's disease.  You might simply be feeling the effects of the sudden bending injury to your penis. Typically it takes longer to notice signs and symptoms of an actual case of Peyronies disease, although it is possible since most everything about PD is variable from one case to another.  Because of this I strongly encourage you to go to a urologist for an examination and to have your problem diagnosed so you are sure of what is actually going on with you at this time.

Please be careful with any future sexual activity that could potentially re-injure your penis, whether it be intercourse or masturbation.  The last thing you need is another injury on top of this one.   This is something for you to keep in the back of your mind for the rest of our life.

If you do indeed have Peyronie's disease the actual Peyronie's plaque and later scar formation will never be visible.  These are tissue changes that go on under the surface of the skin in a layer of tissue called the tunica albuginea, and can be located by light and sensitive touch.

Your list of supplementation is interesting but I cannot comment on what you are taking because the quality of the supplementation is just as important as what you are taking and the quantity you are taking.  Since I have no idea about the quality of these items I cannot assume you are doing the right thing for yourself.  If you are interested in using a supplement program to assist your recovery I suggest you consider using those on the PDI website since I have utmost confidence and experience with them when used to increase healing of Peyronie's disease. I can tell you from looking at your list of supplementation that you are incorrect in addressing your problem by only taking supplements and not using what I will call external therapies to assist recovery from the exterior of the body.   I will be able to work with you when it is these products you are using.

Every month I hear from men whose Peyronie's disease started after using a penis traction device; they can and do cause injury.  For this reason I think it would be wrong thing to use for any man, especially after having sustained an injury such as the one you describe. 

Please do not massage your penis directly because doing so could cause further injury.  Perhaps you have read about the PDI Massage and Exercise video.  Well, in that video we clearly instruct men with PD to not directly massage the penis.   The message we propose to use is applied to areas and tissue other than directly over or to the penis.  You can find out more about this by clicking Peyronies disease exercises.

Right now it appears that you are guessing about a lot of things when it is important that you should be doing the right things.  Please spend some time reading different aspects of this subject, as with the article  Guide for Peyronie's disease treatment.   If you have additional concerns or questions please let me know.  TRH

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Depressed 22 year old student thinks he has Peyronie's disease and mentions suicide

Hi Dr.Herazy,
I am young student of just 22. I am feeling some cord-like lesions (around 4) around my penis and the penis is curving just right at the base lesion,the curve is though minor but my penis is loosing girth at the base and I am sure this is peyronies.  I can find the lesions i.e plaque very soft and moving like veins. please help me. Depressed a lot. Went till suicide.

Greetings young man,

I will be happy to help you.

First of all, you do not know you have Peyronie's disease.  You think you have Peyronie's disease.  You could easily be wrong because a few things you mentioned in your email does not fit a good description of this problem. 

1.  You are far younger than average to develop Peyronies.

2.  Seldom does Peyronie's present itself as multiple cords.

3.  Seldom does Peyronies in the early stage appear as a soft lesion, but usually firm to hard. 

4.  Seldom are the Peyronies lesions moveable to any great degree.

5.  Seldom does someone have four separate lesions that are easily located; most men cannot find one. 

6.  You did not mention pain, which is a rather common complaint in the early phase of Peyronie's disease.  

7.  You did not mention trauma, which is usually a large part of Peyronie's disease when someone your age develops it, so this is a missing part of your story that is almost always mentioned from someone like you. 

Based on the above, I have serious doubts your problem is Peyronie's disease.  I suggest the first thing you should do is to go to your local doctor for a complete examination to determine the actual problem that is going on.  My suspicion is that you have a small congenital anomaly or curved penis you were born with that you are just now noticing; that the four cords are indeed veins; and that your overactive imagination is suggesting that you have lost girth.

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If you read some easily available information like, What is Peyronie's disease? , you can learn more about it.

Lastly, you are more than a penis.  You are an important and valuable person with or without Peyronie's disease.  Anyone who thinks less of you because you might be missing an arm, an eye, a leg, or the use of your penis, would only do so because of immaturity and distorted values on their part, and the fact that they do not know you.  You need to organize your thinking and control your emotions which are now only being guided by fear and poor judgment.   Look around you for just a few moments to see how fortunate you are and how good your life is at this moment, and in the future that you are creating.  Put your personal, moral and spiritual values where they belong .  Realize how good life is regardless of small problems that arise while we live the wonderful life that we choose for ourselves.  

There is a lot that a person like you could do to help yourself heal if it did turn out that you have a case of Peyronie's disease.  That is why we have so many people who come to this website to help their body reverse and correct the Peyronie's problem.  Go to  Testimonials from the Peyronie's Disease Institute to learn about the many people who have used the PDI therapy ideas and eliminated their problem by supporting their natural ability to heal the Peyronie's scar.     

Keep your heart and your mind on the positive.    Please keep in touch with me and let me know soon what you learn.  TRH

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Comments about Peyronie's disease measurements and difficult or painful sexual intercourse

Hi doctor,

I saw a picture of a individual on your site with Peyronies where the claim was, he was 45 degrees. It didn't seem to me like his curved penis was 45 degrees, obviously there's more than one way you can measure. 

I always believed the side with the curve is the side you measure. The problem is that when measuring Urologists can do it differently because there is no set standard. Its like penile length measurement,some doctors/researchers will press the ruler to the pubic bone, but others will only touch the ruler lightly to the abdomen. When measuring girth some measure at the base, some in the middle.  Some researchers /doctors stretch the length only with some doing it once,others a few more times & elongating it ,others use pharmaceutical induced erection. 

The bottom line is that a congenital curve or Peyronies curve (if it doesn’t hurt) doesn’t matter if its 0 degrees or a 1,000 degrees if intercourse can be done without pain for both parties.

Bill

Greetings Bill,

Often I will notice that the person will only estimate the degree of penis curvature, and usually on the exaggerated side.  Actually, while the degree of curvature is of course important to know and record, it is really much more important and significant to know the size, shape, density and surface features of the PD scar that is causing the curvature. You see, the curved penis is just a result or secondary factor to the real problem of Peyronie’s disease – the Peyronie’s plaque. Too much time and attention is paid to the secondary problem (the bent penis) and not enough to the cause (PD scar). I can certainly understand why the curved penis and distortion get so much attention from people, but being all engrossed only in the curvature does prevent a man from focusing on the actual problem and how to treat it correctly.

I have worked with men who swear they cannot penetrate with a 10 degree bend, and other men who say that their 60 degree bend only slows down penetration. The problem of penile distortion and resultant difficulty of sexual intercourse is a complex problem, that is made so because human emotions and motivation are a part of the equation. Many times the amount of difficulty of penetration, or pain during intercourse, with a couple who must deal with Peyronie’s disease is due to lack of natural lubrication and lack of preparedness of the female partner; if she is tense and fearful that she will hurt him, she is less likely to be relaxed and fully sexually stimulated to produce the level of natural readiness for that makes penetration easy. If you are interested in this subject because of some difficulty with sex now that you have Peyronies, please see my book “Peyronie’s Disease and Sex.”

Your last comment is quite true.  Most men would not care or do much about their Peyronie's disease if they could still have intercourse without a problem.

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TRH

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