Tag Archives: sexual intercourse

Can I cause more damage to my Peyronie’s disease due to difficult penetration during sex because of a partial erection?

Posted on by Dr.Herazy

Hi Dr. Herazy,

I started having some pain with erections about March 2012, seen family doctor, asked if penis was bent and when I self examined, and yes it was. He then told me I had Peyronie's Disease. I had about 30 degree bend to left and could still enjoy sex. Most pain has subsided, but about 2 weeks ago, found I could not make penetration with my wife. Upon self exam, I see I am not getting full erection, top of penis is soft while base is erect. I gather there must now be full blockage to the end of penis? I am thinking of trying your medium treatment plan. Also, can I do more damage if I try again with my wife? I was also thinking of trying CyberSkin Transformer, would that help? Like every other guy, this is a huge blow to me.

Thanks!

 

Greetings,

Your assumption that your poor erection quality is due to a "full blockage to the end of the penis" is not correct.  Actually, the opposite is probably true.

In Peyronie's disease the reduction of erection strength is typically due to the Peyronie plaque preventing the closure of valves in the penis veins.  When these valves cannot close the blood that is normally circulating within the penis simply is not trapped and collected to create the hydraulic effect known as a erection.  Imagine what would happen if you attempted to blow up a balloon that had the other end cut off.  Any amount of air you would blow into the balloon would not be trapped inside and the balloon would not swell and become firm with increased internal pressure caused by air being collected in an enclosed space.  To say it another way, if you try to warm up your bathroom in the winter you must close the door so the heated air can collect inside the enclosed space.  Opening the door allows the heated air to escape.  In the soft area of your penis the blood is not being trapped because the scar prevents closure of the valves that trap blood.  Your blood circulation in the penis is probably as good and uninterrupted as it has ever been, it is just not being collected to create the hydraulic pressure a good erection requires. 

What is probably happening in your situation is that the fibrous material related to your Peyronie's disease has advanced now to the point that the internal Peyronie's scar or plaque material is getting larger and reducing the ability of the valves to close to trap blood and create a complete and normal erection.  The solution involves reducing the size of scar, or even eliminating it.  That is where the PDI treatment plans come in to help you heal them as they normally are healed in about half of the cases.  The medium plan is a popular way to get started with Peyronies treatment.     

Sexual penetration with a partial erection can be difficult and dangerous.  It is dangerous in the sense that a partial erection can suddenly bend and buckle during intercourse and this can result in further damage to the tunica albuginea and make your PD worse than it is now.  I suggest that you get the 2nd book I wrote, "Peyronie's Disease and Sex" that will explain in great detail how you can maintain your sexual activity in spite of having PD.  It is a great book that has helped many couples in this vital area of life.  

The Cyberskin Transformer series of products are effective in providing additional support to the penis to reduce – but not totally eliminate – the possibility of sudden bending during sexual activity that can further injure the penis.  There are other products as well that PDI has available for this purpose like the Girth Prosthetic Rings, Invisi-rider Enhancer and the Reversible Sleeve.  All of these can be found at the sex supports/aids section of the PDI store front.

Peyronie's disease can be a tremendous personal stress to everyone who is in a relationship who has to deal with the outlandish physical changes that can happen to a penis.   The important thing is that you work to do all you can to reduce those changes by increasing and supporting the natural ability of your body to eliminate the internal fibrous scar tissue that causes the curved penis and weak erections of Peyronie's disease. Please let me know if I can help you in any way to correct your problem to the greatest extent possible.   TRH   

Will sexual activity aggravate my Peyronie’s disease?

Posted on by Dr.Herazy

hi doctor,

you said that pd scar heal it self in (12 -18) months, but i think that is possible if one prevents any sexual activities . I am saying that because i already have pd and i almost ordered the treatment from your site knowing that i don't have sexual activities and never had ,but a few days ago i notice that my pd scar has  increased after my penis became erect while i am sleeping .Now i am scared that this scar will increase more and more and the treating process will be harder, so help me.

forgive me for my tedious question.

abduallah, 20 years

 

Greetings Abdullah,

I am not sure I exactly understand what it is that you are trying to say.  

As a general statement I can tell you that simply having, or not having, sexual relations will not help or hurt your recovery from Peyronie's disease or worsen your condition.  The primary issue about sexual activity in regard to Peyronie's disease is any potential for abuse and injury that might occur during sexual activity. Further, what I mentioned about sexual activity when done gently, safely and while using reasonable judgement and restraint, will not necessarily aggravate Peyronie's disease, the same can be said about developing an erection.  Erections do not cause and cannot aggravate the problem, except if there are extenuating circumstances associated with the erection. An example of this situation would be if there is not enough room for the erection to extend outward and so it becomes painfully restricted, and forced to remain bent even though it is erect.

For further information please see "Peyronie's disease and sex safety concerns."

If this explanation does not help you, please let me know.  TRH 




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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Peyronie’s Disease and Intercourse

Posted on by Dr.Herazy

Peyronies and problems with sexual intercourse

Sexual intercourse can be a problem in Peyronie’s disease due to the penile distortion that occurs because of the presence of fibrous scar tissue, or Peyronie’s plaque, within the shaft of the penis.  The presence of this fibrous plaque can cause the penis is bend in any direction to a minor degree that is hardly noticeable, up to and even beyond a 90 degree curve.  In addition to a significant bend, Peyronies disease can also cause distortions that are described as “bottle neck” and “hour glass” for their resemblance, as well as simple dents or dings along the side of the shaft. Click here for Peyronie’s pictures.

The cause of Peyronie’s disease has not yet been determined even thought the condition has been known for almost 500 years.  Some researchers theorize the distortion forms as a result of trauma to the penis, or when minor contact causes an indirect micro-trauma shearing force that can result in minor bleeding into the wide area of tissue.   While healing is taking place certain growth factors that appear to be genetically determined cause an abnormal amount of scar tissue (or plaque) to form at the site of injury.

The penis is composed of three cylindrical cavities, with two of these at the top and one below.  The top two are wider and thicker, and are called the corpus cavernosa, while bottom cylinder is the corpus spongiosum and contains the urethra or the tube through which urine flows.  During erection the two top corpora cavernosa expand to trap and hold the blood that produces the pneumatic force that results in enlargement and rigidity.   Each of these paired cylinders is surrounded by a very elastic covering called the tunica albuginea, similar to the casing of a sausage.

In a case of Peyronie’s disease the elastic tissue of the tunica is replaced by scar tissue, so it lacks flexibility and the ability to stretch.  Because the plaque is not elastic, but rather hard, it will not stretch with erection.  When this happens the erection that occurs is not even or symmetrical, and often smaller than before.

What starts out as a small nodule or constriction on the penile shaft just below the skin surface, eventually expands to form a flat plaque or deposit that can sometimes extend along the entire length of the shaft.  This plaque invades and replaces the elastic tunica albuginea covering of the internal tissue of the penis, leaving a mass of inflexible material. In some patients the penis beyond the plaque will not become as rigid. When a man with this degree of extensive Peyronie’s has an erection, the scar or plaque material cannot expand, resulting in a curved or bent penis, or one that exhibits a bottle neck or hour glass deformity – or a combination of these distortion patterns.

Often the plaque is located on the top surface of the penis, causing an upward curvature.  However, plaques can occur anywhere on the penis; the scar or plaque will always be worse on the concave portion of the distortion pattern.

Many men with Peyronie’s disease complain not only about their curved or distorted erection, but also about the loss of length and girth. These are all results of the inelastic tissue within the substance of the penile body.

Peyronies curved penis and sexual intercourse

One-third of men with Peyronie’s have pain when erect, and a smaller number become impotent. In some cases, the head of the penis does not fill with blood, resulting in a penis that is erect on the bottom near the pubic area, and soft or flaccid toward the top part of the penis – this is called a bottle neck deformity.  This type of distortion would make intercourse difficult due to penetration problems.  About half of men with Peyronie’s disease continue to function sexually when their curving penis is gradual and minor.  But as the curvature becomes abrupt and large the amount of sexual difficulty also increases.   Half of men with Peyronies experience frequent to constant problems with intercourse due to their distortion pattern.

For in-depth solutions and discussion of the sexual problems related to Peyronie’s disease please review the contents of Peyronie’s Disease & Sex, a one-of-a-kind book written by a man who completely cured his PD using the Alternative Medicine treatment principles found on the Peyronie’s Disease Institute website.

Peyronie’s Disease and Masturbation

Posted on by Dr.Herazy

Masturbation prominently factors into Peyronie’s disease.   A man will either cause his own Peyronie’s problem when he abusively or violently masturbates , or later as he attempts to cope with the growing sexual frustration and limitation created by  the curved penis of his Peyronie’s disease.

Masturbation is the self-stimulation of the female or male genitals to arouse sexual pleasure, usually to the point of orgasm or sexual climax.  It is commonly performed by touching, stroking, or in some way pleasurably stimulating the penis or clitoris until orgasm occurs.

Peyronie’s disease intersects with masturbation in particular for several reasons:

  1. Older boys and men of all ages can injure themselves during rough masturbation rituals with the potential to lead to Peyronie’s disease, especially if genetically predisposed to develop PD.
  2. Men who are unable or too embarrassed to expose their deformity to their sexual partner often resort to masturbation to release sexual tension, and perhaps in a negative mindset will be abusive to themselves.
  3. Men who are unable to engage in sexual intercourse because of severe penile distortions can receive masturbation from them partner as a way to share sexual pleasure, serving as a substitute for traditional intercourse.
  4. Women who are denied sexual intercourse because of a partner’s severe penile distortion or erectile dysfunction related to Peyronie’s disease can be masturbated as a way to share sexual pleasure, as a substitute for traditional intercourse.
  5. Women who are denied sexual intercourse because of her partner’s emotional and physical withdrawal, thus isolated from the man with Peyronie’s disease, can use masturbation to release sexual tension while he is working out his own problems.

General masturbation comments

At one time or another or all life long, just about everyone masturbates – male and female.  It is an extremely common behavior, even among people with access to sexual intercourse and other erotic outlets with a partner. While in one national study 95% of males and 89% of females reported they have masturbated, those who reported they had never masturbated admitted they would be reluctant to admit it if they did – thus these numbers are probably low.

For young children masturbation is a normal part of youthful exploration, often becoming the first sexual act. Most people continue to masturbate in adulthood, and many do so throughout their lives.  The most common explanation given why people limit or avoid masturbation is the shame and guilt that arises from religious and societal pressure.

Once regarded as a perversion and sign of a mental problem, masturbation is now seen as a normal, healthy sexual activity that is pleasant, fulfilling, acceptable, and safe. Masturbation is only considered a problem under certain circumstances:

  1. Directly or indirectly inhibits sexual activity with a partner.
  2. Causes significant distress if done compulsively and uncontrollably, against the greater desire of the individual to stop.
  3. Interferes with daily activities of life.
  4. Compulsively done in public or at socially inappropriate times.

No longer considered as being harmful, masturbation is thought to improve sexual health and interpersonal relationships, if after learning what is personally pleasurable this knowledge is shared with a partner.  Especially in the situation of Peyronie’s disease many partners use mutual masturbation to develop and refine techniques for a more satisfying sexual relationship, when more traditional sexual outlets are not an option.

Masturbation can contribute to sexual dysfunction in Peyronie’s disease

Men who habitually masturbate in ways that are not common with a sex partner – employing mechanical measures that produce an unusually intense stimulus, stroking with great pressure or unnatural friction, resulting in soft tissue damage of the penis – can become so accustomed and dependent on that particular level or type of stimulus that partner-sex becomes insufficient for sexual arousal and leads to retarded ejaculation.  When a man experiences this sexual dysfunction he finds it difficult or even impossible to climax during more conventional partnered sex.

Michael A. Perelman, PhD, clinical associate professor of psychiatry, reproductive medicine, and urology at Weill Cornell Medical College in New York City and the president of the Society for Sex Therapy and Research states, “Any man experiencing any sexual dysfunction should ask himself if he’s masturbating in ways that produce sensations that differ from those he gets from his partner’s hand, mouth, or vagina.  If so, then he should consider what he could say to her to make the stimulation more similar — and how he could change the way he masturbates to make it feel more similar to what his partner does.”

Safe masturbation in Peyronie’s disease

Generally, the best and safest masturbation you can enjoy by yourself or with a partner is that which is most like vaginal stimulation.  This can be as simple as using the hand in a fist to surround the erection while applying upward and downward stroking, oral stimulus, or sex toys that feel like a vagina.   This kind of masturbation is therapeutic once the Peyronie’s curvature has been corrected and more traditional sexual encounters can be enjoyed once again.

Lastly, because penile injury is thought to be a prime cause of Peyronie’s disease, it is mandatory that all masturbation be gentle and well lubricated to avoid worsening of an already bad situation. For more information, click on “Peyronie’s Disease and Sex.”