7 Common Peyronie’s Disease Symptoms You Should Know

Peyronie’s disease is a connective tissue disorder that affects the penis, characterized by the formation of fibrous scar tissue (plaques) inside the organ. This condition can cause significant physical and psychological distress for men who experience it. Named after François Gigot de la Peyronie, the French surgeon who first described it in 1743, Peyronie’s disease affects an estimated 3-9% of men, though the actual number may be higher due to underreporting.

The condition typically develops in two phases: an acute phase where symptoms are actively changing and a chronic phase where symptoms stabilize. Understanding the symptoms is crucial for early detection and proper medical management. While some cases may improve on their own, many require medical attention to prevent worsening and to address the physical and emotional impacts of the disease.

Recognizing the signs early can help men seek appropriate medical care and discuss treatment options with their healthcare provider. Below are the most common symptoms associated with Peyronie’s disease.

1. Penile Curvature (Bent Penis)

The most recognizable symptom of Peyronie’s disease is an abnormal curvature of the penis during erection. This bending occurs because the fibrous plaque that forms prevents that area of the penis from expanding normally during an erection, while the surrounding healthy tissue expands as usual.

The curvature can occur in various directions:

• Upward curvature: The most common type, where the penis bends toward the abdomen
• Downward curvature: The penis bends toward the floor
• Lateral curvature: The penis bends to the left or right side
• Complex curvature: Multiple plaques causing curves in multiple directions

The degree of curvature varies significantly among individuals, ranging from mild bends that don’t interfere with function to severe curves exceeding 90 degrees. The curvature may worsen during the acute phase of the disease before stabilizing. Even a moderate bend can make sexual intercourse difficult or painful, and severe curvature may make penetration impossible.

2. Palpable Plaques or Hard Lumps

Men with Peyronie’s disease can often feel hardened areas, lumps, or bands of scar tissue under the skin of the penis. These plaques are the hallmark of the condition and represent areas where fibrous tissue has replaced normal elastic tissue.

Characteristics of these plaques include:

• They feel firm or hard to the touch, similar to thick scar tissue
• They may be located on the top, bottom, or sides of the penile shaft
• Size varies from small nodules to larger bands that extend along the shaft
• They’re typically painless when touched in the chronic phase, though they may be tender during the acute phase
• Multiple plaques can be present in some cases

These plaques can sometimes be felt more easily when the penis is stretched or semi-erect. The location of the plaque usually corresponds to the direction of penile curvature. In some cases, calcium deposits form within the plaque, making them feel even harder.

3. Penile Pain and Discomfort

Pain is a common symptom, particularly during the acute or early phase of Peyronie’s disease. The pain can manifest in several ways and may significantly impact a man’s quality of life and intimate relationships.

Types of pain associated with Peyronie’s disease:

• Erection-related pain: Pain that occurs specifically when the penis becomes erect, caused by stretching of the fibrous tissue
• Flaccid pain: Discomfort even when the penis is not erect, though this is less common
• Tenderness: The area around the plaque may be sensitive to touch
• Pain during intercourse: Discomfort or pain experienced during sexual activity

The intensity of pain varies considerably among men, ranging from mild discomfort to severe pain that makes erections extremely uncomfortable. Fortunately, in many cases, the pain decreases or resolves completely as the disease moves from the acute phase to the chronic phase, typically within 12-18 months. However, the physical changes like curvature and plaques usually persist even after pain subsides.

4. Erectile Dysfunction or Difficulty Maintaining Erections

Erectile dysfunction (ED) is a significant concern for many men with Peyronie’s disease. Studies suggest that 20-50% of men with Peyronie’s disease experience some degree of erectile dysfunction, which can occur for several reasons.

How Peyronie’s disease contributes to erectile dysfunction:

• Physical obstruction: The fibrous plaque interferes with the normal expansion of erectile tissue and blood flow
• Vascular changes: The disease can affect the blood vessels necessary for achieving and maintaining erections
• Structural damage: The scar tissue disrupts the normal architecture of the penile chambers
• Psychological factors: Anxiety, stress, and depression related to the condition can contribute to ED

Men may notice that their erections are not as firm as before, that they have difficulty achieving a full erection, or that they cannot maintain an erection long enough for satisfactory intercourse. The curvature itself may also make it mechanically difficult to engage in intercourse, even when erectile function is partially preserved. The combination of physical and psychological factors often creates a cycle that worsens erectile function over time.

5. Penile Shortening

A distressing symptom that many men with Peyronie’s disease experience is a noticeable reduction in penile length. This shortening can occur in both the flaccid and erect states and may significantly impact a man’s self-esteem and body image.

Several mechanisms contribute to penile shortening:

• The fibrous scar tissue contracts and doesn’t stretch like normal tissue
• The curvature causes an apparent shortening as the penis bends rather than extending straight
• Loss of elastic tissue reduces the overall expandability of the penis
• Chronic lack of full erections can lead to tissue changes that reduce length

The amount of shortening varies among individuals but can range from barely noticeable to several centimeters. This loss may be gradual during the active phase of the disease. Both actual shortening (due to tissue loss and scarring) and apparent shortening (due to curvature) contribute to the perceived reduction in length. This symptom often persists even when other symptoms like pain improve.

6. Hourglass Deformity or Narrowing

Some men with Peyronie’s disease develop what’s known as an hourglass deformity, where a section of the penile shaft appears narrowed or constricted, creating an indentation that resembles an hourglass shape.

Characteristics of hourglass deformity:

• A band of scar tissue encircles the penis, creating a ring-like constriction
• The narrowing may be visible both when flaccid and erect, though it’s typically more pronounced during erection
• The constricted area prevents normal expansion during erection
• This can occur alone or in combination with curvature
• In some cases, multiple constriction bands may be present

The hourglass deformity can affect sexual function by creating an uneven rigidity along the shaft, making intercourse uncomfortable or difficult. The narrowed section may also be more prone to injury during sexual activity. This particular presentation of Peyronie’s disease can be challenging to manage and may require specialized evaluation by a urologist familiar with the condition.

7. Psychological and Emotional Symptoms

While not physical symptoms per se, the psychological and emotional impacts of Peyronie’s disease are real and significant aspects of the condition that deserve recognition and attention.

Common psychological effects include:

• Anxiety: Worry about sexual performance, partner satisfaction, and the progression of the disease
• Depression: Feelings of sadness, hopelessness, or loss related to changes in sexual function and body image
• Embarrassment and shame: Reluctance to seek medical care or discuss the condition with partners
• Relationship stress: Difficulty in intimate relationships due to physical changes and emotional distress
• Loss of self-confidence: Diminished self-esteem and masculine identity
• Social withdrawal: Avoiding intimate situations or new relationships

The psychological burden of Peyronie’s disease can be as debilitating as the physical symptoms. Men may avoid sexual encounters altogether due to fear of embarrassment or inability to perform. The condition can strain existing relationships when communication breaks down or when partners struggle to understand the impact of the disease. Studies have shown that men with Peyronie’s disease have significantly lower quality of life scores compared to the general population. Recognizing these psychological symptoms is important, and men should feel encouraged to discuss these concerns with their healthcare provider, who may recommend counseling or support groups in addition to addressing physical symptoms.

What Causes Peyronie’s Disease?

While the exact cause of Peyronie’s disease remains not fully understood, researchers have identified several factors that contribute to its development. The condition is thought to result from repeated minor injury to the penis, combined with certain genetic and physiological factors that affect wound healing.

Primary Contributing Factors:

• Penile trauma or injury: Repeated minor injuries during sexual activity, athletic activities, or accidents can trigger abnormal healing responses. Even injuries that seem insignificant at the time can contribute to plaque formation, particularly in men with predisposing factors.
• Abnormal wound healing: Some men have an excessive healing response to minor injuries, leading to excessive scar tissue formation. This may involve an overproduction of collagen and other fibrous proteins that create the characteristic plaques.
• Genetic predisposition: Peyronie’s disease appears to run in some families, suggesting a genetic component. Certain genetic variations may affect how connective tissue forms and heals, making some men more susceptible to developing the condition.
• Autoimmune factors: Some evidence suggests that autoimmune processes, where the body’s immune system attacks its own tissues, may play a role in some cases. This could explain why Peyronie’s disease sometimes occurs alongside other autoimmune or connective tissue disorders.
• Age: The condition is most common in men between 40 and 70 years old, though it can occur at any age. Age-related changes in tissue elasticity and healing may contribute to increased risk.
• Connective tissue disorders: Men with Dupuytren’s contracture (a hand condition involving abnormal tissue in the palm) have a higher risk of developing Peyronie’s disease, as both conditions involve abnormal collagen deposition.
• Medical conditions: Diabetes, high blood pressure, high cholesterol, and cardiovascular disease have been associated with increased risk, possibly due to effects on blood flow and tissue health.
• Lifestyle factors: Smoking and excessive alcohol consumption may increase risk by affecting blood flow and tissue healing processes.

It’s important to note that many men with Peyronie’s disease cannot recall any specific injury, suggesting that very minor, unnoticed trauma or a combination of subtle factors may trigger the condition. The disease likely results from a complex interaction between injury, individual healing responses, genetic factors, and overall health status.

Prevention Strategies

While it’s not always possible to prevent Peyronie’s disease, especially in men with genetic predisposition or certain medical conditions, there are strategies that may reduce risk or minimize the severity of the condition if it develops.

Risk Reduction Approaches:

• Protect against penile trauma: Use care during sexual activity to avoid injury to the penis. Communication with partners about comfort and pain, using adequate lubrication, and avoiding overly aggressive movements can help prevent minor trauma that might trigger the condition.
• Manage underlying health conditions: Properly control diabetes, high blood pressure, high cholesterol, and cardiovascular disease through medication, diet, and lifestyle changes. These conditions affect blood flow and tissue health, which may influence risk.
• Quit smoking: Smoking affects blood flow throughout the body, including to the penis, and may impair healing processes. Quitting smoking benefits overall vascular health and may reduce risk of developing Peyronie’s disease or experiencing more severe symptoms.
• Limit alcohol consumption: Excessive alcohol use can affect sexual function and overall health. Moderate alcohol intake or abstinence may support better urological health.
• Maintain a healthy lifestyle: Regular exercise, a balanced diet, stress management, and maintaining a healthy weight support overall vascular and tissue health.
• Early medical attention: If you notice changes in penile shape, new lumps, or pain during erections, seek medical evaluation promptly. Early detection and intervention may help prevent progression to more severe symptoms.
• Avoid certain medications if possible: Some medications, particularly beta-blockers for blood pressure, have been weakly associated with increased risk. However, never stop prescribed medications without consulting your doctor, as the benefits typically outweigh any potential risk.

It’s important to understand that even with preventive measures, some men will still develop Peyronie’s disease due to genetic factors or other uncontrollable variables. The focus should be on maintaining overall health and seeking prompt medical attention if symptoms develop, rather than feeling responsible for causing the condition.

Frequently Asked Questions

How common is Peyronie’s disease?

Peyronie’s disease affects approximately 3-9% of men, though the actual prevalence may be higher as many men don’t seek medical attention due to embarrassment. It most commonly occurs in men between ages 40 and 70, but can affect men of any age.

Will Peyronie’s disease go away on its own?

Some cases, particularly those detected early, may improve spontaneously without treatment. However, this occurs in only about 5-15% of cases. Most cases either stabilize or worsen without intervention. The pain often improves over time, but physical changes like curvature and plaques typically persist without treatment.

When should I see a doctor about penile curvature?

You should consult a healthcare provider if you notice any new curvature, lumps, pain during erections, difficulty with sexual intercourse, or changes in erectile function. Early evaluation is important because treatment may be more effective during the acute phase of the disease before the condition becomes chronic.

Can Peyronie’s disease affect fertility?

Peyronie’s disease doesn’t directly affect sperm production or fertility. However, the physical changes and erectile dysfunction associated with the condition can make sexual intercourse difficult or impossible, which can indirectly affect the ability to conceive naturally. Many men with Peyronie’s disease can still father children, especially with appropriate medical management.

Is Peyronie’s disease painful?

Pain is common during the acute phase of Peyronie’s disease, particularly during erections. This pain typically decreases or resolves as the condition moves into the chronic phase, usually within 12-18 months. However, not all men experience pain, and the severity varies greatly among individuals.

Does Peyronie’s disease increase cancer risk?

No, Peyronie’s disease is not cancerous and does not increase the risk of developing penile cancer. The plaques are benign fibrous tissue, not tumors. However, any new lumps or changes in the penis should be evaluated by a healthcare provider to rule out other conditions.

Can Peyronie’s disease come back after successful treatment?

Recurrence is possible but relatively uncommon after successful treatment. The risk of recurrence may depend on the underlying causes, particularly if factors like repeated trauma or certain health conditions continue to be present. Following your healthcare provider’s recommendations and maintaining good overall health may help reduce recurrence risk.

How is Peyronie’s disease diagnosed?

Diagnosis typically involves a physical examination where the doctor palpates the penis to identify plaques, assesses the degree of curvature (often with photographs taken by the patient at home during erection), and evaluates erectile function. Ultrasound imaging may be used to assess the plaques and blood flow. Your doctor will also review your medical history and discuss how the condition affects your sexual function and quality of life.

References:

• Mayo Clinic – Peyronie’s Disease
• University of Michigan Health – Peyronie’s Disease
• Urology Care Foundation – Peyronie’s Disease
• National Institute of Diabetes and Digestive and Kidney Diseases – Peyronie’s Disease
• Johns Hopkins Medicine – Peyronie’s Disease