Size matters. No man wants to think he’s got a small dick. But for some guys—about one in ten, in fact—their most immediate worry is caused by the changing shape of their cock. Now, most men’s dicks will stand slightly to the left or right when they’re erect—and that’s nothing to worry about. What we’re talking about here is a severe bend or curve caused by Peyronie's disease (also known as penile curvature, penile fibrosis or induratio penis plastica).
Peyronie's disease is caused by a buildup of plaque or scar tissue at either at the tip or the base your penis. There’s a lot of misinformation surrounding the condition so before we look at it in more detail, let’s set the record straight and debunk three of the most common myths:
Why has this happened to me?
It’s estimated around one in ten men suffer from Peyronie's at some point in their life. It can impact men of any age, but it’s more likely to affect you over the age of 35, with most guys developing the condition around 49.
No-one really knows what leads to the onset of Peyronie’s. Some doctors think it occurs after an injury to an erect penis—perhaps getting bent or ‘broken’ during sex. Remember guys, you can't technically break your penis as there are no bones in it, but you can suffer a penile fracture—and in some cases the healing process can cause the plaque to build up. It’s also worth noting that the damage doesn’t have to be sexually-related at all—sports injuries or car accidents can lead to penile fractures as well. Other healthcare professionals believe that it might be an autoimmune immune response, while a growing number think it could be hereditary.
Development and prognosis
Peyronie’s disease develops in two phases. The acute phase starts from the onset and lasts about a year. At first, the buildup may look like inflammation, but as the plaque continues to develop you’ll be able to see it under the penis skin in flat lumps or as a ring of hard tissue.
The plaque is deposited within a layer of connective membrane called the tunica albuginea which surrounds the erectile tissue. The tunica albuginea plays a significant role in getting and maintaining an erection as it traps your blood in place and keeps you hard. This is why, in some instances, there appears to be a physical link between Peyronie's disease and Erectile Dysfunction (ED).
The curve or bend can become more pronounced as the plaque continues to build over time. In some cases, it becomes painful to get an erection and can make sex difficult or impossible. This is because the scar tissue doesn't stretch when the penis is erect and forces it to bend. Some guys have reported penile pain even without an erection and say that taking a leak can be difficult.
During the acute phase, Peyronie's can also lead to loss of length and girth, or give your cock an hourglass shape. For this reason, it can lead to psychologically-linked ED as guys try to cope with increasing levels of anxiety, worry, and self-consciousness. It’s no surprise, then, that about half of the men suffering from Peyronie's report severe psychological distress and, in some cases, depression. This is really tragic because, although there is no cure, the condition can be treated in nearly all cases.
After about 12 months, Peyronie’s will stabilize and the plaque and symptoms shouldn’t get any worse. At this stage, most guys will stop experiencing any penile pain, but the penis will not return to the way it was before the illness. For just over 10% of men with the disease, the symptoms may lessen during the acute phase and the plaque might even dissolve by itself. At the moment, doctors do not know why it recedes for some men and not others.
If you decide to see a doctor (and we recommend that you do), they’ll probably carry out a physical examination of your penis—holding it and feeling it to search for scar tissue. Although this is a very intimate part of your body, you should try not to be worried. Doctors are professionals, they will be respectful and will treat you with dignity. You might also be asked to bring in some pictures of your erect penis—this is probably the only time where it will be OK to show a stranger a picture of your dick. In some instances, your doctor might also decide to run an ultrasound test. If that's the case they’ll give you an injection that brings on an erection just before the test is carried out. Again, do not be worried or embarrassed.
The treatment that you decide on with your doctor will really depend on how advanced the disease is and which phase it is in. During the acute phase, treatment is really geared to improving the symptoms and attempting to halt further physical penile changes. Once the acute phase has passed more options including surgery are available.
It’s worth knowing a little about the different treatments before you visit your doctor so you can have a more engaged discussion and decide how you want to proceed. Here are a few of the most common options:
Invasive therapies and surgery
Conclusion: a few words on coping and support
A lot of guys find it very difficult to cope with the onset and the acute phase of Peyronie’s disease. If you’re in a relationship, it could help to explain to your partner what it is and how it could impact lovemaking. And, although most of us guys aren’t so good at talking about stuff like this—it could help to discuss how feel about the changed appearance of your dick and your performance in the bedroom. Some guys really genuinely benefit from seeking emotional counseling too, but we know that’s not for everyone.
If you are suffering from Peyronie’s disease or know someone that is, you might be interested in joining one of many online support groups. There's also a website with the results from the latest Peyronie’s disease-related clinical trials if you want to read more on the latest thinking on the condition. There are sources of further information and suggestions for additional reading in the footnotes of this article too.