# Peyronie's Disease: Curvature, Pain and ED

> Peyronie's disease causes scar tissue in the penis, leading to curvature, pain and often erectile dysfunction. It is more common than most men realise, and there is a specific window when treatment works best.

- **Source:** ED Treatment Guides (https://www.edtreatmentguides.com/causes/peyronies-disease)
- **Last updated:** 2025-11-18
- **Type:** cause
- **Category:** Structural & surgical
- **Mechanism:** Fibrous plaque forms in the tunica albuginea, preventing that part of the penis from expanding evenly during erection.
- **See a doctor promptly if:** New curvature developing rapidly; Pain with erection that is worsening; Inability to have penetrative sex because of the deformity

## Key points

- A fibrous plaque forms in the sheath around the erectile tissue, so that part cannot stretch — producing a bend towards the plaque.
- There are two phases: an **active** phase with pain and changing curvature, and a **stable** phase where the deformity settles.
- Treatment differs by phase. Surgery is reserved for stable disease; injectable and non-surgical options belong to earlier stages.
- Erectile dysfunction accompanies Peyronie's in a large proportion of men, from both the mechanical problem and the anxiety it causes.
- It is associated with Dupuytren's contracture of the hand and with diabetes.

## What is happening

The erectile chambers are wrapped in a tough, elastic sheath called the tunica albuginea. In Peyronie's disease, fibrous scar tissue — a plaque — forms within that sheath. Scar tissue does not stretch. When the penis becomes erect and the rest of the sheath expands, the scarred segment does not, and the penis bends towards it.

The trigger is thought to be repetitive minor trauma during intercourse in men predisposed to abnormal wound healing. Most men cannot identify a specific injury.

**The two phases**

|  | Active (acute) phase | Stable (chronic) phase |
| --- | --- | --- |
| Duration | Roughly 6–18 months | Thereafter |
| Pain | Common, often with erection | Usually resolved |
| Curvature | Changing, often worsening | Stable for 3+ months |
| Treatment approach | Non-surgical: injections, traction, oral options; surgery avoided | Surgery becomes an option once deformity is stable |

## Symptoms

- **Curvature** — most often upward, but it can be to either side or downward.
- **A palpable lump or firm band** along the shaft, usually on the upper surface.
- **Pain**, particularly with erection, during the active phase.
- **Shortening** of the erect penis.
- **Indentation or hourglass narrowing** at the plaque, sometimes with instability during sex.
- **Erectile dysfunction** — from the mechanical deformity, associated vascular changes, and the anxiety the condition creates.

> **Some curvature is normal**
>
> A degree of natural curvature is common and is not Peyronie's disease. What matters is a **change** — new curvature, new pain, or a new palpable lump.

## Treatment options

- **Observation** — A minority of cases improve spontaneously. Reasonable when curvature is mild, painless and sex is still possible.
- **Collagenase clostridium histolyticum injections** — The only FDA-approved drug treatment for Peyronie's disease. Injected into the plaque over a course of treatment cycles, for men with stable disease and curvature above a threshold. Corporal rupture is a rare but serious complication, so it must be given by a trained clinician.
- **Traction therapy** — Mechanical devices worn for defined periods daily. Evidence is modest but improving, and it is sometimes combined with injection therapy. Requires substantial commitment over months.
- **Intralesional verapamil or interferon** — Alternative injectable options used in some centres, with a weaker evidence base than collagenase.
- **Surgery** — For stable disease with deformity that prevents intercourse. Options include plication on the opposite side, plaque incision or excision with grafting, or — where ED is also significant — a penile implant that straightens the penis at the same time.
- **Oral treatments** — Vitamin E, colchicine and pentoxifylline have been widely used historically. Guideline support is weak, as trial results have generally been disappointing.

> **See a urologist, and see one early**
>
> Peyronie's disease is a condition where phase matters. Getting assessed during the active phase opens options that close later. If you have new curvature or pain with erection, do not wait a year to raise it.

## Frequently asked questions

### Will Peyronie's disease go away on its own?

A minority of cases improve spontaneously, but most stabilise with some degree of permanent curvature. Waiting is a reasonable choice only when the deformity is mild and sex is still comfortable.

### Can I still have sex?

Many men can, particularly with mild curvature. Where the bend prevents penetration or causes pain for either partner, treatment is indicated.

### Do ED tablets help?

They help the erectile dysfunction component but do not affect the curvature. Where both problems are significant, an implant can address them together.

### Is it linked to other conditions?

Yes — there is a well-described association with Dupuytren's contracture of the hand, and it is more common in men with diabetes.

## Sources

- American Urological Association. [Peyronie's Disease: AUA Guideline](https://www.auanet.org/guidelines-and-quality/guidelines/peyronies-disease-guideline) (2015)
- Urology Care Foundation. [What is Erectile Dysfunction?](https://www.urologyhealth.org/urology-a-z/e/erectile-dysfunction-(ed))
- National Institute of Diabetes and Digestive and Kidney Diseases. [Definition & Facts for Erectile Dysfunction](https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction)

## Related pages

- [Penile Implants: The Definitive Treatment, and Why It Is Last](https://www.edtreatmentguides.com/treatments/penile-implants)
- [Diabetes and ED: Why It Happens Earlier and Hits Harder](https://www.edtreatmentguides.com/causes/diabetes)
- [ED Symptoms and How It Is Diagnosed](https://www.edtreatmentguides.com/guides/symptoms-and-diagnosis)
- [Penile Injections (Alprostadil, Trimix): The Most Reliable Non-Surgical Option](https://www.edtreatmentguides.com/treatments/penile-injections)

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_This page is general health information, not medical advice. It cannot account for your own history, medications or risk factors. Talk to a licensed clinician before starting, stopping or changing any treatment._

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