Causes and Risk Factors of Peyronie’s Disease

Peyronie's disease is the result of inflammation and scarring in the erectile tissues of the penis, which leads to and abnormal curvature of the penis. Scarring causes areas of the penis to become less flexible. During an erection, the penis curves towards the area that can't stretch. Depending on the location of the scarring, the penis may also lose length.

Only a small fraction of cases of Peyronie's disease occur after there has been a clear, noticeable injury to the penis. The remaining cases are thought to be caused by small injuries and inflammation that has occurred over a long period of time. Because of this, the major risk factors for Peyronie's disease are injury, age, smoking, and health conditions associated with inflammation and scarring.

Common Causes

Peyronie's disease is first and foremost a wound-healing disorder. Its symptoms are the result of fibrous plaques, or scars, forming in the tunica albuginea. The tunica albuginea is the tissue that surrounds the erectile bodies of the penis.

Peyronie's disease is thought to occur in between 0.5%and 20%of men, depending on the population. It can happen in men of any age, but it is more common in older men. It is also more common in individuals suffering from one or more of the following health problems:

• Diabetes
• High blood pressure
• High cholesterol

Peyronie's is thought to be the result of injury to the penis. This injury can be severe and acute, for example, because of surgery on the penis or trauma during sex.

More often, the injuries that lead to Peyronie's are small, or even unnoticeable. Most, if not all, men experience some microtrauma during penetrative intercourse. However, only some men develop Peyronie's disease. This is likely because Peyronie's disease occurs in men where healing is impaired.

Having sex with a penis that is not fully erect may predispose the penis to microtrauma. This may also explain why the incidence of Peyronie's disease increases with age. As people have more difficulty getting a firm erection, they experience more sub-acute injuries they need to heal.

Cardiovascular Health

High blood pressure, high cholesterol, and diabetes are all associated with both cardiovascular health and Peyronie's disease. So is the use of certain cardiovascular drugs, such as beta-blockers. This is thought to be because the particular vasculature of the penis, and damage to those blood vessels, is critical to the formation of plaques and scars. There is also some evidence that oxidative stress plays a role in Peyronie's disease as well as heart disease.

In addition to potentially playing a direct role in causing Peyronie's disease, cardiovascular disease also contributes significantly to one of its symptoms.

In other words, it's not the scarring that causes problems with getting and sustaining an erection; it is blood flow. This is another reason why Viagra and other erectile dysfunction drugs may be useful for Peyronie's patients.

Lifestyle Risk Factors

There are a number of lifestyle risk factors for Peyronie's disease. Basically, these can be divided into two groups. The first group are risk factors that affect healing. These include:

• Smoking
• Alcohol abuse
• A history of unprotected sex leading to non-gonoccocal urethritis or exposure to another inflammatory STD

The other group of risk factors are those that affect the likelihood of penile trauma. These include:

• Rough sex or sex at angles that bend or stretch the penis.
• Starting penetration before the penis is fully erect
• Other activities that could damage the penis.

Frequently Asked Questions

Does Peyronie's disease get better on its own?

Sometimes. For 13 out of every 100 people with Peyronie's disease, the penis returns to normal without medical intervention. This is most likely to occur when the plaques in the penis are small and the curvature is mild.

What happens if Peyronie's disease isn't treated?

Untreated Peyronie's disease can lead to a number of complications. Although not everyone will have these (or any) complications, the most common are:

• Erectile dysfunction
• Inability to have penetrative sex due to pain
• Depression and anxiety
• Relationship issues
• Challenges fathering a child

Is stretching the penis an effective treatment for Peyronie's disease?

Manually stretching the penis may do more harm than good, but there's evidence penile traction therapy (PTT) may have positive outcomes for some people with Peyronie's disease. PTT involves a device that gently straightens a curved penis. In a 2019 study of one such device used twice a day for 20 minutes at a stretch, 94% of men regained an average of 1.6 centimeters in penis length, 77% had an improvement in curvature of around 17 degrees, and 80% of those who weren't able to have penetrative sex prior to treatment were able to after 12 weeks.

A Word From Verywell

To a great extent, Peyronie's disease is not a condition you can avoid. You can maintain a healthy body, but inflammation and penile injury are not necessarily things you can control.

Fortunately, Peyronie's disease is often a relatively minor condition. Many individuals affected by it do not need any treatment. There is a range of treatments available for those who do.

If you are experiencing pain during erection, or noticing a new curve to your penis, talk to your doctor. If it is Peyronie's disease, sometimes early treatment can help.