LET’S START WITH the obvious: No two penises are exactly alike. Some are bigger, some thinner, and some are more “growers” than “show-ers.”
The shape, too, can vary from person to person, with some having a distinct bend to them. While a little bit of a curvature—say, 15 degrees or less—is totally normal, some guys have a more pronounced bend, caused by Peyronie’s disease.
“Peyronie’s disease is basically a scarring process where some of the normal penile tissue is replaced by fibrous plaque,” says Amarnath Rambhatla, MD, a Detroit-based urologist with expertise in men’s sexual health. This plaque pulls on the surrounding tissues, causing the penis to bend, usually during an erection. This is the hallmark symptom of Peyronie’s disease.
“If the curvature is less than 30 degrees, that’s a mild curve, whereas up to 60 degrees is a moderate curve,” Dr. Rambhatla says. “If it’s above 60 degrees, that’s a significant curvature and can really impact sexual activity.”
If you’ve experienced penile curvature, particularly of the significant variety, you’ve come to the right place. Here’s what’s behind the bend, according to Dr. Rambhatla—and what you can do about it.
What causes a curved penis?
IT’S NOT ENTIRELY clear, but it’s thought that as you age, your penis endures “micro-traumas”—small injuries to the penile tissue that typically occur during sex or sports. “Over time, that can lead to scarring,” Dr. Rambhatla says. (If you fracture your penis, for example, you’re more at risk for Peyronie’s, he says.)
That’s one of the reasons why the disease tends to develop as you age; it’s much more common in a man’s 40s, 50s, and 60s than in his 20s or 30s. (Peyronie’s is different from congenital curvature, a condition present at birth that may not be obvious until you get an erection later in life.)
But even though Peyronie’s develops over time, some people are more predisposed to it than others, including men who have a family history of the condition and those with certain connective-tissue disorders, such as Dupuytren contracture (in which the tissues under the palms and fingers tighten and thicken).
How can I find relief from the pain of penile curvature?
THE PAIN FROM Peyronie’s is usually temporary, flaring during the 6-to-12-month acute phase, when plaque builds up under the skin. “Initially there’s an inflammatory process when the scar develops, and with inflammation people sometimes get pain and discomfort,” Dr. Rambhatla says. Oftentimes you can ease the pain with non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Once the curvature stabilizes, the disease has reached the chronic phase. During this time, much of the pain should subside, but it may still hurt during sex or when you get an erection.
If that’s the case—or if your partner is uncomfortable during sex—see a urologist, who may recommend treatment with either collagenase injections, traction therapy, or both, Dr. Rambhatla says.
The injections, which are made directly into the penis, can be given in the acute phase. Collagenase is an enzyme that helps break down the plaques responsible for creating the bend. Xiaflex (collagenase clostridium histolyticum) is currently the only FDA-approved treatment for men with Peyronie’s disease who have more than a 30-degree curve.
Traction therapy, in which the penis is inserted into a device that can stretch or bend it in the opposite direction of the curve, has been shown to improve curvature by anywhere from 20 to 50 percent, according to research. This can be done during either the acute or chronic stage of the disease.
Men usually don’t need surgery to correct the condition, Dr. Rambhatla says, but it is an option for more severe cases. Usually, it’s only performed in the chronic phase of the disease.
Peyronie’s rarely goes away by itself, so if the pain or other symptoms are interfering with your sex life, don’t ignore them. “In a very small percentage of men, it can get better on its own, but for the majority it will persist or sometimes even get worse over time,” Dr. Rambhatla says.
Instead, seek treatment sooner rather than later—in part because some treatments can limit the degree of curvature when given in earlier stages of the disease. But even once the curve has developed, medication, traction therapy, or surgery can fix much of the bend. “[Your penis] may not look completely the same as it did before, but our goal is to get you to have a functional erection,” Dr. Rambhatla says.
How can I deal with the embarrassment—particularly when talking to my partner about it?
FIRST, KNOW THAT you’re not alone. About 1 in 10 men have Peyronie’s disease, according to a study published in the journal PLoS ONE. “And it’s likely we’re underestimating the prevalence, partly because men can be embarrassed to talk about it,” Dr. Rambhatla says.
The men with the condition who cope the best tend to be the ones who have supportive partners at home, he adds. To that end, try to be frank about your symptoms. For example, if you don’t want to have sex because getting an erection is painful, speak up about it, rather than letting your partner think you aren’t attracted to them anymore.
Seek the help of a sex therapist if you’re having difficulty during sex or experiencing other performance issues, like erectile dysfunction (which can go hand-in-hand with Peyronie’s). If you’re experiencing anxiety or depression, talk to a general therapist.
Dr. Rambhatla also suggests asking your doctor for a referral to a urologist who specializes in sexual-dysfunction disorders. “Sometimes general urologists don’t treat as much Peyronie’s as urologists who have a subspecialty in this specific sexual dysfunction,” he says. “This is something [specialists] see day in and day out, and there are very effective treatment options.”
Maria Masters is a contributing editor and writer for Everyday Health and What to Expect, and has held positions at Men’s Health and Family Circle.
