Peyronie’s Disease and Your Sex Life: 7 Things to Know

7 Ways Peyronie’s Disease Can Affect Your Sex Life

Medically reviewed by Joseph Brito III, MD — Written by Cathy Lovering on February 19, 2021

This article is a repost which originally appeared on Healthline

Edited for content

Peyronie’s disease is when plaques (scar tissue) form under the skin of the penis and cause it to bend. Living with this condition often includes pain and changes to sexual function that can affect personal intimacy, your relationships, and mental health.

Understanding the ways Peyronie’s disease can affect your sex life and partner can help you know what to expect from the disease, along with how treatment options can help.

Here are seven things to know about Peyronie’s disease and sex.

1. Getting and keeping an erection can be challenging

Erectile dysfunction is more common among people with Peyronie’s disease. A 2020 study on 656 men who were receiving care at a urology clinic in Brazil found that nearly 60 percent of men with Peyronie’s disease had erectile dysfunction, compared with 46 percent of men without the condition.

There are a few possible reasons for the connection between Peyronie’s disease and erectile dysfunction. For some, the scarring can make it difficult to get an erection.

Erections can also be challenging if the nerves or blood vessels of the penis have been damaged by inflammation or trauma to the penis, which is associated with Peyronie’s disease.

Many people living with Peyronie’s experience anxiety and depression because of the condition. These feelings can also lead to challenges with sexual function, so the symptoms often compound each other.

Finally, pain (especially during the active phase of the disease) can contribute to erectile dysfunction for some people with Peyronie’s.

2. Your partner may experience pain and discomfort

Peyronie’s disease often causes pain during erections. But that condition doesn’t only cause pain to those living with it — it can also make sex uncomfortable for their partners.

A 2020 study found that nearly half of the female sexual partners of men with the condition experienced at least moderate pain or discomfort during vaginal intercourse.

In some cases, couples couldn’t engage in certain sexual activities they enjoyed before the onset of Peyronie’s.

With that being said, the appearance of your penis might not be as much of an issue to your partner. The research found that nearly 60 percent of men with Peyronie’s disease were very or extremely bothered by how their erect penis looks, while just 20 percent of their female sexual partners felt the same way.

3. Communication can help couples cope

While it can be difficult to talk about Peyronie’s disease, communication is key to maintaining intimacy with your partner and finding new ways to be sexual.

Here are some ways to make the conversation easier, according to the Association of Peyronie’s Disease Advocates (APDA):

  • Discuss the condition and its effects over several conversations. Don’t feel like you have to cover everything in one sitting.
  • Your feelings and symptoms can change over time, so you may need to revisit topics in future conversations. Try to be honest about what you’re going through.
  • Make sure the conversation is a dialogue, not a monologue. As much as you share your concerns, listen to your partner express how your condition is affecting them, as well.

The APDA also encourages people with Peyronie’s disease to involve their partners in exploring treatment options and going to doctor’s appointments.

4. Couples may need to explore new forms of intimacy

If Peyronie’s disease is making it challenging to have sex the way you’re used to, it might be time to explore new techniques.

Partners can use different positions or explore other forms of intimacy and pleasure besides intercourse to achieve satisfaction.

Speaking with a sex therapist or counselor can help both people in the relationship share their sexual needs and desires and work through challenges in the relationship.

5. Over-the-counter (OTC) medication can provide pain relief

Treatments for Peyronie’s disease, which range from injections to surgery and penile implants, usually have the goal to reduce curvature and improve sexual function.

However, not all people with the condition need medical treatments. If pain is your main symptom, OTC pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil) or naproxen (Aleve), may be all you need to have a more comfortable erection.

6. Treatments can boost sexual satisfaction

There are a number of surgical and nonsurgical treatments for Peyronie’s disease. While they’re typically focused on reversing curvature and breaking up plaques, some treatments have the added benefit of boosting satisfaction for partners of people with the condition.

A 2020 review of small studies found that 70 percent of female partners of men with Peyronie’s disease who were treated with collagenase clostridium histolyticum injections experienced higher sexual satisfaction.

Female partner sexual satisfaction also climbed by 34 percent to 88 percent when men were treated with penile plication, 90 to 100 percent after they underwent plaque incision or partial excision with grafting, and 40 to 75 percent after penile prosthesis implantation (a treatment typically reserved for people with severe Peyronie’s disease and erectile dysfunction).

It’s important to note that available research only surveyed women who were intimate with men with Peyronie’s disease, so further study is needed to determine how the condition and treatments can affect non-female partners.

7. Talking with others can make you feel better

The psychological impacts of Peyronie’s disease can affect your emotional well-being, as well as your ability to be intimate.

According to APDA, the condition can change the way a person sees themself and hurt their self-confidence.

People with Peyronie’s disease may avoid intimacy, lose interest in sex, and withdraw emotionally. This can cause a range of psychological challenges for both people in the relationship.

Overcoming emotional and social isolation can help reduce the impact of the condition on your sex life and overall well-being. Consider talking with others who are living with the condition or joining a support group.

A mental health professional, such as a psychologist or a therapist, can also give you a safe space to work through concerns and find ways to cope.

Takeaway

Peyronie’s disease can make a big impact on a person’s sex life, both due to the physical symptoms and the emotional impacts of the condition.

The condition can also make an impact on your partner’s comfort and satisfaction during sex.

Exploring treatment options, having open and honest conversations, and seeing a sex therapist are some of the ways to reduce the effects of Peyronie’s disease on intimacy.

You may also consider joining a support group to connect with others who have the condition.

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

A Doctor with Hard Flaccid – Updates and Advice

A Doctor with Hard Flaccid – Updates and Advice

by Romero MD

Original post: A Doctor with Hard Flaccid – Updates and Advice

Hi everyone I am 26 years old and I recently developed this mythical problem called Hard Flaccid.
I am a medical doctor. I finished medical school a few months ago, and I am currently applying for Obstetrics-Gynecology.

First, my story. I have been practicing PE, intermittently, for the past 4-5 years. Basically, only manual stretches (I am satisfied with my girth), but, like many others, I think my injury was caused by Edging and excessive Kegeling, which I have been practicing for over 10 years, for stamina training and erection quality.

And without knowing the extreme importance of Reverse Kegeling. Every time I have sex, I also do intense kegels, in order to last 60-90 minutes of penetration. I know, I know… maybe it’s a little too much… But my girlfriend and I have always liked long love sessions Almost 2 months ago, while I was having sex with my girlfriend, I started to lose my erection suddenly, after performing an intense Kegel, during a sex position that placed my penis at a downward angle (so, I did a “very weighted Kegel”).

I thought I might have torn a muscle or ligament, and we stopped at that moment. The next day, I woke up with a hyper contracted and cold penis. As it didn’t seem to be a penile fracture, nor did I have any skin lesions, hemorrhages or bruises, I decided to simply rest. Because I thought that any fellow urologist would tell me to simply do the same – to rest.

After two weeks of online research, I discovered my diagnosis – Hard Flaccid/CPPS. However, I only have/had symptoms related to the anterior/superficial pelvic floor (Ischiocavernosus and Bulbocavernosus Muscles). I don’t have pelvic pain, difficulty passing stools or other posterior/deep pelvic floor symptoms. But I have/had:

– Sudden erectile dysfunction (9-10/10 to 4/10)
– Sudden premature ejaculation (90min to 3-5min)
– Hyper contracted penis (Hard Flaccid). Which improves sitting, lying down, with Reverse Kegels and with heat; and worsens standing, with physical activity, with Kegels and with Involuntary Kegels
– Cold and soft glans (sometimes scrotum and penis too)
– Mild urinary retention
– Loss of morning and spontaneous erections
– Slight bend of the penis to the left, from the base of the shaft. (IC injury?)
– Slight downward curvature of the penis, from the middle of the penis (BC injury?)
– And a slight twist of the entire shaft, clockwise (IC injury?)

The next day, I visited the Urology Department at my hospital. I was observed by 4 urologists. As expected, none of them had ever heard of Hard Flaccid… After explaining the whole story, situation and symptoms, I was medicated with:

– Ibuprofen (anti-inflammatory), for 7 days
– Cyclobenzaprine (muscle relaxant), for 30 days
– Tamsulosin (alpha blocker, to decrease all sympathetic nervous activity, stressful or non-stressful, to the pelvic floor), for 30 days
– Total sexual abstinence (masturbation and sex), for 30 days, which I was already doing for 2 weeks.
After these 30 days, I will have an appointment with one of the best Andrologist in my country, which will be on August 27

So, after 3 weeks, I have been doing a lot of research (books, websites, forums) … And, according to my symptoms, I am almost sure that I had/have a strain of the Left IC Muscle (and maybe the Left and/or Right BC), which is, consequently, contracting the anterior/superficial pelvic floor and the penile smooth muscle (giving rise to the Hard Flaccid and the shortening of the penis, while it is erect) and, consequently, compressing the pudendal nerve, dorsal nerve and pudendal arteries, giving rise to all the other symptoms.

And that’s why REVERSE KEGELS are so important for the progressive relief of all the symptoms.

Treatments. What I have done to recover:
– Ibuprofen, Cyclobenzaprine, Tamsulosin
– Extraordinary healthy eating (Proteins, vegetables and fruits. Very important in the recovery of any injury) and supplementation (Ginkgo Biloba, Ginseng, L-Arginine, Fish Oils, Vitamins E, D, C, B complex and Zinc)
– No masturbation, no sex, NO PORN. And no pictures, no Instagram girls, nothing. Just hugs and kisses from the girlfriend. (Alright… We make love, but only with my hands and mouth. I don’t let her touch my penis… I was in this hardmode for 4 weeks. In the last week, I have been trying very light Edging (5 minutes of very light massage, very soft touches, always with REVERSE KEGEL), every other day, to give a little physiotherapeutic stimulation to the tissues. But without ejaculation (to avoid the Involuntary Kegels associated with orgasm, to keep my libido high and to increase the likelihood of spontaneous erections)

– Lots of REVERSE KEGELS/Front Reverse Kegels, throughout the day.
– Very light and Soft Squeezes (“massages”) of the flaccid penis, while Reverse Kegeling, to help relax tissues, throughout the day.
– Belly Breath Combos, Hindi Squats and Happy Baby, along with Reverse Kegeling.
– Light external massages, on the anterior/superficial pelvic floor
– 1 hour of STRETCHING (flexibility training) every other day – Pelvic Floor, Hamstrings, Psoas, Piriformis, Quadriceps, Adductors and Abs. (All along with Reverse Kegeling and Belly Breaths). Again, hardmode – Static, Dynamic and Weighted Stretches. I’m literally training to do the front and side splits.

– HEAT. Heat relaxes muscles and dilates arteries, increasing blood flow and, consequently, relieving symptoms. I wear shorts, under my pants, during the day. When I get home, I wrap my lower body in a blanket and I use a hot rice sock sometimes. And I place a big and soft pillow under my buttocks, when I am sitting in my chair.

– Sleep. A lot. (Very important in the recovery of any injury)
– I am a very active person (running and weighted calisthenics), but I stopped this type of physical activity since the day of the injury (to avoid Involuntary Kegels). However, I am doing some bodyweight Squats and Hip Thrusts (along with Reverse Kegels) before stretching. I read somewhere that gluteal and posterior chain strength is also important.

– ABSOLUTELY NO STRESS (!!!). I have always been a very calm and peaceful person, in all situations of my life. But, after reading that Hard Flaccid was highly influenced by stress and anxiety, I am now completely in a “ZEN state with the Universe” Buddhist monk style.

Not only to avoid any nerve discharge from the Sympathetic Nervous System to the pelvic floor (and, consequently, Involuntary Kegeling, which prolongs the contraction of the pelvic floor muscles, which worsens the compression of nerves and arteries), but also to prevent the rise of Cortisol and Adrenaline and, consequently, the drop in testosterone levels. And (as many of you claim) this is absolutely essential.

I was a little stressed during the first week (before I knew the real diagnosis) and my penis was terrible… Hard Flaccid like a rock, with a loss of 1.5inches in BPFL. After knowing that I really have to relax completely, I immediately felt the first improvements in 3-4 days.

However, on the other hand, I am very convinced that I did a muscle strain, at least, of the Left IC. Those left curvature and left twist… Hmmm… On August 27, I will ask for an MRI. If the radiologist tells me it is normal, I will try to take the images to more doctors.

So… after almost 2 months, I have improved a lot – Now, I only have hard flaccid if I’m standing. A few times, I don’t even have it standing. It happens when I get up after doing Reverse Kegels for a few minutes (or sitting for a while in a more comfortable position) and continue to do Reverse Kegeling while I’m standing. This was impossible 1 month ago.
– The morning erections are progressively coming back
– 3 days ago, I’ve managed to have a 8-9/10 erection during the mini Edging sessions.
– However, I still have a slight bend to the left and the clockwise twist, during erection (I no longer have the downward curve), and I lost about 0.5 inches in BPEL…

1- Now, I would like to ask Pegym’s brightest minds and everyone in this group who is still recovering from Hard Flaccid, what are the most recent updates on this disease/symptom? Regarding physical treatment, exercises, medications and supplements. What am I missing? Where can I improve to speed up recovery?

2- I have been thinking about starting to do a small daily session of Kegels/Front Kegels/IC kegels… In order to give a physiotherapeutic stimulus, just like any other muscle injury. But I’m afraid it could get worse… What’s your opinion? (See post 26)

3- What do you think about adding very light and soft manual penile stretches? (along with Reverse Kegeling) I feel a lot of relief with the soft squeezes. But, in these, the applied force is perpendicular to the penis. I’m not sure if extra parallel force will be beneficial for the tissues. (See post 26)

4- Okay, the last question might be a little funny, but I think it might be relevant. I think I have an injury mostly on the left side. So, is it more advisable to rest the penis in the left groin or in the right groin? It tends to get softer on the right, but naturally falls to the left. (See post 26)

Thanks a lot for reading my story Best regards to the entire PEGym community
And thank you so much, for saving me during the past 2 months UPDATES: post 21, post 23 (stress management), post 26, post 29, post 63, post 66 (HF & Stretching)