Thursday, November 5, 2015

Answering Frequently Asked Questions about Peyronie's Disease

From time to time I get questions about alternative approaches toPeyronie's disease, curvature of the erect penis. There are some "natural" approaches, even though most men opt for surgery.  Here's an excerpt from my book, Healing without Medication.

Symptom Summary
∆     Curvature of the penis during erection (only during erection)
∆     May have hourglass deformity with flaccidity in the tip
∆     Fibrous mass in the midline of the shaft of the penis

Understanding the Disease Process

Peyronie’s disease is a surprisingly common but seldom discussed condition causing curvature of the penis during erection. Described in a historical medical text as “a rare affection of the genitals in people with excessive sexual intercourse” and made a matter of public record during a recent American political scandal, Peyronie’s disease begins when microscopic blood vessels in the penis are damaged during excessively vigorous sexual intercourse. Immune-mediated inflammation leads to the deposit of fibers that eventually accumulate in a plaque about an inch (2.5 centimeters) wide, causing a curvature of the penis during erection.

            The lump in the penis associated with Peyronie’s disease can appear “overnight,” but men with the condition more commonly notice an increasing curvature of the penis during erection. Eventually Peyronie’s disease causes intense pain during erection, and it may lead to impotence.

            Approximately 1 in 250 men in the United States has Peyronie’s disease. About 10 percent of men with Peyronie’s disease have Dupuytren’s contracture, and about 3 percent of men with Dupuytren’s contracture have Peyronie’s disease. Men who get Peyronie’s disease tend to have thick knuckles. The condition is more common among Caucasians than in other racial groups. Peyronie’s disease seldom appears before the age of 30, and most commonly begins between the ages of 40 and 60.

Treatment Summary


          Include soy foods in your daily diet.

Nutritional Supplements

          Para-aminobenzoic acid (PABA): 12 g daily.

          Vitamin E: at least 200 IU per day.

Understanding the Disease Process

Peyronie’s disease sometimes resolves on its own if there is complete abstinence from all forms of sexual activity for 2–3 years. Many men opt for surgical correction of the condition. Otherwise, certain nutritional interventions are helpful.

            The process of fibrosis in the penis leading to curvature is accelerated by estrogen, the female hormone present in men’s bodies in trace amounts. Men with Peyronie’s disease should avoid supplements that increase estrogen levels, such as androstenedione (which also increases testosterone levels), and should include soy foods in their daily diet. Some physicians note improvement when men eat soy food, and it is theoretically possible that soy phytochemicals “lock” receptor sites in the penis that would be occupied by estrogen. The evidence for vitamin E is also anecdotal, but there are no side effects from a small dose. Be sure to inform your doctor that you take vitamin E if you are planning to have surgery, since vitamin E could increase bleeding.

            A clinical study confirmed that treatment with a compound similar to the B vitamins, para-aminobenzoic acid, helps about 50 percent of men who take it. Clinicians gave 32 men with Peyronie’s disease 12 g of a potassium salt of PABA daily for 8–24 months. Penile angulation improved in 18 of 31 patients, plaque size decreased in 18 of 32 patients, and pain during erection was diminished in 8 of 32 patients. Loss of appetite, nausea, vomiting, fever, and rashes occasionally occur when PABA is taken at this dosage. The side effects stop when the supplement is discontinued.

Concepts for Coping with Peyronie’s Disease

          The greatest damage to the penis occurs when vigorous intercourse is attempted with a weak erection.

          Peyronie’s disease never leads to penile cancer. It is a long-term condition, but it sometimes completely resolves without surgery.

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