Sex may permeate our popular culture, but conversations about it are still associated with stigma and shame in Indian households. As a result, most individuals dealing with sexual health issues or trying to find information about sex often resort to unverified online sources or follow the unscientific advice of their friends.
To address the widespread misinformation about sex, News18.com is running this weekly sex column, titled ‘Let’s Talk Sex’. We hope to initiate conversations about sex through this column and address sexual health issues with scientific insight and nuance.
The column is written by sexologist Prof (Dr) Saransh Jain. In this article, Dr Jain will explain all about Peyronie’s disease and what are its symptoms, causes and available treatment options.
It’s common for the penis to curve slightly to the left or right when it’s erect. But if you have a more significant bend in your penis, which may cause you pain or difficulty having sex, these can sometimes be symptoms of Peyronie’s disease. Peyronie’s disease causes the penis to become curved when it’s erect. This problem is caused by scar tissue, called plaque, that forms inside the penis. It can result in a bent, rather than straight, erect penis. Some men with this condition don’t have a curve, but might have an area of indentation or “hourglass” appearance.
Most men don’t have perfectly straight erections. Just because there is a little curve in your penis, that doesn’t mean you have Peyronie’s disease.
What are the causes of Peyronie’s disease?
The cause of Peyronie’s disease is largely unknown. However, research suggests that the condition may develop after trauma to the penis, such as bending or hitting. This can cause bleeding and subsequent scar tissue buildup. Most likely, it is the result of damage to small blood vessels, which may have occurred during sex, a sporting event, a blow, or a vehicle accident. Cells might become trapped where the injury took place during the healing process, resulting in scar tissue.
Other cases, which develop over time, may be linked to genes. In some men, injury and genes could both be involved. Some medications list Peyronie’s disease as a possible side effect. But there is no proof that these drugs cause the condition. Although it mostly happens in middleaged men, younger and older men can get it. It becomes more common as a man gets older. But it’s not a normal part of aging.
What are the Symptoms of Peyronie’s Disease?
Symptoms of Peyronie’s disease may develop slowly or can seem to appear overnight. The pain of Peyronie’s disease is usually mild and often does not require treatment, but medications like ibuprofen can be used if needed. In most cases, the pain decreases over time, but the bend in the penis related to the scar can remain a problem. If the bend is bad enough, such as greater than 30 degrees, the curve can interfere with sex.
The primary symptom of Peyronie’s disease is curvature in the penis. You may feel scar tissue (a plaque) under the skin of the penis. You may be able to tell that the plaque is forming because of the following signs:
• Sex is difficult because of the bend
• A thickened area or hard lump (plaque) in the shaft of the penis
• A curve in the penis when it’s erect
• Pain in the penis, usually during an erection
• The penis looking misshapen, like an hourglass
• Loss of length or girth of the penis
A man with Peyronie’s disease may also notice that this condition affects their mental health. Changes in the penis can cause body image issues, anxiety or even depression. It can cause strain in a relationship and in other aspects of life.
Treatment options for Peyronie’s disease
Many men don’t need treatment, as they don’t have pain or the condition doesn’t affect their sexual function. Mild cases of the condition rarely need treatment. Also, the pain that comes from Peyronie’s disease happens only with an erection and is usually mild. If it’s not causing a problem with your sex life, treatment may not be necessary. The condition can sometimes improve without treatment.
However, if you need treatment, your doctor will consider surgery or medicine. Firstly, your doctor will probably prescribe pills or medications to treat this condition. If those don’t work, you may get a shot (injection) into the scar tissue of the penis. If nothing else works, your doctor may consider surgery, but usually only for men who can’t have sex because of their Peyronie’s disease.
There are three basic ways to treat Peyronie’s disease with surgery:
• Remove the plaque and get a tissue graft in its place.
• Remove or alter the tissue on the side of the penis opposite the plaque, which counters the disease’s bending effect.
• Placing a prosthetic device inside the penis if the man has both Peyronie’s disease and erectile dysfunction
Unfortunately, these procedures aren’t a sure solution. With the first method, you could have some erection problems. The second method, which doctors call the Nesbit procedure, shortens the erect penis. Most types of surgery help. But because of the possibility of complications that can’t be corrected, most doctors prefer to operate only on the small number of men with curvature so severe that it prevents sex.
When to Consult a doctor
Consult your doctor as soon as possible after you notice signs or symptoms of Peyronie’s disease. Early treatment gives you the best chance to improve the condition. or prevent it from getting worse. If you’ve had the condition for some time, talk to your partner about Peyronie’s disease and how it may affect your performance in bed. Don’t hesitate to tell your doctor exactly what your symptoms are. Be specific & talk about your concerns and fears so that your doctor can suggest the next steps you can take to manage your Peyronie’s disease.
Prof (Dr) Saransh Jain is the winner of the Swasth Bharat Rattan Award and is a Certified and Licensed Sexologist by the American Board of Sexology. He is currently a Senior Consultant at Dr SK Jain’s Burlington Clinic in Lucknow.