Peyronie’s Vitamin E Dosage

The usual Peyronie’s disease vitamin E dosage advice from a medical doctor will be to “take no more than 400 IU of vitamin E a day.”   Sometimes this number will be doubled to 800 IU daily by some doctors who are more aggressive with their recommendation.  All of this is of valuable interest because vitamin E is the most commonly recommended non-drug Peyronie’s disease treatment, and very often it is the only non-drug Peyronie’s disease treatment that will be discussed.

Since vitamin E is available in both a synthetic form and a naturally occurring organic form, which form you use determines how much you can safely take.  Eight different members of the vitamin E family, four known as tocopherols and four known as tocotrienols, make up the vitamin E family.  A balanced diet – very difficult to achieve these days – contains all eight members of the vitamin E group.  The most widely found member is known as gamma tocopherol, which works to eliminate nitrogen free radicals and is a very effective anti-inflammatory agent.  Tocotrienols are primarily found in the skin and subdermis where they protect against UV and free radical damage.

Most vitamin E supplements contain only alpha tocopherol because it was thought that only this single part of the family of eight is the most important for Peyronies disease treatment. In fact, most vitamin E skin products contain a small amount of synthetic dl-alpha-tocopheryl acetate.  This means that they contain only one of the eight members of the vitamin E family in the less effective synthetic form. Only products which supply the complete vitamin E family and are particularly rich in gamma tocopherol and tocotrienols in their natural and unesterified form contribute to accelerated wound healing and minimized scarring.  This is why PDI is most insistent on men using a vitamin E therapy that is heavily slanted toward gamma tocopherol and all the tocotrienols.

Peyronie’s and vitamin E controversy

Concern about vitamin E safety during the past decade or so has been due solely to bad publicity in this area, which is based on perpetuation of questionable research and misunderstanding about vitamins.   Faulty research reporting and misinterpretation of findings are the same two reasons for the condemnation of vitamin E supplementation.

First, vitamin E confusion arises from a medical reporting that ignores details of a particular vitamin E study reported in the Annals of Internal Medicine.  The problem is gross generalization or not understanding the vitamin E research study.

The Annals of Internal Medicine vitamin E report is presented in  http://www.annals.org/cgi/content/full/0000605-200501040-00110v1 Review this information to verify what I report is accurate:

• Those who took part in this vitamin E research often combined vitamin E with various drugs while they were being studied.  All potential and actual adverse drug reactions to these different drug combinations were not factored in or considered anywhere in the study results.
• All study participants were elderly people, already being treated for a variety of chronic diseases. The researchers report this as a strong complicating issue, and puts suspicion on all conclusions because these elderly and sick people are far more likely to be taking high doses of vitamin E. They readily admit it is inaccurate to generalize these findings of this group to a healthy, normal, average or younger age group population.
• This study contained too many variables.  It evaluated many different research studies, all of them used different procedures and protocols such as different vitamin E dosages administered for a widely variable amount of time. They admit they evaluated and combined data from sources that originated and were collected in different ways; they went beyond comparing apples and oranges, they compared grapes and bowling balls.
• None of the studies reported took the time to report or differentiate chemical immense differences of natural and synthetic vitamin E.
• Within the scientific community the findings of the original research has been questioned and criticized.

Vitamin E safety

The Annals of Internal Medicine report states vitamin E has a relative risk of 1.05. A relative risk of 1.0 is actually a neutral finding.   This 1.05 risk level is not clinically significant to establish an association between a fatal dose or use high dose vitamin like vitamin E.  Consider that water might have a relative risk of 1.05 in certain situations.

Before taking higher doses of vitamin E for therapeutic benefit, consult a health professional first.  Discuss your health concerns, possible vitamin E side effects, and what dosage of vitamin E might be best for you.  Vitamin E may be deficient in some diets, especially very low fat diets. Most nutrition experts agree that taking vitamin E supplements is safe.

Vitamin E study limitations and problems

Here is a summary of this study presented by those who conducted this study:

The evaluation of high-dosage vitamin E trials in which more than 400 IU of vitamin E was used was often too small to establish accuracy of findings.  This study should not have included elderly patients with one or more chronic diseases, yet they were the primary participants.  It is not clear how to generalize the findings of this study conducted on ill and elderly people to a population of healthy adults.  It is also not clear how to determine the exact dosage at which someone might be at risk of taking too much vitamin E based on this study using ill and elderly people.

In spite of these large obvious flaws and limitations, the conclusion of this study is that any dosage at or above 400 IU daily of vitamin E may increase mortality and should be avoided.

Secondly, misunderstanding and confusion exists over the many subtle differences between natural and synthetic vitamin E.  The ultimate error is that natural and synthetic vitamin E will chemically react the same, and that is not true.

Problem #2 – Natural or Synthetic Vitamin E

Natural vitamin E is d-alpha-tocopherol, and synthetic vitamin E is dl-alpha-tocopheryl. Since the names of the chemicals are different you know the chemicals are different.  As the chemicals are different, their reaction is also different in the body.

The Townsend Letter for Doctors and Patients reports, “Natural vitamin E supplements outperform synthetic forms, according to a VERIS Research Summary. Results of recent studies suggest that natural vitamin E is more bioavailable and is retained in body tissues significantly longer than synthetic vitamin E. These studies show that previously accepted differences were underestimated and that the bioavailability of natural vitamin E is about twice that of synthetic vitamin E compounds.”

Vegetable oil, specifically soybean oil, is the primary source of naturally occurring vitamin E.  However, synthetic vitamin E is manufactured from petroleum chemicals (yes, the same oil that comes out of the ground, used to make tar, motor oil and gasoline, often linked with cancer).

Doctors are very comfortable and familiar with prescribing synthetic chemicals.  For this reason they are not hesitant to prescribe a synthetic vitamin.  But, the primary difference scientists use to determine toxicity and function within the body is the molecular structure of a compound.

When taking levels of “vitamin E” above 400IU is found to be unsafe, it is because the vitamin E is synthetic and not tolerated well. All biomedical testing proves that within the human structure there is a strong chemical discrimination or preference between natural and synthetic vitamin E.

“Our studies suggest without question that natural vitamin E delivers at least twice the impact as synthetic E,” said Robert Acuff, PhD, Professor and Director, Center for Nutrition Research at East Tennessee State University.  He concludes it is the natural form of vitamin E is obviously the one human tissue was designed to use.  Margaret Traber, Associate Professor at the Linus Pauling Institute, Oregon State University, seems to discriminate between the two forms of vitamin E, reporting that the human body will retain the natural organic form of vitamin E, while rapidly eliminating the synthetic form in the urine and bowel.

It is my opinion that the human organism will tolerate much higher doses of natural vitamin E – provided by PDI and the Natural Complementary Medicine LLC website – and can tolerate much less synthetic vitamin E available found in lower cost and lower quality products.  For this reason PDI only uses organic and natural vitamin E for use in Peyronie’s disease treatment plans.  Using the kind of vitamin E we have available, many men use levels in the 800IU-1,200IU range while attempting to reduce their Peyronies plaque or scar.

For additional information go to the PDI website at vitamin E.

Medical treatment for Peyronie’s disease is basically limited to simple reduction of pain and hope for some level of sexual function.  Since no known medical treatment of Peyronie’s disease exists, several experimental approaches are used with only half-hearted enthusiasm by the average medical doctor.

Current experimental medical approaches used to treat Peyronie’s disease:

• COLLAGENASE – Currently being researched as an injection directed into the scar tissue to enzymatically digest and eliminate it.   It is found that repeated injections into the penile tissue can cause Peyronie’s disease, and hence the long term outlook for this method is questionable.
• POTABA – This is PABA, a B vitamin, with a potassium molecule attached.  PABA is a safe form of Peyronies treatment, but the addition of potassium to the B vitamin requires a large dosage often resulting in severe gastric pain and digestive problems.

• COLCHICINE – This is a standard gout medication that is used to treat Peyronie’s disease because it is supposed to reduce inflammation and scar formation.  Not many reports of success are evident in the literature, and for this reason this drug is not a very popular Peyronie’s treatment.
• INTERFERON – A protein that is used because it is thought to disrupt the production and promote the breakdown of collagen.  Of all medications used, this is the least popular Peyronies’ disease treatment.
• VERAPAMIL – A drug normally used to treat high blood pressure. Can be administered topically in gel form over several months, or is directly injected into the plaque in a series of 8-20 shots into the penile tissue. This drug, in either form, is also less popular than it was when first introduced several years ago due to poor clinical results.
• STEROIDS – This is the same common drug used for many conditions, basically because of its anti-inflammatory ability.

• RADIATION – In low dosage thought to reduce pain, and no other benefit to Peyronie’s treatment.   Can lead to other problems of excess radiation.
• SURGERY – Because the body does spontaneously resolve about 50% of Peyronie’s disease cases without any treatment or medical intervention, surgery should not be considered for at least one or two years following onset of signs and symptoms of the disease.  Peyronies surgery is used only in severe cases, because it is not uncommon for surgery to make Peyronie’s disease worse or lead to complications that are worse than the original problem.

Most men who contact the Peyronie’s Disease Institute have already tried one or more of the above treatments, and are still looking for Peyronie’s help.  The philosophy to treat Peyronie’s disease is simply to treat the man who has the Peyronie’s scar so he is better able to eliminate and correct his own problem – just as happens with the 50% of men who spontaneously heal their own Peyronies scar without any help from anyone.

The basic approach used by the Peyronie’s Disease Institute is to use as many well-researched Alternative Medicine therapies as possible so as to support the natural healing ability of the body.  This can be done with vitamin E and C, acetyl-L-carnitine, PABA, dietary guidance, gentle manual soft tissue stretching of the scar tissue, DMSO, copper peptides, and others.   For more details click Treatment for Peyronie’s Disease and you will see how easy it is to take control of your future.

Before I discuss what can be called a “Peyronie’s penis,” it would be good to mention the normal penile curvature of many men.  Many men look for answers to “Why is my penis curved?” and eventually come to think they have Peyronie’s disease, when that is not the case.  They think that just because they have curvature of the penis, that it must be a Peyronie’s penis, when it is not.

Normal penile curvature

A small degree of curvature of the penis is common among men and can be considered normal, as many men are born with this benign condition, commonly referred to as congenital curvature. Probably the single best and easiest way to determine is a curved penis normal, is to answer the question “Have you had this curved penis problem all of your life?  When you were a small boy, was your erection bent?”  If the answer is “yes,” then it is most likely your current problem is not a Peyronie’s penis.

It is most common for the curvature of Peyronie’s disease to cause a bend or distortion that is angular or abrupt, like a sudden bend in the road, while a congenital curvature is usually gradual and milder in degree, like a banana.  Some cases of Peyronie’s disease will cause a gradual, mild, banana-like curvature, however.  Because no case of Peyronie’s disease can be diagnosed on the basis of the appearance of the curved penis, a doctor must evaluate the condition for other signs and symptoms.

When a man has Peyronie’s disease the condition is characterized by an internal scar or plaque, or hard lump that forms within the substance of the penis. Congenital penile curvature will not exhibit this internal scar material.  If the cause of the penile curvature is Peyronies, it will often appear rather suddenly, be accompanied by pain, be accompanied by some degree of lost penile length or girth, and cause a certain degree of erectile problem that has not been experienced before.   Not all of these factors must be present for a diagnosis of Peyronie’s disease; the presence of the internal scar or lump is most valuable to make the decision.

Peyronie’s disease can cause pain, penile distortion and reduced sexual ability due to the presence of flat or cord-like internal lesions (scar tissue known as “plaques”) located on the top, bottom or sides of the penis within a thin but tough membrane known as the tunica albuginea.  Although it is a popular notion that Peyronie’s Disease always involves curvature of the penis, the scar tissue sometimes causes other distortions like a bottle neck deformity, an hour-glass deformity, or divots or indentations or nicks, rather than the classic curvature.

How to fix penile curvature

Once it has been determined that a man has only a normal congenital curvature of the penis, it is still possible to help him using a few parts of the standard Peyronie’s disease treatment approach.  He can use topical DMSO, Callisto topical vitamin E oil, Super CP Serum, and the gentle manual penis stretching technique developed by the Peyronie’s Disease Institute to make positive improvement safely and effectively once he knows he does not have a Peyronie’s penis.

The Peyronie’s Disease Institute is not against Peyronie’s disease surgery. 

The Peyronie’s Disease Institute is against the abuse of surgical treatment of Peyronie’s disease.  Considerable surgical risk exists for any man with PD who has an operation to attempt correction of penile distortion.  Adverse outcomes and worsening of the original problem are associated with even a small incision (or injection) made to a penis that already has demonstrated the tendency to create excess Peyronie’s scar formation.

The overuse and abuse of Peyronie’s surgery should be suspected when the treating doctor does not follow reasonable and conservative guidelines to consider a patient a surgical candidate.   The man with Peyronie’s disease should fulfill these basic points:

1. Severity, the most important indicator. The deformity must be severe enough to seriously interfere or stop sexual intercourse. 
2. Adequate time for healing and spontaneous recovery must be given.  Usually thought to be from 12-18 months from the time of onset of PD. 
3. Non-responsive to a fair trial of medical therapy.  In practice, many doctors attempt only one form of medical treatment.  When that fails the patient is told surgery is the only other option.  It appears that doctors know the poor results achieved by medication to make a difference with Peyronie’s disease that they are quick to want to skip this step and proceed to the operating room.   

   When vitamin E is offered as a therapy option, it is done so reluctantly and with little hope for success.  Further, no instruction is offered for the correct use of vitamin E, or information about the eight different members of the vitamin E family.  Since no real help is offered to assure that the patient will use vitamin E correctly, it is no wonder that so many men fail.   There is a large body of information available that can assure a man is more successful with vitamin E therapy for his Peyronie’s disease.  Using the correct type of vitamin E, and using it correctly in conjunction with other forms of therapy that work synergistically with it, would only increase the chance of success. 

4. Stable and unchanging scar.   This can mean changing for the better or worse. Since so few doctors, and the men with PD, even locate the PD scar, it is doubtful that this criteria is seriously considered.

Risks of Peyronie’s surgery

Surgery does not cure Peyronie’s disease.  Because of the unique anatomy and physiology of the penis, the risks of surgery to this area are a little different than other tissues.

1. Additional scar formation and possible worsening of PD.  Because any man attempting a surgical correction of PD who already has massive scarring, must expect more scarring to develop as a result of that surgery. It is a known fact – seldom discussed with a PD patient before surgery – that surgery for PD will result in more PD, sooner or later. 
2. Loss of penis size. Extensive scar tissue that is severe and persistent enough to cause a deformity serious enough to justify Peyronies surgery, represents a large mass of internal scar tissue. Surgery will remove a large and irreplaceable loss of connective tissue and loss of elasticity of the tissue that is not removed. If it is not bad enough that surgical correction and return of sexual function cannot be guaranteed because of the possibility of complications, every surgical candidate must understand that there will always be a loss of length and diameter of the penis.   Many men tell me that this secondary consequential loss of penis size is hardly discussed before surgery. Most men learn about the loss of penis size after it is too late.
3. Incomplete straightening, no change, or worsening of the original PD deformity.  Loss of elasticity, additional scarring, and damage to the veins of the penis that can occur as a result of surgery, can also reduce or prevent correction of the original PD problem.
4. Loss of sensation.  Due to anatomical location of important sensory nerves of the penis, PD surgery can slightly, or greatly, or totally, reduce skin sensation and  pleasure associated with sexual activity.  Temporary reduction of sensation is very common, and permanent sensory loss is less common.
5. Loss of erection strength.  Surgery cannot help but alter both the inflow and/or outflow of blood to the penis.   By disturbing the pneumatic mechanism that creates an erection it is not uncommon for men to report either loss of erectile rigidity (hardness) or inability to maintain an erection (impotence) – and sometimes both.

If a surgeon has been attempting you to undergo PD correction surgery, and you were told the surgical outcomes are “good,” I strongly suggest you get a very clear and detailed explanation for what the surgeon means by “good.”  You might think “good” means that you will be perfect again, that your PD will be gone, that you will feel like a teenager.  The surgeon might be thinking that “good” means only a one or two inch loss of length, only a 50% chance of loss of penile rigidity, only a 50% loss of skin sensation, and restoring your curve from 90 degrees to only 30 or 40 degrees. 

If your surgeon tells you these things are not true, and that surgical results are “excellent” and that you are worrying too much about such a safe and simple operation, ask the surgeon to put that in writing.  Ask the surgeon to guarantee that the surgery will not result in impotence, loss of skin sensation, that you will have a completely straight penis, and that your PD will never return.  You will not get that guarantee because no one can say what will happen to you as a result of PD surgery.

What is good for the surgeon might not be good for the man with Peyronie’s disease.

 Every now and then I get a question about the variety of unusual sensations and reactions that men notice during Peyronie’s treatment, or immediately after, a particular therapy used in Peyronies treatment.  These are the Peyronie’s disease therapies most often associated with this kind of response: 

1. Genesen Acutouch Pointers
2. Manual stretching method found on the CD
3. DMSO PMD formula
4. Super CP Serum copper peptide ointment

 Most often the sensation is described as a “tingling” or “aching” or “electrical” sensation in or near the area of treatment.  It can be felt during or within the hour any of these therapies are applied.  The intensity can be variable from time to time it is felt; sometimes very mild and hardly noticeable, and at other times enough to wake a person from a sound sleep. Sometimes the response occurs each time the treatment is done, and for other men the reaction occurs every now and then at irregular times.

 If you experience this kind of reaction in the area of your Peyronie’s scar, do not become alarmed. It is common and usually signals some good response to your Peyronie’s treatment as changes are occurring in the condition of the scar.   

 This is not something that has been studied much in the scientific literature since those researchers prescribing drugs or standard medical procedures for PD do not get the kind of reactions and responses that occur while following the Peyronie’s Disease Institute therapy principles.  They do not report this kind of reaction because they do not make the kind of rapid changes that are seen in men using the PDI protocols. 

 Therefore, there is no research that has been done to explain this phenomenon.  It is my theory that these reactions are due to the rapid changes that take place in the tissue in and around the scar material.  During or after a particular Peyronie’s treatment a change may occur in the tension and length of the otherwise contracted scar material of the penis.  These alterations of tension and position of the tissue layers could easily explain the unusual sensations that occur. I find from my own treatment experience, and that of other men who have had improvement in their Peyronie’s disease, that these “moving” or “tingling” or “aching” sensations appear when the scar is undergoing some level of change (improvement).  Many men come to count on the appearance of these changes to herald improvement of their scars from time to time.          

 It is most probably NOT just one therapy or just the one product causing this usual sensation.   It is closer to the truth to say that these sensations are the sum total of all the synergistic efforts that are included in your therapy plan. The problem (a good problem) with using so many of these therapies together is that you will never be able to accurately say which one did the most or least for you.   A synergistic Alternative Medicine therapy plan is a group effort, with all therapies making some contribution to whatever happens to you.

 Please email your questions about Peyronie’s disease treatment to this blog.

While the primary interest of Peyronie’s disease treatment is the internal scar tissue or fibrous  plaque material that causes the distortion or curved penis to develop, it is not the primary interest of the man who has PD.  For him, the most important aspect of Peyronie’s disease is the curved penis that plagues him.  For this reason Peyronies is also known as the “bent nail disease.”

Peyronie’s disease causes a curved penis when the fibrous tissue of the Peyronie scar or plaque pulls unevenly or causes incomplete filling within the erect penis.  This can vary in degree or severity from man to man.  For this reason the curved penis does not indicate the severity of the Peyronies problem or success of Peyronies disease treatment.  The true success of Peyronies treatment is based on the change that occurs in the Peyronies plaque or scar.  Once the fibrous scar changes, eventual improvement in the curved penis can be expected in time.

The internal tissue of the healthy penis is flexible and expandable.  This normal tissue is able to allow for a normal erection to develop when blood is trapped inside the organ.

In Peyronie’s disease some of the tissue is not healthy or flexible and elastic.  Specifically, the deep tissue known as the tunica albuginea is not elastic because it replaced by dense and inelastic fibrous tissue that is called a scar or plaque.   As an erection develops the elastic tissue of the tunica albuginea must stretch and expand evenly on both sides, left and fright, and top and bottom, of the penis.  If this cannot happen because an area of the penis is no longer flexible and expandable, then a curved penis results.

Peyronie’s disease usually begins with a small nodule or bump that is found on the top or sides of the penis, just immediately below the surface.  A few weeks to several months to a year later, a small fibrous nodule can expand into a larger irregular scar of variable size, shape, density and surface quality.  These scars can be as long as the penis.  Some appear like a collar to go around the shaft.   Some are one large mass, while others appear to be like small isolated islands of fibrous tissue in many areas.   Scars can be so soft or small, with edges so tapered and vague that no scar can be found.  In a case of Peyronie’s disease when no scar or plaque can be found, it is still assumed to exist when a curved penis develops during erection. .

Normally curved penis

Most men have a straight erection, but some are born with a penis that curves or bends (usually upward).   Just as fingers on the hand or a nose can display a natural bend, or arms can be of different length on the same person, the penis can be bent without the presence of Peyronies.  Typically, the normally curved penis follows a more gradual and arched design, more like a banana.  In Peyronie’s disease the curved penis is more localized and abrupt, like an angulated bend.

When the two primary chambers (corpora cavernosa) of the penis are a different diameter or length, the penis will bend when erect.   The penis will appear straight when flaccid, and on erection it will bend.

This slight penile distortion will not be associated with pain, there will be no trauma in the history, and it will not appear suddenly as does the curved penis of Peyronie’s disease.

Curved penis affects sexual intercourse

It is estimated that 75-90% of Peyronie’s disease couples will sooner or later experience a sexual intercourse problem, in regard to either pain or difficult penetration – or both.   The curved penis of is the primary reason sexual penetration is compromised, and it is also the reason for the pain that can be experienced by either – or both – partner. This is especially so in those cases in which the distortion is so severe it is described as “cork screw” or “cane handle.”

Incomplete filling of the penis with blood during erection can also happen in Peyronies.  This results in an area of the penis, either small or large, that is soft and unable to sustain the rigors of intercourse.  A soft area within an otherwise firm erection presents a weakness and vulnerability of the normally turgid erection.  A weak area of erection can suddenly collapse or buckle during intercourse, causing additional injury to the penile tissue.  This can cause pain, inflammation and additional fibrous infiltration.

It is a rare Peyronies couple that does not deal with some level of sexual difficulty related to penile distortion and reduced firmness of the erection.  The many physical, emotional and social issues of Peyronie’s disease are complex.  For this reason the reader is referred to “Peyronie’s Disease and Sex” for more information about this complicated area of life with a curved penis.

Treatment of the curved penis

It is important to remember that any penile distortion that develops in Peyronie’s disease is not the primary problem of this condition.   A curved penis that appears one night is difficult to ignore, but is only a symptom of the real problem of Peyronie’s disease – the scar. Without the Peyronies scar there would be no curved penis.

This is the reason I advise men who are undergoing Peyronies treatment to focus on the size, shape, density and surface qualities of the scar or plaque to determine if their Alternative Medicine treatment is being effective.  The curvature can improve or worsen as the scar is reduced.

A small scar can cause a large bend, just as a large scar can cause no bend at all if it is balanced and symmetrical.   For this reason a curved penis can worsen as the scar is being reduced or eliminated.   Estimating progress or success of a PD therapy plan is difficult .  A man can have many more scars than he is aware of, and they can be larger than can be detected since they are often difficult to locate and often overlap.

If only one scar is present the curvature problems are direct and easy to understand, although  this is unusual.   However, if multiple scars are present the internal pulling and twisting they cause can be very complicated.   Several scars can interact on many  planes of internal penile tissue.   Any reduction in one or more scar will alter the internal tension and pulling of the tissues, resulting in an altered curvature.  There is no guarantee the curvature will change for the better initially – sometimes it can look worse as the scars become smaller.  This is why I advise to focus all attention to the size, shape, density and surface qualities of the scar while treatment of the Peyronies problem continues.  Realize the curved penis is just a reflection of what is going on with the scar9s) below the surface.

Do not be discouraged by the curved penis of Peyronie’s disease.  Instead, stay focused on your plan for effective Peyronies treatment.  Learn more about Peyronie’s disease treatment.

Questions about Peyronie’s disease and Viagra are common.   Viagra, one of the PDE5 inhibitor drugs, is wildly popular and widely used not only among men who have erectile dysfunction (ED, impotence), but healthy men who merely use it to have longer lasting and more repetitive sexual intercourse.

While I hate to spoil the fun, over the years I have had a disturbing number of men tell me that they now have Peyronies, and Viagra was the cause of it.  They report the erections that occurred after using Viagra were super-erections and caused greater than normal internal pressure and pain.  Shortly after having such and episode they report having Peyronie’s disease; Viagra use is the only possible cause, because no trauma occurred.

It makes sense that any of the PDE5 inhibiter drugs (Cialis and Levitra are the others) increase pressure that is sometimes greater than normal with the tunica albuginea. In addition, these drugs create such hard and long-lasting erections because they induce an artificial condition within the penis.

If it were possible to take a drug that would allow you to lift a truck above your head and keep it there for an hour, should you do it?  That would be an interesting, and very impressive to the ladies, but is that reason enough to subject your body to the potential risk that would be involved?   The fact is that the body is not built to be used that way.  Lifting a great amount of weight causes internal pressure on tissue and organs that were not meant to bear that kind of weight.  Great injury would occur to internal organs, your spine, knees, hips, shoulders, blood vessels, and so on.  The same relationship exists between Peyronies and Viagra, and the rest of these products.

All of this is so unfortunate because there are far safer methods for Peyronie’s disease treatment.

Even though it sounds like a teenagers dream come true, the penis is not designed or intended to sustain such great internal pressures that are created by these drugs, nor is the penis built to be used in hour after hour of intercourse.  Just because you can, doesn’t mean you should.  That kind of activity can be abusive to the delicate tunica albuginea and could be the connection between Peyronies and Viagra or any other PDE5 inhibitor drug.

Several months ago a man told me he injured his penis while using Viagra.  He took some Viagra for the first time to the delight of his wife, and him.  After rousing intercourse, both fell asleep except his penis stayed erect.  He enjoyed the enormous erection and at first he thought it was great.  While asleep with this huge erection he rolled over and jammed his penis into the mattress.  In great pain, he heard and felt the tissue of the penis “pop.”  Two months later he was diagnosed with Peyronie’s disease.

Weekly I am told or I read that MDs write orders for their patients with Peyronies and Viagra is the most commonly prescribed drug.   The MD will explain that the Viagra will increase the blood flow to the penis and this is beneficial to Peyronie’s disease.  I think this is nonsense.

While there is an increased amount of blood within the penis during an erection that causes the greater size of the organ, it is perhaps only 2-3 tablespoons more blood than is normally present.  But here is the most important point that explains why this idea is so silly:  The extra blood, and even the normal amount of blood that is inside the penis during an erection, is TRAPPED there.  It is not freely flowing, or moving in and out as you would like to happen, to actually increase circulation.  During an erection, there is less true circulation of blood – that is why the penis gets darker, because there is less oxygen present – and so there is no therapeutic purpose in creating super erections with Viagra because that is not the way to get better circulation.

A man would know he actually is suffering from poor circulation in his penis, just as he would know he has poor circulation in any other part of his body – like his feet or hands.  When the feet or hands have poor circulation they become cold, painful and pale.  If your penis is not cold, painful and pale, then reduced circulation is not your problem.  And enduring prolonged erections from a PDE5 inhibitor will not help your Peyronie’s disease, and could make it worse.

If you want to increase circulation to the penis, you can do it as you would to your feet or hands.  You would apply heat to the area as with a hot water bottle, or cover it with a blanket.  You can even rub it!  It is as simple as that.

The increased occurrence of Peyronies and the increased use of Viagra is not a coincidence.  There is a reason more and more men are getting Peyronie’s disease at the same time that more and more men are using Viagra and the other PDE5 inhibitors.  Now you know about Peyronies and Viagra.

While I spend a good part of my day communicating with men about Peyronie’s disease treatment, I also am asked frequent questions by men who are unsure if they even have Peyronies.

One of the common vexing questions is, “If that lump or bump on my bent penis is not Peyronies disease, what else could it be?”

The truth of the matter is that it is difficult to answer this question because it often just opens up a large door of possibilities since many conditions can cause a penile lump.  This, of course, starts many questions about a curved penis.  To prevent the eruption of a long list of questions from this one particular question, I will not go into much discussion about the various problems and conditions that can be mistaken for Peyronie’s disease.

The real value of this kind of list of possible conditions that can cause,  contribute, or be associated with or confused with a bump or lump on the penis is one of simple recognition.  If you already recognize you have one or two health problems that you personally have been dealing with or one or two health problems that are present within your family history, then seeing it mentioned in this list will alert you to the possible connection between these two your penile problem and this other problem.

This list is not meant to be an education about any of these problems, just a way to offer possibilities other than Peyronie’s disease.

Conditions that sometimes can contribute to, cause, or be associated with  lumps and bumps within the penis, but not Peyronie’s disease, are:

1. Congenital curvature of the penis – you were just born that way
2. Penile dorsal vein thrombosis
3. Local trauma
4. Acute penile fracture
5. Alcohol Abuse
6. Diabetes Mellitus
7. Tertiary Syphilis – a structure known as a Gumma, that develops late in the progression of this sexually transmitted disease
8. Scleroderma
9. Gouty tophi or nodules – important if you have a history of gout, or that you notice your penis nodules get worse during a bad episode of gout

10. Metastasis of cancer to the penis – very rare

11. Chordee with or without hypospadias

12. Ventral curvature secondary to urethral instrumentation

It is important that Peyronie’s treatment is directed toward the correct problem.  If you are unsure about the cause of your lump, bump or penis curvature it is important that you have your physician examine you for a competent medical examination.  After that, review the PDI website to learn as much as you can about the Alternative Medicine treatment of Peyronie’s disease.

An important consideration of Peyronie’s disease treatment concerns how the ability to develop a normal erection will be influenced.

While erections can be difficult to develop on demand during a sexual situation, paradoxically, an erection can be difficult to stop, especially when it develops while asleep.  Nocturnal (nighttime) erections occur for a reason, and they are important for the overall health of the spongy tissue of the corpora cavernosa and corpora spongiosum (deep tissues of the penis that fill and trap blood to create the erect state).

It is as though the body takes the opportunity to develop an erection during the night when there is little other activity going on, to assure that the penile tissue is stretched and used in this particular way for its own benefit.  The problem with nocturnal erections in Peyronie’s disease is that confinement and binding of the erection can be sustained against the penis for a long period of time at the risk of additional injury.  Be especially careful about getting an erection during a time when the penis has no comfortable place to go – do what you can to avoid an erection while wearing tight underwear or pants.

For this reason it is important to not wear tight clothing to bed in order to avoid this problem.

For the most part, a normally occurring erection that can simply “stand on its own” with no pressure against it, is not going to bind or stretch out the penile tissue to any great excess that is going to be detrimental to the penis. Where you can get into trouble is in creating a drug-induced or artificial erection, during which an abnormally great amount of blood is drawn into the penis by more soft tissue relaxation than normal.  So in this way we see that a naturally occurring erection is safer than an artificially created erection.

Over the years I have communicated with many men whose Peyronies disease started after a drug induced erection that stressed the penile tissues by greatly increased internal pressure.  This process would not be much different than taking a car tire that is meant to go no higher than 40-50 PSI during normal use, and over-inflating it to 100-150 PSI during use.  Because it is not built to take that kind of pressure, you could expect some problems to develop in using a tire that way.  Not much different with the penis.

Sexual activity is NOT to be avoided if you have Peyronie’s disease, but rough, aggressive, hard sex could really hurt you.  Developing and using a natural erection is not to be avoided either in PD.  Just keep your wits about you and do not go wild during sex.  The emphasis should be on an easy, smooth and gentle sexual encounter.  Anything that causes pain should be avoided.

Many important related topics about taking care of yourself, avoiding injury, doing nothing to set your progress back while you are attempting to heal your problem, are covered in my recent book, “Peyronie’s Disease Owner’s Manual.”   Check out the website about this book at  http://www.peyronies-disease-help.com/PD-owners-manual.html I think you would enjoy learning more about what you can and should do to take care of this nasty problem.

Every now and then someone emails a question to me about an herbal Peyronie’s disease treatment (ginkgo biloba, echinacea), a micronutrient (coenzyme Q, EPA), or an old home remedy (garlic, castor oil, olive oil) that might be used as a Peyronie’s disease cure.  Along a similar line, I am sometimes asked if I know anything about a legendary Peyronie’s treatment known as Thacker’s formula, what I would think about using the treatment, and why does this treatment not appear in the PDI lineup of therapies?

How is a Peyronie’s treatment method selected by PDI?

In order for any therapy or procedure to be included in the PDI lineup of 14 potential Peyronie’s treatments, it has to have either been applied specifically in treatment of PD in a series of scientific studies and proven at least 50% effective in several trials (even though it might have done poorly in others), or it must have demonstrated good success and acceptance within the scientific community for treatment of other unrelated health problems (acupuncture and homeopathy).  With this simple criterion we establish some level of scientific credibility for those therapies in our PDI lineup, and further increase the possible effectiveness of therapy when several of these are united in a synergistic program of care.

There are probably some really good Peyronie’s disease treatment ideas that that could be actually very effective.  But who among us wants to waste his time, effort, energy, money, and most importantly, his opportunity to get over his Peyronie’s disease by experimenting with theories that have absolutely no proven ability to influence the body to promote healing? I did not want to waste my time on theories of questionable merit, when I knew there were many available that had already achieved some level of success.  This last group seemed to be a better place to look for answers, than chasing unproven ideas.

Edgar Cayce’s castor oil pack might indeed be an effective Peyronies’ disease treatment, but for one reason or another it has not been subjected to even minimal scrutiny for PD.  The goal of recovering from Peyronies is too great to use an untried treatment, when there are so many others of higher credibility and logic to work with.

PDI was started on the basis of using treatments of some level of known and proven merit, and uses this standard today to determine what additions will be recommended and used in future therapy plans.  Rumors, stories, and speculation you read about on a Peyronie’s forum is not enough.  Alternative Medicine employs early science to see through the maze of superstition and learn the truth of what may or may not work to regain health.  These are the principles used to formulate the current Peyronie’s disease treatment strategies you have learned about.  We are already working on the outer rim of established medical practice, but we must be careful to not go too far away from common sense and valuable scientific information that will help us achieve our health goals.

Usually, my suggestion for someone who wants to use such a new Peyronie’s treatment is to do it in combination with several other known and better proven therapies already in the PDI lineup.  This way there is back-up treatment, and the total effort will create a therapeutic synergy.  Never is it suggested to use only the one therapy of any type, proven or unproven.

So, if you are just adding in an extra type of therapy because you read about it on a Peyronie’s forum, I say, all the more power to your curiosity and sense of adventure, but please do not have that constitute the majority of what you do for yourself.

Try not to become so desperate that you grab at straws. There is a lot of good information about sensible Peyronie’s disease treatment I can offer if you need help with your rehabilitation program.