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Peyronie’s Disease Treatment and Vitamin E

Monday, March 8th, 2010

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.

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Peyronie’s penis

Friday, February 26th, 2010

What causes curved penis?

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.

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Peyronie’s treatment sensations

Monday, February 15th, 2010

Strange reaction to Peyronies therapy

 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.

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Curved Penis and Peyronie’s Disease

Monday, February 8th, 2010

Peyronies bent penis is focus of problem

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.

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If it is not Peyronie’s disease, what is it?

Tuesday, January 19th, 2010

Peyronie’s disease treatment to be successful must be directed to the correct condition.

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.

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Peyronie’s disease and the erection

Friday, January 15th, 2010

Peyronie’s treatment and how to care for erections

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.

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Peyronie’s disease treatment question

Friday, January 15th, 2010

Peyronie’s treatment that are not mainstream

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.

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Peyronie’s disease and baby boomers

Saturday, December 26th, 2009

Peyronie’s disease:  male health problem no one knows about

If you are a member of the baby boomer generation and have never heard of Peyronie’s (pay-row-neez) disease, you are not alone.  However, if you are a male baby boomer or married to one, you are in the prime age group to experience a problem you know nothing about.  This is so because Peyronies disease primarily affects men between 50 to 65 years of age, although an age range of 18 to 80 years has been reported, with an average age at onset of 53.

Few people know about the problem until they need Peyronie’s disease treatment.   This is why it is important for all baby boomers to know about, and how to avoid, it because this health problem can easily ruin your life.

Peyronie’s disease remains one of the most perplexing and difficult urologic diseases to treat; it has been called “the doctor’s nightmare”.  Most everything about this condition (cause, progression, symptoms, age distribution, response to treatment) is variable and unique to the man who has it.  The great variability of Peyronie’s disease that makes it difficult to study and to understand, also makes it almost impossible to treat like other medical conditions.

It is a complex problem that is much more common than most people realize. Estimates suggest that up to eight out of 100 men over the age of 40 have Peyronie’s disease – that is a lot of people worldwide – and still only a small percent of people have ever heard of it.

People are reluctant to discuss this problem because it involves the male organ.  For this reason it is difficult to develop accurate information and statistics, especially since men are so shy on one hand, yet also inclined to exaggerate.

Definition of Peyronie’s disease

Peyronie’s disease can best be understood as an exaggerated wound healing in response to an injury in which an excessive amount of Peyronie’s scar tissue develops within the man’s shaft.

Peyronie’s disease (also known by over 12 different names, among which is “iduratio penis plastica”) is very special disorder of the connective tissue in which fibrous “scars” or “plaques” develop usually after direct injury.   This Peyronie’s plaque occurs in a special tissue of the shaft known as the tunica albuginea, a fibrous chamber or envelope that surrounds the two penile cylindrical shaped masses of spongy tissue known as the corpora cavernosa.  The corpora cavernosa enlarge during sexual excitement, and the tunica albuginea covering, are designed to expand and elongate.  If there is fibrous scar or plaque material in the tunica albuginea, the expansion and elongation cannot develop properly resulting in bending, weakness, shortening and incomplete filling of the organ.  Sometimes this distortion is mild (just a few degrees) and does not affect the ability to perform, while at other times the distortion can be extreme (more than 90 degrees) resulting in greatly adverse consequences.

A certain degree of normal penile curvature can and does occur in some men.   This is a benign and natural condition many men are born with, commonly referred to as congenital curvature; this is not Peyronie’s disease.

Peyronie’s disease signs and symptoms

Four common findings of Peyronie’s disease:

  1. Pain – caused by inflammation and stretching of internal tissues in response to injury and distortion; can be present constantly or only during erection
  2. Nodule or mass formation – variable size lumps or elongated cords can develop in one or multiple areas; sometimes these are difficult or impossible to locate depending on the density, depth and size of the scar formation
  3. Curvature or distortion – caused by presence of one or more nodules or masses of scar tissue in the tunica albuginea, preventing normal expansion during erection; can be minor to gross in appearance
  4. Reduced sexual ability – due to physical distortion that prevents penetration or due to reduced firmness that also prevents penetration (erectile dysfunction).

The onset of Peyronie’s disease symptoms can be sudden or slow, but often appears within a month or two after direct injury.  The pain of Peyronie’s disease is extremely variable; from hardly noticeable to the kind of pain that prevents sleep.  Peyronie’s pain is worse in the beginning, usually gradually improving over time – improvement in a few weeks while others continue for years. For these reasons Peyronie’s pain is not a reliable way to judge the severity or calculate the time for eventual recovery.

Even though Peyronie’s disease is a male health problem, women are also affected by it.  They are indirectly and adversely affected by the erectile dysfunction, organ curvature and distortion that make intercourse often impossible, as well as loss of organ size that often occurs over time.  Additionally, and perhaps even to a greater degree than men, woman bear the brunt of the mood swings, anger, brooding and ill-temper that accompany their partner’s Peyronies problem.

Treatment of Peyronie’s disease

There is no standard or accepted medical treatment for Peyronie’s disease since no drug is proven to eliminate the scar within the shaft.  The only accepted and available medical treatment is surgery.  However, given enough time after Peyronie’s surgery the condition will only re-appear in a worsened presentation.  This surgical outcome is made bleaker by knowing that even the first Peyronie’s surgery can result in total loss of sensation (anesthesia), increased pain and increased curvature and greater scar formation than before surgery, and in some cases amputation.

The Peyronie’s Disease Institute has specialized for the last eight years in the use of Alternative Medicine therapies and techniques that are found to be successful in perhaps 60-80% of cases. None of the therapies are known to result in adverse reactions or side effects.  For more information about the Alternative Medicine approach, visit Peyronie’s disease treatment.

Prevention of Peyronie’s disease

With so many variable aspects of this problem to consider, it is important to know that in addition to everything else, there is no universal agreement about the cause of Peyronies. Some say that injury alone cannot start the problem as we have described above, but that other genetic and metabolic factors must also be present.  The Peyronie’s Disease Institute takes the position that this is true.  However, if a man never sustains direct injury to the area he is far less likely to develop Peyronies.

With age not working in the favor of any baby boomer couple, it is important to evaluate all situations in which direct injury can affect this area – especially sexual activity.  This requires  that special caution is exercised if a baby boomer gentleman finds he no longer has the usual firmness he previously possessed (erectile dysfunction).  Attempting intercourse with a partially flaccid organ can result in sudden buckling or abrupt bending during insertion or the sex act itself.  Another way to prevent injury is to modify the techniques used during sexual relations.  The single most common injury that starts Peyronie’s disease occurs when the female partner is on top, and she loses hold of him while she thrusts down, jamming and painfully bending him against her upper thigh.  To avoid this kind of injury it is important to not use any female-superior position, but to use other techniques in which physical contact is controlled, firm and not likely to disengage during activity.

Even if baby boomers have never heard of this terrible condition that robs a couple of one of the greatest pleasures of life, it happens every day.  Now that you know about Peyronie’s disease you can do a lot to protect the best years of your life.

Dr. Theodore Herazy has practiced Alternative Medicine for over 40 years, and has directed the Peyronie’s Disease Institute for the last eight years.  He has written two books about this problem, “Peyronie’s Disease Handbook” and “Peyronie’s Disease and Sex.”   He can be reached at http://www.peyronies-disease-help.com

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Peyronie’s plaque or scar

Monday, December 21st, 2009

The central issue of Peyronie’s disease is the infamous Peyronie’s plaque, also called a scar. Peyronie’s disease typically occurs in men between 40 and 65 years of age, although a range of 16 to 80 years is documented; some experts say it can occur at any age. From personal communication with a particular man, I was told that his own Peyronie’s disease was started after a dog bite to the groin – at the age of 10. Nonetheless, it is most important to recognize that all clinical signs and symptoms of Peyronie’s disease originate from the effects of the plaque upon the internal tissue layers (tunica albuginea) of the penis.

A developing Peyronie’s plaque appears in response to either micro-trauma to the small blood vessels from a single injury of great force, or multiple injuries of a small force. While there is strong evidence that genetic factors and drug factors also influence the start of PD, it is trauma that is usually considered to be the most likely cause of the Peyronies scar, or plaque.

A Peyronie’s plaque on the cellular level initially consists of fibrin threads deposited in a massive network throughout an area of injury within the tunica albuginea of the penis. Peyronie’s plaques, or scars, later combine the dense threads of fibrin connective tissue with reduced and fragmented elastic connective tissue fibers, as well as excessive amounts of type III collagen material, which happens to be specially inclined to excessive scar development. In about one-third of chronic cases of Peyronie’s disease, calcification of the plaque can occur over time. For more technical information about the Peyronies plaque, please go to http://peyronies-disease-help. com/ peyroniespathology.html

The curvature of the Peyronies penis is due to the fact that scar tissue does not stretch as easily or as fully as healthy normal tissue. The normal tunica albuginea is composed of elastin fibers and collagen, although the site of scar tissue from Peyronie’s disease is composed mostly of collagen. This difference in composition of these two tissues is what causes a bent penis to develop during erection.

Eventually as one or more Peyronie’s plaques develop into a mass of hardened tissue in the delicate tunica albuginea, it results in variable pain and penile distortion that most often takes the form of a bend or curve; sexual function is often reduced as a result of direct or indirect affects of Peyronie’s disease, also. The penile curvature of Peyronie’s disease is caused by the dense inelastic scar, or plaque, material that shortens the involved side of the tunica albuginea layer that covers the corpora cavernosa of the penis. In approximately one third of patients, the scarring involves either the top or bottom portion of the penis shaft, occasionally both. The lateral sides of the penis can also be affected by Peyronie’s plaque development, if that area experiences injury.

In some men the Peyronies plaque is easily found on manual examination, in others it is found with difficulty, and in some men no Peyronies plaque is ever located. It can be frustrating to have a wicked penis distortion, and still not be able to locate the Peyronie’s plaque.

To locate the plaque or scar material a light and inquisitive touch is most effective. Do not be heavy-handed, or press down into the deeper layers to find the Peyronie’s plaque material, because it is found just below the surface of the skin. And, oh yes, you will never directly see the plaque or scar, since it is not on the surface of the skin, but below. Make peace with the Peyronie’s plaque and do not hate it, just determine how to assist your body to remove it.


To learn about using Alternative Medicine to increase your ability to heal and repair the Peyronie’s plaque, a good place to start is the PDI website at http://peyronies-disease-help.com/ treatmentintroduction.html

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What is the best Peyronie’s disease treatment PDI uses?

Monday, December 14th, 2009

Every week, without fail, some poor guy who just learned he has PD will write an email to me asking, “What is the best one of all the Peyronie’s disease therapies PDI uses?”

A common question, and a good one.

The best way to treat PD is with everything you can throw against it. It is that kind of problem.

There is no one therapy that is a magic bullet. There are no wonder cures, no nifty little tricks that will get you a larger penis and somehow this is a Peyronie’s disease treatment.

Each person must educate himself about the problem, read about the different Alternative Medicine therapies and what they can do, determine if there are any indictors that one or more might be indicated, and then consider time, effort and cost. Lastly, it is necessary to determine how important it is to you to regain your health. Based on all this, a man should feel comfortable with a plan of action he can follow for several months as he goes about doing all he can to improve his body’s ability to heal and repair the injury of PD.

Those men who get good results with their Peyronie’s disease are the tough SOBs who just keep going after it day after day with as much therapy as they can afford to use, until they seem to wear the fibrous tissue down. Slowly they gain on it, with the scar(s) becoming softer and smaller; slowly they come around. Some get fantastic results and some get only moderate results – few who work hard at it do poorly. There usually is progress to be made if you work at it.

So, again, “What is the best way to treat PD?” I would say the answer is that you do all that you can for as long as you can until your body overwhelms the Peyronies plaque tissue. To do less than that is to allow Peyronie’s disease to ruin your life.

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