Couples are always concerned if they can safely engage in sexual activity, especially during the early phase of Peyronie’s disease treatment.

The short answer is, YES.   Sex is good on may levels for you as individual people and as a couple, so go for it. You can and should engage in as much sexual activity you are comfortable with and desire, during treatment and in spite of your Peyronie’s disease.

The longer answer is, YES, but you must be careful and cautious in exactly how and what you do during sex.   Careful, gentle, non-stressful sex is certainly the safe and smart goal.  As the owner of the Peyronie’s curved penis, it is important to stay in control of yourself, and your partner should do the same, without becoming so carried away that you injure yourself further.  You are the only one who is going to suffer further if you bend or jamb yourself during sex, so it is your ultimate responsibility to be careful.

If any sexual activity or position causes ANY amount of pain or distress to either of you, it should be stopped.  Pain is your signal that something is wrong.  Do not do anything further to even slightly injure your penis while you are spending all this time, effort and money trying to get well.   Figure out other ways to enjoy sex without generating a pain response, and you will do fine.

Slow and careful does not mean dull.  It should mean more passionate sex, taking more time doing what feels good, all based on better communication between the two of you.

Please make sure that you do not attempt sexual entry too early, if she is too dry or otherwise unprepared for intercourse.  If you usually do not need to use any external lubrication (water-based lubricant like K-Y jelly), it is simply a smart thing to start using it now. This is a vital step to prevent further injury, since a second injury could be catastrophic.

Do not use positions and techniques in which the man does not control movement and activity.  Rear-entry sex positions are usually safer to use since they allow the man more control, but caution is still needed.

“Peyronie’s Disease and Sex”

The topic of sex in relation to Peyronie’s disease is immense.  When I began writing my first PD book, I intended to combine the topics of Peyronie’s disease treatment and sex all in one book.  When it became apparent how large this sex topic is, I simply decided a separate book would have to be written; it eventually became “Peyronies Disease and Sex.”

Any questions about sex and Peyronie’s disease?   Send them along at the heading on the right column, “Ask Dr. Herazy…”

Peyronie’s disease often causes pain during erection because the shortened scar tissue located in the tunica albuginea cannot lengthen, and causes pain.  Occasionally, men will also report Peyronie’s pain when erect and non-erect; some men will even report never having pain during erection but only when non-erect or flaccid.

Since pain is often a part of the Peyronie’s disease landscape, let us take a closer look at penis pain that occurs only during sexual activity, with the most common causes being listed first. .

Peyronie’s disease is a common explanation when men have sexual pain, but it is not the only one. See your doctor for an official diagnosis, but here are some other culprits.

Poor sexual technique and insufficient foreplay to cause adequate sexual lubrication.  Rushing into genital penetration before the female partner is adequately prepared sexually can be painful due to the vagina being dry and too contracted.  Use of adequate sexual lubrication can be extremely helpful.

Prostatitis is an inflammation or infection of the prostate gland that can cause swelling and pain in the area behind your penis (just below your bladder), pain or burning when urinating, and painful ejaculation.

Genital herpes can cause a sore on the penis that results in very painful sex.  In addition to avoiding sexual contact with a partner during an outbreak because these sores are extremely infectious, part of the therapy for herpes is to refrain from sex in any case.

Urinary tract infections anywhere from the bladder to the tip of the urethra (urinary tube that runs the length of the penis to pass urine out of the body).  This needs to be treated rapidly, because they can spread and become very serious.

Yeast infections of any part of the urinary tract are often accompanied by itching or burning at the tip of the penis.

Allergies and dermatitis caused by sensitivity to chemicals or soaps can result in inflammation of the skin on the penis, especially for those men who are uncircumcised.

Psoriasis of is a non-infectious chronic skin condition that results in scaly, itchy and painful red patches.  These are usually treated with low-dose steroid creams. When psoriasis of the penis develops, sexual contact can be painful.

Phimosis is a condition of the penis in which the foreskin, also called the prepuce, is too tight to be completely retracted over the head of the penis.  Movement of this tight skin during sexual activity can be very painful.

Paraphimosis is a similar condition in which the tight foreskin becomes stuck behind the head of the penis.  Low grade infections can develop, and reduced blood flow to the area can occur, either or both of which are very painful.

Any pain that develops during sex should be investigated by a medical doctor.

For a more in-depth discussion about matters of penis pain, and the role of Peyronie’s disease in sexual activity, please refer to my book, “Peyronie’s Disease & Sex”

Technically, Peyronie’s syndrome is not the correct way to refer to Peyronie’s disease.  Actually, calling it Peyronie’s disease is not correct, either, but more on that later.

First, the term Peyronies syndrome.   A syndrome refers to a group of several essential and clearly recognizable clinical signs, symptoms and characteristics of a health problem that often occur in association or together.  In the situation in which a syndrome occurs, the presence of one feature, sign or symptom would alert a doctor to the possibility a particular syndrome was present, so he/she would automatically look for other features, signs and symptoms that normally occur with it.  If those additional findings are detected, then  a diagnosis of that syndrome could be made.

Peyronie’s syndrome is not a valid term because the characteristic Peyronies symptoms are actually too few, and they do not usually form a tightly bound set of features that suggest this particular health problem. The few symptoms and signs associated with PD are actually vague by usual medical standards. Since there are typically only three such standard features or clues associated with Peyronie’s disease  (penis pain, distorted or curved penis, and the common Peyronie’s plaque or scar), this set of presenting characteristics is not large enough or strongly suggestive of the condition, hence syndrome is not a good term to use.

Peyronie’s syndrome is not a disease, either

Then we come to the term Peyronie’s disease, which is not all that accurate either.  A disease refers to any condition that causes extreme pain, significant organ or system dysfunction, social problems, and even death, and is usually acquired through direct or indirect transmission or communication from one person to another.  Of course, there are many definitions and ways of looking at what constitutes a disease, but that is generally acceptable in most cases.

Since Peyronie’s disease seldom causes extreme pain, and sometimes no pain at all, it does not fulfill that requirement.   Since the genitourinary system of which the penis is only a part continues to function, and the penis continues to carry urine and oftentimes is still capable to function sexually, it does not fulfill the requirement of loss of function.  While having a bent penis plays havoc with the man who has it, and the woman or women he is sexually active, it does not affect society as a whole, the way actual diseases like the flu or measles, syphilis, tuberculosis or alcoholism do.  Peyronie’s disease is not fatal, except to some couple’s sex life, so it also does not fulfill that part of the requirement.  And lastly, this problem is not communicated or transmitted from one person to the next; you cannot catch Peyronies.

When referring to Peyronie’s disease it is more accurate and fair to use other terms like “condition,” or the more descriptive terms that follow in this list.  These are more clinically accurate names that have been collected and were taken from the PDI website:

1. Indurato penis plastica
2. Chronic cavernositis
3. Fibrous sclerosis of the penis
4. Fibrous cavernositis
5. Fibrous plaques of the penis
6. Penile fibrosis
7. Penile fibromatosis
8. Penile induration

This list of descriptive terms was taken from the PDI website where the basics of Peyronie’s disease are discussed at length.  If you wish to learn more about this condition, called Peyronie’s disease, please review this additional information.  But whatever you do, do not call it Peyronie’s syndrome, OK?

If having Peyronie’s disease was not stressful enough on a relationship, it has been reported by The New York Times that more men and women than ever are cheating on each other.

This blog article does not intend to plant the seeds of anxiety, doubt, or suspicion about an unfaithful mate, because these thoughts have likely occurred within the first hour for any every man who learns his curved penis is caused by Peyronies disease.  This blog post is offered to address that common fear and anxiety, and offer advice for what you can do to increase your ability to keep your relationship solid and strong.  So read on, since this is additional reason for men with a bent penis to be interested in improving their romantic talents and sexual skills.    In a recent newspaper article, The New York Times commented that University of Washington researchers discovered more men and women are cheating today than in the past.  What is termed the lifetime rate of infidelity is greater for both sexes; for men over 60 infidelity is now at 28 percent, up from 21 percent. The frequency of infidelity has tripled for women, with infidelity now at 15 percent.

Apparently it is the temptation offered by the modern age, in the form of cell phones, e-mail communication and instant text messaging that allow people, including women who work at home, to create intimate relationships with those who are not their traditional partners.   Pepper Schwartz, Ph.D., author of Prime: Adventures and Advice on Sex, Love and the Sensual Years, believes women are more inclined to wander and experiment with others is because of growing independence and ease of maintaining private communication with different people.  Dr. Schwartz notes that if a person was sexually active while single or unattached, that person is more likely to be dissatisfied and roam if their current relationship develops problems.

“If things aren’t great, they are more open to reliving some of the sexual passion and high points of their single days,” Schwartz says.

At what point in a relationship do things become not great?  “[People] get bored or feel like, ‘Is this all there is?’ ” Schwartz says. “[The reasons] for men and women are the same: They need reassurance and they’re feeling unappreciated.”   So, notice here that Dr. Schwartz is not replying that a woman becomes unfaithful because she is not receiving adequate sexual activity, or that she is unhappy with the number of orgasms or the size of his penis.  This is an extremely important point.  It has been my observation that men with Peyronie’s disease develop relationship problems more because of how they behave on the emotional relationship or social level, than on the sexual physical level.

Dissatisfaction in a romantic relationship usually revolves around something any man with Peyronie’s disease can always provide, in spite of a bent penis – he can always offer her respect, reassurance and appreciation.  Keep in mind that the real dissatisfaction in a romantic relationship is often more about emotional issues than physical issues.  Even when the woman expresses sexual dissatisfaction with her mate, they come to the surface only because of deeper and larger problems that are emotional in nature.  Men tend to think of a relationship more so from the purely physical aspect, while women tend to think of a relationship more so from the purely emotional aspect.  This is the wonderful, and problematic, difference between the sexes.

A man with the bent penis of Peyronie’s disease thinks he has a problem in his relationship because of the physical problems with sex.  This is often not true.  A man would think this way, while a woman doe not.  For a woman the real issues of highest importance are the critical personal human issues of respect, reassurance, appreciation, and an emotional bond that is strong and frequently satisfied.  I have seen that if a woman is emotionally satisfied, she is far, far more likely to willingly accept her mates reduced physical limitations.

I spend a great amount of time discussing all phases and aspects of this exact issue that arises in Peyronie’s disease between a man and a woman in my book, “Peyronie’s Disease & Sex.”  This book has saved many marriages and relationships over the years.  I urge you to read it if you are having relationship problems because of your Peyronies.

Peyronie’s disease and romance

On a daily basis, with so many interferences and stresses that separate a couple, romance is difficult to maintain.  However, there many easy and fun things any man with Peyronie’s disease can do, no matter how badly his penis curvature interferes with usual sexual activity.   These are five positive and pleasant steps you can take, even if you cannot engage in intercourse, that will assist you greatly to keep her interested and close to you:

1. Spend more time together. A good relationship requires time together and alone with that special person.  Give her the attention she craves.  Go out with her to do things that you previously avoided.  Go grocery shopping together.  Tag along when she does a few errands, or to her work functions you usually avoid. Help her with some chores that you can share together.  Be a friend to her in ways that you did not see before.  Dr. Schwartz advises, “You can’t do it all, but even if you’re there sometimes, it will remind her that she’s part of a great couple instead of an individual out there on her own.

2. Keep your relationship fresh and fun. See where you have fallen into a level of dullness in your lives, and make some changes.  While you might simply see a schedule, she might see a rut.  Eating at the same restaurant, doing the same things each evening after work, being far too predictable, or not adding variety to your lives together can take the edge off a relationship.  Even sex can become part of that predictable quality that becomes less fun and boring.  Suggest a “nooner,” then meet her back at the apartment for lunch in bed. “Rent an erotic movie, go shopping for a sex toy, buy her a sexy teddy,” Schwartz suggests. “Make her believe no one could be as romantic or as much fun as you are.”    Go to http://www.natural-complementary-medicine.com/ index.asp?PageAction=VIEWCATS&Category=7 Here you will find a few things to spice up your sex life.   With Peyronie’s disease putting limits on your sexual activity, it is important that you compensate by improving those elements of your personal and romantic relationship that can be improved, no matter how far your penis is curved.

3. Deal with all that sudden anger. Men with Peyronie’s disease are notorious for their anger.  I will write a blog post about this problem soon, but for now let’s just agree that your temper lately has gotten out of control far too often and far too extreme.  Do not use anger as a way to avoid the problems of Peyronie’s disease.  Take the issues and problems you now face, and discuss them directly with her because she needs to know what is going on with you – your fears, your embarrassment, your feelings about your masculinity, your insecurity about your relationship with her, all of it.  Many men cannot talk about these things, so they explode.  ”Anger is like a termite—you don’t see it, but it’s eating the walls and the structure of the house you’re living in,” Dr. Schwartz says. “The house is the relationship, and if you don’t handle it, the termites will ultimately destroy that bond which keeps someone loyal.”   You did not ask to have Peyronie’s disease, but it is your decision and your ultimate fault if you allow your anger to erode your relationship.

4. Learn how to use time. Dr. Schwartz advises that time can be used to diffuse and calm a tense situation.  “What you don’t want to do is have a fight when you’re mad. Say, ‘Look, you’re upset, I’m upset, let’s meet tomorrow at breakfast and talk about this. I’m not in the best shape to deal with it right now.’ ” Talk about your problems, sure, but only do so when you are levelheaded and in control of yourself.  If you are not, the chance is good that you will only make things worse.  Use time to work in your favor to solve your relationship problems.

5.  Create, or take advantage of, romantic moments. Even though it can be extremely corny and uncomfortable for a man, let’s just assume that all women really enjoy those Hallmark moments:  sitting by the fireplace, reading a book together, washing her hair or doing her nails, sending her an email that tells her in simple language how much you love her, or just holding hands while you walk.  Women think of these small things as great foreplay, and that is why they appreciate it when a man holds open a door, or takes care of her in small but important ways.  Dr. Schwartz says, “The less [of these moments] you have, the more she’s thinking how it used to be, or how nice it would be to have a man offering to fly her to a cabin in the woods.”  Make sure you are the one she is fantasizing about, by creating foreplay with simple acts of consideration, reassurance that you value her, and appreciation for who she is and what she does.   “You don’t have to do it all the time, but if you can’t remember the last time you did any of this, it’s way too long,” Schwartz says.

Even if you do not have Peyronie’s disease, these things will improve and deepen your relationship.  But if you have Peyronie’s disease these things become all the more important.  You must do all that you can to support and strengthen your relationship with her, now that one element of your physical ability to satisfy her is diminished.

Peyronie’s disease does not destroy a relationship; it is allowed to die when the man who has PD does not understand what motivates his woman.  Wise up.

Women need a Peyronie’s forum for their special needs and issues.

While no one can doubt that the man who has Peyronies suffers in many ways with this problem, the women who love and live with these men suffer greatly in their own way.  Every woman touched by Peyronie’s disease suffers not less because hers’ is an indirect involvement, but perhaps more because of the acute frustration and helplessness of being unable to do anything to comfort her man during his times of distress.

Many of the emails I receive each day come from the women who are just as confused, frustrated, and angry about all the same issues that each man experiences in trying to deal with PD – with a few added issues.

Just as the man who first learns he has Peyronies, the woman must also attempt to grasp the answers to the basic questions that commonly arise at this time:

1. This condition I have never heard of before – Peyronie’s disease – just what is it, and what do we do to get rid of it?
2. Is it life threatening?
3. What do you mean, there is no known cause or Peyronies cure?
4. In the early part of the 21^st century, when even cancers are being cured, how is it possible that science has no help for this problem?
5. Could it be that we have talked to a doctor who is lazy or incompetent: should we talk to someone else?
6. Would we get better answers, and help, if we spent more money and went to a higher level specialist?
7. How could this problem affect up to 9% of the male population, but I have never heard of it before?
8. What do you mean, you do not know if it is going to get better or worse?

On and on the questions pour out, trying to make sense of a terrible situation.  But there are other questions that a woman must naturally ask in the privacy of her own self:

1. I am sorry that he got injured during intercourse.  He knows I did not do it on purpose.  I feel so guilty when I see him suffering.  Is he holding all this against me?
2. What about my sexual needs; what am I going to do now?
3. I didn’t do anything wrong, why am I suffering too?
4. Why is he being so quiet and secretive about this; why won’t he talk to me about this problem?  Doesn’t he realize It is affecting me, too?
5. What is going on with him?  He is getting so moody and irritable that I am afraid to talk to him sometimes.
6. I feel like there is a brick wall around him, and he is a hundred miles away.  Why won’t he talk to me?

Of course, there are all the sexual problems and sexual discussions that are so unique between couples.  These too, are a part of the problems associated with Peyronie’s disease treatment– sometimes minor and manageable, and sometimes so major that a couple can not sustain themselves together.  In these cases where I counsel couples, I find that most all of the time each couple has a problem communicating on a much deeper level necessary to truly understand each other to the degree needed in this time of special need.

Throughout all this time, during discussion and lack of discussion, the woman suffers in her own unique way.  There are no easy answers to any of this, but it is necessary that a woman be able to communicate with someone, express her fears and her needs, and learn she is not alone.  This section of the Peyronie’s Disease Treatment forum blog is intended for this purpose.

Please feel free to ask questions, post comments and replies to each other, so you may feel this is a place of understanding and comfort for you.