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Men's health

Curved, Painful Erection: Understanding Peyronie's Disease and What to Do Next

A new, painful, or worsening curve in the erect penis is most often Peyronie's disease, in which scar tissue (a plaque) forms inside the penis and causes it to bend. It is a recognized, treatable condition with multiple options, and the right next step is evaluation by a urologist.

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What is Peyronie's disease?

Peyronie's disease occurs when scar tissue — called a plaque — forms within the tunica albuginea, the fibrous sheath surrounding the erectile tissue of the penis. Because the plaque does not stretch like healthy tissue during an erection, the penis bends toward the stiffer side 1.

The underlying trigger is thought to be minor, often unnoticed trauma during sex — small tears that, in some men, heal abnormally into fibrous scar rather than returning to normal. Not every man who experiences penile trauma develops Peyronie’s; a genetic predisposition appears to play a role. Prevalence estimates in clinical studies range from roughly 3 to 9 percent of adult men, making it considerably more common than many men realize 3. It is also considerably more treatable today than it was a decade ago 1.

How is Peyronie's disease different from a lifelong curve?

Many men have some degree of natural penile curvature — this is normal variation and not Peyronie's disease. Peyronie's is distinguished by change: - A curve that is new or worsening in adulthood - A palpable firm lump or hardness along the shaft - Pain with erections, particularly in the earlier phase - Curvature that makes penetration difficult or impossible

Congenital (lifelong) curvature is typically present since first erections in adolescence, stable over time, involves no palpable plaque, and is painless. If the curve has been present since puberty and has never changed, Peyronie's is an unlikely explanation.

What are the active and stable phases — and why does it matter for treatment?

Peyronie's disease typically follows a two-phase pattern 1:

Active phase (usually the first 6–18 months): the plaque is forming, pain with erections is common, and the curvature may be changing.

Stable phase: pain usually resolves, the curvature stops progressing, and the plaque has matured.

This distinction is clinically important because some treatments — including collagenase injections directly into the plaque — work best around the transition to stability. Waiting through the active phase before considering surgery is generally recommended. A urologist helps you identify which phase you are in.

What treatment options are available?

Peyronie's disease is not simply something to live with — treatment options have expanded substantially 1:

  • Collagenase clostridium histolyticum (CCH) injections — an enzyme injected directly into the plaque that breaks down scar tissue; a well-established, non-surgical approach for men with stable disease and curvature that impairs sexual function
  • Penile traction therapy — mechanical devices used over months to gradually reshape the plaque; evidence supports modest benefit, particularly during the active phase
  • Surgery — including plaque incision with grafting or plication (shortening the opposite side) for men with stable, severe curvature that significantly limits function; generally reserved for men who have not responded to other options
  • Oral medications — studied; evidence is mixed and not strongly supported by current guidelines

Do not attempt to self-treat with supplements marketed online — most lack evidence and some are not safe. A urologist specializing in sexual medicine is the right person to navigate these options with you.

Does Peyronie's disease affect erections?

Peyronie’s disease and erectile dysfunction (ED) frequently coexist 24. The plaque can interfere with blood flow distribution within the erectile tissue, and the psychological stress of the condition — anxiety, avoidance of intimacy, relationship strain — compounds physical effects. When evaluating Peyronie’s, a urologist typically assesses erectile function as well, since the treatment plan may need to address both.

If significant psychological distress is present, mentioning it to your clinician opens the door to counseling or couples therapy, which are recognized parts of comprehensive Peyronie’s care.

Common questions

Can Peyronie's disease go away on its own?

In a minority of men, the curvature stabilizes or partially improves without treatment. However, spontaneous resolution is uncommon, and many men have persistent or worsening curvature without intervention. Early evaluation gives you access to options that work best before the condition fully stabilizes.

What should I bring to my first urology appointment?

A photograph of the erect curvature taken at home is commonly requested by urologists — it can be on your phone. Also useful: a timeline of when you first noticed the change, whether it is still progressing or has stabilized, whether you have pain and how it has changed, and whether you also have difficulty with erections.

Is Peyronie's disease more common in certain men?

It is most commonly diagnosed in men in their 50s and 60s, though it can affect younger men. Men with Dupuytren's contracture (thickening of connective tissue in the palm) have a higher risk, as both conditions involve abnormal fibrous tissue formation. Diabetes is also associated with higher risk.

Do I need to go to the emergency department for penile curvature?

Not for Peyronie's disease — a routine urology appointment is appropriate. The exception is a penile fracture: if you heard or felt a 'pop' during sex followed by rapid loss of erection, bruising, and significant pain, go to the emergency department immediately. A penile fracture is a surgical emergency.

How common is Peyronie's disease?

Clinical studies estimate Peyronie’s disease affects roughly 3 to 9 percent of adult men, though it is likely underreported because many men do not seek evaluation. It is most common in men in their 40s to 60s but can occur at younger ages.

Talk to a clinician

Nina Osei, NP — Nurse Practitioner

checkups, refills & skin. Gale can match you with a licensed clinician for a visit.

Find care →

When to seek immediate care

  • —A 'pop' during sex followed by sudden loss of erection, rapid bruising, and pain — this may be a penile fracture; go to the emergency department immediately
  • —Curvature that has appeared or worsened rapidly over weeks — consistent with active Peyronie's; see a urologist soon
  • —Inability to achieve any erection alongside curvature — worth evaluating promptly together
  • —Pain so severe it prevents any sexual activity

If you heard or felt a 'pop' during sexual activity followed by loss of erection, rapid bruising, and significant pain, go to an emergency department immediately. This may be a penile fracture — a surgical emergency.

This article is general health information and does not constitute a diagnosis. Penile curvature and pain have several possible causes that can only be accurately assessed by a licensed clinician.

References

  1. 1.El-Sakka AI (2021). Medical, Non-invasive, and Minimally Invasive Treatment for Peyronie's Disease: A Systematic Review. Andrology. doi:10.1111/andr.12927 ✓Pathophysiology of plaque formation, active vs. stable phases, collagenase injections, penile traction therapy, and surgical options for Peyronie's disease
  2. 2.Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh J, Khera M, McVary KT, Miner MM, Nelson CJ, Sadeghi-Nejad H, Seftel AD, Shindel AW (2018). Erectile Dysfunction: AUA Guideline. Journal of Urology. doi:10.1016/j.juro.2018.05.004 ✓Coexistence of Peyronie's disease with erectile dysfunction and the importance of combined evaluation and management
  3. 3.Gholami SS, Gonzalez-Cadavid NF, Lin C-S, Rajfer J, Lue TF (2003). Peyronie's Disease: A Review. Journal of Urology. doi:10.1097/01.ju.0000053800.62741.fe ✓Peyronie's disease prevalence estimated at 3-9% of the male population; pathophysiology of fibrous plaque formation in the tunica albuginea following micro-trauma
  4. 4.Mulhall JP, Creech SD, Boorjian SA, Ghaly S, Kim ED, Moty A, Davis R, Hellstrom W (2004). Subjective and Objective Analysis of the Prevalence of Peyronie's Disease in a Population of Men Presenting for Prostate Cancer Screening. Journal of Urology. doi:10.1097/01.ju.0000127744.18878.f1 ✓Peyronie's disease detected in 8.9% of men presenting for prostate cancer screening; association with erectile dysfunction in affected men; prevalence higher with diabetes and older age

4 sources, numbered by first appearance. General health information, not medical advice — synthetic demonstration content.