Peyronie’s disease: symptoms, causes, and treatments for penile curvature

Peyronie's disease (also called induratio penis plastica) is the formation of a fibrous plaque in the lining of the corpora cavernosa, which can cause penile curvature, pain, and sometimes erectile difficulties. In Italy, it affects about 7 in 100 men between the ages of 50 and 69. It is not a tumor and is not contagious: it may worsen during the first few months, then usually stabilizes. European and American guidelines do not recommend oral supplements as treatment; effective therapies are those assessed by a urologist.

This guide explains the causes, symptoms, and stages of the disease, when to see a urologist, which treatments are recommended by the guidelines, and what studies say about supplements.

Reading time: 10 minutes

Last updated: October 2026

Scientific review: GP Nutraceuticals Team

Main sources: EAU and AUA guidelines, 2023 Cochrane review, clinical studies on vitamin E, POTABA, carnitine, and coenzyme Q10

What is Peyronie's disease?

The corpora cavernosa of the penis are two cylinders that fill with blood during an erection. They are surrounded by an elastic, strong sheath of connective tissue called the tunica albuginea. In Peyronie's disease, an area of scar tissue called a plaque forms in this sheath. It is less elastic than healthy tissue: when erect, the penis bends toward the side of the plaque, like a balloon with a piece of tape stuck to it.

The disease is named after French surgeon François de La Peyronie, who described it in 1743, and is also known as La Peyronie's disease. And what is induratio penis plastica? It is the scientific name for the same disease, describing its appearance: a hardening of the penis. Estimates of prevalence vary widely, from 0.4% to over 20%, depending on the studies and populations examined. A study conducted at ten centers in Italy among men aged 50 to 69 found it in 7.1% of cases. It typically begins between the ages of 50 and 60, but the disease can also appear before age 40. Many cases probably never reach a doctor because of embarrassment.

Peyronie's disease: 5 key points

The guide's central message in five points: it is a benign disease, should be recognized early, and is treated with therapies recommended by a urologist.

• It affects about 7 in 100 men between the ages of 50 and 69 and is neither a tumor nor an infection.
• During the first 12-18 months (active phase), pain and changes in the curvature may occur; then the disease stabilizes.
• A penis that begins to bend, a hard lump, or pain during an erection warrant a visit to a urologist or andrologist.
• Treatments are chosen according to the phase: traction and injections into the plaque in suitable cases, surgery only when the disease is stable.
• Guidelines do not recommend oral supplements as a treatment: studies are few and their findings are conflicting.

What you'll find in this guide

The guide begins with an overview of the disease, covers causes, symptoms, and tests, and ends with treatments, supplements, and frequently asked questions.

• Causes and risk factors.
• Symptoms and stages of the disease.
• When to see a urologist and what tests to have.
• Treatments recommended by the guidelines.
• What studies say about supplements.
• Frequently asked questions.

This guide is for informational and educational purposes only and is not a substitute for advice from a doctor or other qualified healthcare professional.

What causes the plaque, and how does it form?

The exact cause is unknown. The leading theory is that repeated minor injuries to the penis, for example during sex, cause microtears in the tunica albuginea. In some men, these injuries trigger an inflammatory process that can lead to fibrosis: instead of healing normally, the tissue fills with collagen and becomes stiff, inelastic fibrous tissue that forms the plaque. People with the condition often do not remember any injury.

Risk factors

The disease is more common in people who have:

• a predisposition to fibrosis and abnormal scarring, such as Dupuytren's disease of the hands;
• diabetes or erectile dysfunction;
• smoking: in the Italian study of men aged 50 to 69, smokers had about four times the risk;
• over 50 years old;
• had penile injuries.

What are the symptoms? Penile curvature, plaque, and pain

The first symptoms are often pain and a hard lump; the deformity develops over time. The most common signs are:

• a curvature during erection, usually upward or to the side;
• a lump or a hard cord that can be felt under the skin;
• pain: in the early stage of the disease, the plaque can make erections painful;
• other deformities, such as an "hourglass" narrowing or indentation;
• a shortening of the penis, meaning a loss of penile length;
• erectile difficulties, present in 30% to 70% of patients, depending on the study.

Besides the physical symptoms, the disease often affects mood and relationships: talking to your doctor is the first step.

How it progresses: active and stable phases

The disease progresses through two phases. In the active phase, also called the acute phase, which typically lasts 12-18 months, the plaque forms, pain during erections is common, and the curvature can change: during this period, the disease is progressive. In the stable phase (or chronic phase), the pain usually goes away and the shape of the penis no longer changes.

In a study that followed untreated men over time, curvature improved in 12% of cases, remained stable in 40%, and worsened in 48%, while pain resolved in nearly 9 out of 10 cases. For this reason, treatment is chosen according to the stage: guidelines consider the disease stable when curvature and pain have not changed for at least three months—in practice, when the disease has stopped progressing.

When should you see a urologist, and how is the diagnosis made?

It is advisable to book an appointment with a urologist or andrologist as soon as you notice that the penis is curved, a hard lump, or pain during an erection. An early examination makes it possible to monitor how the disease progresses and choose the right time for any treatment. An examination is also important when the curvature makes sexual intercourse difficult or when erectile problems arise.

The disease is diagnosed based on:

• the medical history: how long symptoms have been present, whether the curvature is changing, and whether there is pain, to determine the stage of the disease;
• the examination, including palpation of the plaque and checking the hands and feet for similar nodules, as in Dupuytren's contracture;
• Photos of the erect penis taken at home, which are useful for measuring the angle over time;
• Penile color Doppler ultrasound, usually after an injection that induces an erection, to examine the plaque, the degree of curvature, and blood flow, especially before invasive treatment.

There are no specific blood tests for this disease; however, the doctor may check blood sugar and cardiovascular risk factors, which are often associated with erectile dysfunction.

Treatment for Peyronie's disease: how is it treated?

There is no single way to treat the disease: the choice of treatment depends on the stage of the disease, the degree of deformity, whether erectile dysfunction is present, and above all how much the problem interferes with sexual activity. If the curvature is mild and causes no problems, periodic checkups may be all that is needed.

Non-surgical treatments

• Traction and vacuum devices: devices that gently stretch the penis for a few hours a day; European guidelines recommend them to reduce curvature, although the evidence is still limited.
• Plaque injections: in patients with stable disease and curvature greater than 30 degrees, interferon alfa-2b and verapamil can be injected directly into the plaque, with varying results. Collagenase, the only drug specifically approved for this disease, has not been available in the European Union since March 2020, following a decision by the manufacturer.
• Low-intensity shockwave therapy (ESWT): may reduce pain, but does not reduce the deformity or plaque.
• Erectile dysfunction medications (PDE5 inhibitors): useful when erectile dysfunction is also present.

European guidelines advise against cortisone injections and, outside clinical trials, injections of platelet-rich plasma or hyaluronic acid. Overall, a 2023 Cochrane review concluded that evidence for the effectiveness of most nonsurgical treatments remains limited.

Surgery and penile prostheses

Surgical correction is the most effective way to straighten the penis, but it is considered only after the disease has stabilized, meaning the curvature and pain have not changed for at least three months, usually about a year after onset. The main techniques are:

• plication, which straightens the penis by shortening the side opposite the plaque;
• plaque incision or excision with grafting, for more severe deformities;
• penile prosthesis, when erectile dysfunction is also present and does not respond to medication.

Supplements for Peyronie's disease: what do the studies say?

Over the years, oral vitamin E, potassium para-aminobenzoate (POTABA), carnitine, coenzyme Q10, and combinations of antioxidants such as propolis and blueberry have been studied. The underlying idea is that oxidative stress and inflammation contribute to plaque formation. However, there are few studies, they are often small, and the results are mixed.

Scientific evidence and regulatory claims are two different things. An approved label claim describes a physiological function recognized by an authority and does not prove that a product treats this disease. Likewise, a favorable study alone does not authorize a claim.

What the guidelines say

The European Association of Urology (EAU) guidelines strongly recommend against oral therapy with vitamin E, POTABA, tamoxifen, pentoxifylline, colchicine, and carnitine derivatives. The American Urological Association (AUA) guidelines also recommend against offering vitamin E, tamoxifen, procarbazine, omega-3, or a combination of vitamin E and propionyl-L-carnitine. A 2022 systematic review and a 2023 meta-analysis reached the same conclusion: no oral therapy has been clearly shown to be superior to placebo.

Studies on individual nutrients

Pay attention to dosage too: the 600 mg of vitamin E used in many studies exceeds the EFSA’s maximum tolerable intake level for adults (300 mg per day), and at high doses vitamin E may increase the risk of bleeding in people taking anticoagulants.

What a supplement can claim

Regulation (EU) 432/2012 does not provide for claims about Peyronie’s disease, curvature, or plaque. Of the nutrients in this section, the only one with a relevant authorized claim is vitamin E, which contributes to the protection of cells from oxidative stress. There are no authorized claims relating to the disease for carnitine, coenzyme Q10, PABA, propolis, or blueberry.

Frequently asked questions about Peyronie’s disease

Brief answers to common questions about plaque, pain, and treatments.

Can Peyronie’s disease go away on its own?

Complete recovery is rare. The curvature improves spontaneously in about one case in ten, while pain resolves on its own in the vast majority of cases by the end of the active phase. For this reason, urologists often recommend monitoring how it progresses for a few months before deciding.

Is Peyronie’s disease a tumor?

No. The plaque is benign scar tissue: it does not turn into cancer and is neither contagious nor transmissible to a partner.

Does vitamin E help with Peyronie’s disease?

The evidence does not demonstrate this. In the largest randomized study, 600 mg of vitamin E per day for 6 months produced no better results than placebo, and European and American guidelines advise against using it as a treatment.

Can you have a normal sex life?

Often, yes. Many men with mild or moderate forms have sex without problems. When curvature or erection problems make sex difficult, available treatments can help restore a satisfying sex life: even pronounced curvature can be treated with surgery.

Does smoking make Peyronie's disease worse?

Smoking is associated with a higher risk of developing the condition: in the Italian study, smokers had about four times the risk. Quitting smoking is also good for circulation and erectile function.

How long does the painful phase last?

Pain occurs mainly during the active phase, which usually lasts 12-18 months, and tends to disappear once the disease becomes stable. If it is severe, the urologist may recommend anti-inflammatory drugs or shock wave therapy.

In summary

Peyronie's disease is a benign scar plaque that can cause the penis to bend, cause pain during erection, and sometimes lead to erectile difficulties. It can progress during the first 12-18 months, then becomes stable: an early visit to a urologist helps monitor it and choose the right time for treatment.

Treatments are chosen according to the stage: traction and injections into the plaque for suitable cases and, once the disease is stable, surgery. Oral supplements studied to date have not been shown to treat the disease, and guidelines do not recommend them as treatment.

The GP Nutraceuticals nutraceutical approach

A supplement is not a treatment for Peyronie's disease and does not replace assessment and care by a urologist. It may complement a healthy lifestyle, starting with quitting smoking.

PeyroSin® is a tablet-based dietary supplement combining L-carnitine, PABA (para-aminobenzoic acid), avocado and soy extracts, bilberry, propolis, and vitamin E. Take one tablet a day for at least three months.

Among the approved claims for its components:

• Vitamin E contributes to the protection of cells from oxidative stress.

The amounts of ingredients in a dietary supplement differ from those used in the studies described in this guide, so the results of those studies cannot be attributed to the product. If you are allergic to bee products, have a medical condition, or are undergoing treatment, it is best to talk to your doctor first.

Scientific sources and references

This guide was prepared based on peer-reviewed scientific literature and institutional sources available at the time of the update.

Guidelines and institutional sources

1. European Association of Urology. EAU Guidelines on Sexual and Reproductive Health – Penile curvature. 2022. uroweb.org
2. American Urological Association. Peyronie's Disease: AUA Guideline. 2015. auanet.org
3. European Medicines Agency. Xiapex (collagenase from Clostridium histolyticum): withdrawal of marketing authorization. 2020. ema.europa.eu
4. EFSA Panel on Nutrition, Novel Foods and Food Allergens. Scientific opinion on the tolerable upper intake level for vitamin E. EFSA J. 2024. PMID: 39099617
5. Commission Regulation (EU) No 432/2012, establishing a list of permitted health claims made on foods. eur-lex.europa.eu

Prevalence and natural history

6. La Pera G, Pescatori ES, Calabrese M, et al. Peyronie's disease: prevalence and association with cigarette smoking. A multicenter population-based study in men aged 50-69 years. Eur Urol. 2001. PMID: 11752860
7. Mulhall JP, Schiff J, Guhring P. An analysis of the natural history of Peyronie's disease. J Urol. 2006. PMID: 16697815

Treatments and supplements

8. Rosenberg JE, Ergun O, Hwang EC, et al. Non-surgical therapies for Peyronie's disease. Cochrane Database Syst Rev. 2023. PMID: 37490423
9. Hayat S, Brunckhorst O, Alnajjar H, et al. A systematic review of non-surgical management in Peyronie's disease. Int J Impot Res. 2022. PMID: 36289392
10. Lee HY, Pyun JH, Shim SR, Kim JH. Medical treatment for Peyronie's disease: systematic review and network Bayesian meta-analysis. World J Mens Health. 2023. PMID: 37382281
11. Safarinejad MR, Hosseini SY, Kolahi AA. Comparison of vitamin E and propionyl-L-carnitine, separately or in combination, in patients with early chronic Peyronie's disease: a double-blind, placebo-controlled, randomized study. J Urol. 2007. PMID: 17706714
12. Weidner W, Hauck EW, Schnitker J. Potassium paraaminobenzoate (POTABA) in the treatment of Peyronie's disease: a prospective, placebo-controlled, randomized study. Eur Urol. 2005. PMID: 15774254
13. Biagiotti G, Cavallini G. Acetyl-L-carnitine vs tamoxifen in the oral therapy of Peyronie's disease: a preliminary report. BJU Int. 2001. PMID: 11446848
14. Safarinejad MR. Safety and efficacy of coenzyme Q10 supplementation in early chronic Peyronie's disease: a double-blind, placebo-controlled randomized study. Int J Impot Res. 2010. PMID: 20720560
15. Paulis G, Brancato T, D'Ascenzo R, et al. Efficacy of vitamin E in the conservative treatment of Peyronie's disease: legend or reality? A controlled study of 70 cases. Andrology. 2013. PMID: 23258640

Update history

We update this guide when new guidelines or relevant studies are published.

Version 1.0 – October 2026

First published. Main sources: EAU (2022) and AUA (2015) guidelines, 2023 Cochrane review, and clinical studies on vitamin E, POTABA, carnitine, and coenzyme Q10.