Peyronie’s Disease and Intercourse

Peyronies and problems with sexual intercourse

Sexual intercourse can be a problem in Peyronie’s disease due to the penile distortion that occurs because of the presence of fibrous scar tissue, or Peyronie’s plaque, within the shaft of the penis.  The presence of this fibrous plaque can cause the penis is bend in any direction to a minor degree that is hardly noticeable, up to and even beyond a 90 degree curve.  In addition to a significant bend, Peyronies disease can also cause distortions that are described as “bottle neck” and “hour glass” for their resemblance, as well as simple dents or dings along the side of the shaft. Click here for Peyronie’s pictures.

The cause of Peyronie’s disease has not yet been determined even thought the condition has been known for almost 500 years.  Some researchers theorize the distortion forms as a result of trauma to the penis, or when minor contact causes an indirect micro-trauma shearing force that can result in minor bleeding into the wide area of tissue.   While healing is taking place certain growth factors that appear to be genetically determined cause an abnormal amount of scar tissue (or plaque) to form at the site of injury.

The penis is composed of three cylindrical cavities, with two of these at the top and one below.  The top two are wider and thicker, and are called the corpus cavernosa, while bottom cylinder is the corpus spongiosum and contains the urethra or the tube through which urine flows.  During erection the two top corpora cavernosa expand to trap and hold the blood that produces the pneumatic force that results in enlargement and rigidity.   Each of these paired cylinders is surrounded by a very elastic covering called the tunica albuginea, similar to the casing of a sausage.

In a case of Peyronie’s disease the elastic tissue of the tunica is replaced by scar tissue, so it lacks flexibility and the ability to stretch.  Because the plaque is not elastic, but rather hard, it will not stretch with erection.  When this happens the erection that occurs is not even or symmetrical, and often smaller than before.

What starts out as a small nodule or constriction on the penile shaft just below the skin surface, eventually expands to form a flat plaque or deposit that can sometimes extend along the entire length of the shaft.  This plaque invades and replaces the elastic tunica albuginea covering of the internal tissue of the penis, leaving a mass of inflexible material. In some patients the penis beyond the plaque will not become as rigid. When a man with this degree of extensive Peyronie’s has an erection, the scar or plaque material cannot expand, resulting in a curved or bent penis, or one that exhibits a bottle neck or hour glass deformity – or a combination of these distortion patterns.

Often the plaque is located on the top surface of the penis, causing an upward curvature.  However, plaques can occur anywhere on the penis; the scar or plaque will always be worse on the concave portion of the distortion pattern.

Many men with Peyronie’s disease complain not only about their curved or distorted erection, but also about the loss of length and girth. These are all results of the inelastic tissue within the substance of the penile body.

Peyronies curved penis and sexual intercourse

One-third of men with Peyronie’s have pain when erect, and a smaller number become impotent. In some cases, the head of the penis does not fill with blood, resulting in a penis that is erect on the bottom near the pubic area, and soft or flaccid toward the top part of the penis – this is called a bottle neck deformity.  This type of distortion would make intercourse difficult due to penetration problems.  About half of men with Peyronie’s disease continue to function sexually when their curving penis is gradual and minor.  But as the curvature becomes abrupt and large the amount of sexual difficulty also increases.   Half of men with Peyronies experience frequent to constant problems with intercourse due to their distortion pattern.

For in-depth solutions and discussion of the sexual problems related to Peyronie’s disease please review the contents of Peyronie’s Disease & Sex, a one-of-a-kind book written by a man who completely cured his PD using the Alternative Medicine treatment principles found on the Peyronie’s Disease Institute website.

Peyronie’s Disease and Masturbation

Masturbation prominently factors into Peyronie’s disease either as a cause of PD, or later as a man attempts to cope with his curved penis.

Masturbation is the self-stimulation of the female or male genitals to arouse sexual pleasure, usually to the point of orgasm or sexual climax.  It is commonly performed by touching, stroking, or in some way pleasurably stimulating the penis or clitoris until orgasm occurs.

Peyronie’s disease intersects with masturbation in particular for several reasons:

  1. Older boys and men of all ages can injure themselves during rough masturbation rituals with the potential to lead to Peyronie’s disease, especially if genetically predisposed.
  2. Men who are unable or too embarrassed to expose their deformity to their sexual partner often resort to masturbation to release sexual tension.
  3. Men who are unable to engage in sexual intercourse because of severe penile distortions can receive masturbation from them partner as a way to share sexual pleasure, as a substitute for traditional intercourse.
  4. Women who are denied sexual intercourse because of a partner’s severe penile distortion or erectile dysfunction related to Peyronie’s disease can be masturbated as a way to share sexual pleasure, as a substitute for traditional intercourse.
  5. Women who are denied sexual intercourse because of her partner’s emotional and physical withdrawal, thus isolated from the man with Peyronie’s disease, can use masturbation to release sexual tension while he is working out his own problems.

General masturbation comments

At one time or another or all life long, just about everyone masturbates – male and female.  It is an extremely common behavior, even among people with access to sexual intercourse and other erotic outlets with a partner.  While in one national study 95% of males and 89% of females reported they have masturbated, those who reported they had never masturbated admitted they would be reluctant to admit it if they did – thus these numbers are probably low.

For young children masturbation is a normal part of youthful exploration, becoming the first sexual act.  Most people continue to masturbate in adulthood, and many do so throughout their lives.  The most common explanation given why people limit or avoid masturbation is the shame and guilt that arises from religious and societal pressure.

Once regarded as a perversion and sign of a mental problem, masturbation is now seen as a normal, healthy sexual activity that is pleasant, fulfilling, acceptable, and safe. Masturbation is only considered a problem under certain circumstances:

  1. Directly or indirectly inhibits sexual activity with a partner.
  2. Causes significant distress if done compulsively and uncontrollably, against the greater desire of the individual to stop.
  3. Interferes with daily activities of life.
  4. Compulsively done in public or at socially inappropriate times.

No longer considered as being harmful, masturbation is thought to improve sexual health and interpersonal relationships if after learning what is personally pleasurable this knowledge is shared with a partner.  Especially in the situation of Peyronie’s disease many partners use mutual masturbation to develop and refine techniques for a more satisfying sexual relationship, when more traditional sexual outlets are not an option.

Masturbation can contribute to sexual dysfunction in Peyronie’s disease

Men who habitually masturbate in ways that are not common with a sex partner – employing mechanical measures that produce an unusually intense stimulus, stroking with great pressure or unnatural friction – can become so accustomed and dependent on that particular level or type of stimulus that partner-sex becomes insufficient for sexual arousal and leads to retarded ejaculation.  When a man experiences this sexual dysfunction he finds it difficult or even impossible to climax during more conventional partnered sex.

Michael A. Perelman, PhD, clinical associate professor of psychiatry, reproductive medicine, and urology at Weill Cornell Medical College in New York City and the president of the Society for Sex Therapy and Research states, “Any man experiencing any sexual dysfunction should ask himself if he’s masturbating in ways that produce sensations that differ from those he gets from his partner’s hand, mouth, or vagina.  If so, then he should consider what he could say to her to make the stimulation more similar — and how he could change the way he masturbates to make it feel more similar to what his partner does.”

Safe masturbation in Peyronie’s disease

Generally, the best and safest masturbation you can enjoy by yourself or with a partner is that which is most like vaginal stimulation.  This can be as simple as using the hand in a fist to surround the erection while applying upward and downward stroking, oral stimulus, or sex toys that feel like a vagina.   This kind of masturbation is therapeutic once the Peyronie’s curvature has been corrected and more traditional sexual encounters can be enjoyed once again.

Lastly, because penile injury is thought to be a prime cause of Peyronie’s disease, it is mandatory that all masturbation be gentle and well lubricated to avoid worsening of an already bad situation. For more information, click on “Peyronie’s Disease and Sex.”