No, this condition was not named after an Italian beer! (Not a month goes by where I don’t hear someone at a party talking about Peroni beer and mispronouncing it as pay-ROH-nee, as in Peyronie’s disease.)
Here’s another situation where the research has finally convinced doctors that some dietary supplements work! In fact, now most physicians want their patients to take some form of dietary supplementation along with the conventional treatment for Peyronie’s disease. However, keep in mind that supplements are most effective for the early stages of Peyronie’s disease (acute or early chronic). As a final thought, ask your doctor about the newly approved drug Xiaflex.
What is Peyronie’s Disease?
Peyronie’s disease is a deformity of the penis that impacts 5 to 10 percent of men. It’s most common among 55- to 65-year-olds, but it has been reported in younger men as well. It’s caused by fibrous lesions that form inside the penis near the surface (they can sometimes be felt and even seen).
Researchers aren’t sure why some men are more susceptible to this condition than others, but some experts consider it to be a wound-healing disorder. When the penis is partially or fully erect during intercourse, it can cause subtle microtears to the tissue inside the penis, resulting in bleeding below the skin and formation of a clot or clots.
In some people, the subsequent immune response to clean up the damage (an otherwise natural process) leads to excess collagen being laid down at the site and plaque formation. Peyronie’s disease has been associated with erectile dysfunction and several other conditions, including diabetes (30 percent of patients), high blood pressure or cholesterol, obesity, smoking, pelvic surgery, and low testosterone levels.
Men with Peyronie’s generally have three primary complaints:
- Painful erections that can interfere with sex (about 50 percent of sufferers experience this)
- Palpable plaque formations on the penis; they can be soft, tender, or really hard
- Curvature of the penis (seen in about 80 percent of patients)
Peyronie’s has two phases: acute and chronic. The acute phase includes pain and curvature of the penis and the formation of one or more nodules, or plaques, that can be felt and sometimes even seen. The pain and discomfort comes and goes and can resolve with treatment over 6 to 18 months. In the chronic phase, there is usually little to no pain, nodule size generally stays the same, and there is some degree of deformity of the penis. The standard treatment for Peyronie’s, usually in the acute or early chronic phase, includes injections, prescription medication, or corrective surgery.
Peyronie’s Disease Home Remedies
1. L-arginine 2,000 milligrams a day in divided doses or L-citrulline1,000 to 1,500 milligrams a day in divided doses
L-arginine increases nitric oxide in the blood, which boosts bloodflow to the penis; it may also have an antifibrotic effect, reducing the development of scars and improving wound healing. (Laboratory studies have suggested that it can prevent inflammation and fibrosis in the liver, kidneys, lungs, and cardiovascular system.)
Research is still ongoing in regard to Peyronie’s, but researchers from Rush University Medical Center in Chicago are seeing reduced fibrosis and scarring from taking 1,000 milligrams of L-arginine twice a day along with conventional treatment, including drugs or injections.
Perhaps the primary benefit for Peyronie’s is that L-arginine helps improve erectile dys-function, which can be a symptom of this disease. (See the Erectile Dysfunction section.) While L-arginine has significant research, I believe L-citrulline, a precursor to L- arginine, is far better and safer. I recommend taking 1,500 milligrams per day of L-citrulline, but see which one works for you.
2. CoQ10 300 milligrams a day
CoQ10 (coenzyme Q10) appears to have anti-inflammatory effects and may also improve bloodflow to different parts of the body, from the heart to the penis. Recently, researchers have been studying its ability to reduce production of a compound called TGFB1 (or transforming growth factor, beta 1), which may contribute to the abnormal inflammatory response, and subsequent scarring, seen in Peyronie’s.
In studies, 300 milligrams of CoQ10 per day for 6 months worked better than a placebo to reduce plaque size, penile curvature, and pain; improve sexual function; and slow the progression of the disease in 85 percent of subjects with early chronic Peyronie’s. CoQ10 is a fat-soluble supplement, so it should be taken with food. It can interfere with blood thinners, so check with your doctor before taking it.
3. Carnitine 2,000 milligrams a day
Carnitine, which comes in various forms, may be able to lower calcium levels inside endothelial cells, which line the inside of the penis, leading to a reduction in the risk of plaque formations or fibrosis.
Research has shown that after 3 months of supplementation with acetyl-L-carnitine (1,000 milligrams twice a day), men with Peyronie’s who were also on conventional prescription treatment saw less pain and curvature of the penis but no significant change in plaque size (although it did help a little). Another clinical trial with 2,000 milligrams per day of propionyl-L-carnitine along with conventional medicine (10 milligrams of intralesional vera-pamil weekly for 10 weeks) showed significantly reduced penile curvature, disease progression, and plaque size compared to verapamil without carnitine.
This supplement isn’t widely accepted yet among physicians because it needs more research. Just an FYI: There is no good research on drug interactions with these carnitine supplements, so check with your doctor first. I have seen minimal drug interactions in patients, and most doctors will allow some sort of dietary supplementation with conventional treatments for Peyronie’s.
What Are Useless For Treating Peyronie’s Disease?
This vitamin (400 to 800 IU daily or more) used to be one of the most common nonsurgical treatments for Peyronie’s, but recent research suggests high doses of vitamin E supplements may be dangerous for the heart and prostate and could cause internal bleeding. As little as 400 IU daily increases risk for prostate cancer and bleeding.
I only recommend vitamin E (or other potentially dangerous supplements) when there are no other good options for a disease and it can make a dramatic difference (for example, in individuals with fatty liver disease or moderate to advanced stages of the dry form of macular degeneration; see those sections if you’re curious). However, using vitamin E cream directly on the penis appears to be less dangerous; it’s a good potential compromise, so ask your doctor about it.
This supplement is capable of increasing the production of collagen in the body, which is exactly what you do not want while receiving conventional treatment for acute Peyronie’s. Plus, there is no research that says vitamin C helps.
Honeybees extract propolis from the saps or buds of trees and other plants and use it as a protectant for the hive from wind, rain, cold, other insects, and even disease. It appears to have antioxidant and anti-inflammatory properties and blocks the production of certain compounds (interleukins) that could make the inflammatory response worse. It sure sounds like it would be helpful for Peyronie’s, but research hasn’t shown it to be beneficial.
Blueberries have strong antioxidant properties and may even have an antifibrotic effect, but again, the research on the extract hasn’t panned out.
What Lifestyle Changes Can Help With Peyronie’s Disease?
Heart healthy = penis healthy
This means that maintaining a healthy weight and normal cholesterol, blood pressure, and blood sugars have been associated with a lower risk of Peyronie’s.
What Else to Know About Treating Peyronie’s Disease?
Without treatment, about half of men get worse and the other half get better or stay the same. In many instances, the pain or curvature of the penis is the deciding factor on when to get treatment. In other words, it comes down to quality of life (and sex!). This is why a specialist is needed.
Some studies of potential interventions look at pain improvement, but pain can decrease over time even without treatment. Other studies look at a reduction in the size of the plaque on the penis, but this does not always improve curvature.
Thus, many urologic experts believe the best way to judge a potential treatment for Peyronie’s is whether it can reduce any deformity (narrowing, shortening, or curvature). But only a specialist can help you decide if the treatment might be worse than the disease itself. Getting surgery or injections is not fun.
Surgery is considered the gold standard to fix the deformity associated with Peyronie’s, but it should only be used in men whose condition has stabilized for 3 to 6 months (in other words, it’s not getting worse or better).
The best candidates are men who have a painless deformity, cannot engage in sexual activity because of the deformity, have hardness issues, or have plaque formations that cannot be corrected with nonsurgical options. Surgery gives the fastest and best result, on average, and most men can still have orgasms and ejaculate afterward. It can’t always fully correct a curvature, and in some cases it can reduce the length or hardness of the penis or (rarely) reduce some penile sensation, so talk to your doctor.