Peyronie’s disease (PD) affects the penis and causes scar tissue (plaque) to form under the skin, creating a curve. The plaque and curve often lead to pain during sex and erectile dysfunction (ED). PD is currently diagnosed in two separate phases:
- Acute or unstable phase: plaque is forming, the penis begins curving, and erections are likely painful.
- Chronic or stable phase: plaque has formed completely, pain may have improved, but ED may still be an issue.
Current treatment methods for PD tend to work better in the chronic phase. These include penile injections to dissolve plaque and surgery to straighten the curve. There are currently no FDA-approved treatments for acute-phase PD. As of now, it's harder to prevent the disease from getting worse.
Is it Possible to Treat Peyronie's Disease Earlier?
Recently, researchers looked at two existing medications to see if they could also treat acute PD.
- 133 patients were given an off-label PDE5-i (Viagra or Cialis) in combination with a SERM (tamoxifen).
- PDE5-i treat erectile dysfunction but have shown success in treating PD.
- SERMs treat and prevent estrogen-sensitive breast cancer and have been studied for PD.
- 26 patients were given either no treatment or vitamin E. They were the control or "standard care" group.
This study uses existing data from two separate hospitals and is not a randomized clinical trial.
Combination Medication May be Successful
In the end, the penile curve of the combination care group decreased, while the standard care group curve did not change. Specifically:
- 1% of the combination care group reported no change,
- 9% of the combination care group reported an improved penile curve,
- 8% of the standard care group reported no change,
- 8% of the standard care group reported a worse penile curve.
This suggests that treating PD earlier (in the acute phase) may reduce the chance of PD getting worse. However, more research is needed to know for sure.
Both groups also reported less pain with erections:
- The combination care group experienced a 66% improvement,
- The standard care group experienced a 23.1% improvement.
It was hard to see if this improvement was because of plaque dissolving or hardening.
This study adds to previous research looking at either PDE5-i or tamoxifen as an option for acute PD. However, because this is not a randomized clinical trial, more research and established trials are needed.
Key Takeaways
- PD can cause long-term sexual dysfunction:
- Pain with sex and erections, erectile dysfunction, etc.
- Current treatments include penile injections and surgery, recommended when the disease is stable.
- This study showed that the combination of PDE5-i and tamoxifen could help at the acute stage of PD - but only if more research is conducted.
- This study should not be generalized, and more research is needed to confirm the results. Future research should include randomized controlled trials and longer follow-up periods.
- If penile curvature or erectile pain is distressing, it may be beneficial to speak with a healthcare provider.
Resources
Shah, M., Megson, M., Al-Mitwalli, A., Fratangelo, R., Shergill, P., Shahzad, R., Di Giovanni, A., Zhang, J., Lee, W. G., Ralph, D. J., & Cellek, S. (2026). Evaluation of a combination of off-label PDE5 inhibitor and tamoxifen in acute Peyronie’s disease. The Journal of Sexual Medicine, 23(6). https://doi.org/10.1093/jsxmed/qdag120
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