Peyronie's disease is a condition in which a plaque (a thickened, hardened piece of tissue) forms on one side of the penis. If the plaque becomes large enough, it reduces flexibility of the penis. During erection, the less-flexible part of the penis expands to a lesser extent, causing the penis to bend. Pain may occur as well. Severe curvature of the penis can make intercourse difficult or even impossible.
The cause of Peyronie’s disease is unknown, but it may involve injury to the penis that causes local bleeding, which in turn leads to the formation of fibrous tissue. However, the majority of cases occur without any obvious preceding injury.
People with Peyronie’s disease may have a generalized tendency to form fibrous tissue, as shown by a higher-than-average incidence of
(a condition in which fibrous tissue develops in the hands among men with Peyronie’s). The condition also appears to be partially heritable.
Treatment of Peyronie’s disease consists first and foremost of watchful waiting. In many cases, the disease never becomes severe enough to cause serious difficulty. Pain on erection generally decreases with time, and in some cases the extent of curvature also decreases.
When the condition is too severe to ignore, there are a variety of methods that may be tried, including injection of various drugs into the fibrous plaque, use of radiation therapy, and surgery. Of all these, only surgery is widely accepted as effective. However, because it can cause complications, such as shortening of the penis, it is usually reserved for serious cases.
L-carnitine is an amino acid the body uses to turn fat into energy. It is not usually considered a nutrient because the body can manufacture all it needs. Two forms of L-carnitine—acetyl-L-carnitine and propionyl-L-carnitine—have been tried as treatments for Peyronie’s disease.
compared the effectiveness of acetyl-L-carnitine to the drug tamoxifen in 48 men with Peyronie’s disease.
Acetyl-L-carnitine (at a dose of 1 g daily) reduced penile curvature, while tamoxifen did not. In addition, the supplement reduced pain and slowed disease progression to a greater extent than tamoxifen.
Another study evaluated the potential benefits of combination therapy with propionyl-L-carnitine and an injected medication (verapamil).
In this trial, 60 people with severe Peyronie's disease were given verapamil injections plus 3 months of treatment with either propionyl-L-carnitine (2 g per day) or tamoxifen. Use of propionyl-L-carnitine plus verapamil significantly reduced penile curvature, plaque size, and the need for surgery, while tamoxifen plus verapamil had little effect.
These studies remain preliminary, but their results are definitely encouraging. For more information, see the full
Para-aminobenzoic acid (PABA)
has been suggested for a variety of diseases in which abnormal fibrous tissue is involved, including Peyronie's disease.
However, there has only been one reported double-blind study. (For more information on why such studies are essential, see
Why Does This Database Rely on Double-blind Studies?
) This trial enrolled 103 men with Peyronie's disease and followed them for 1 year.
The results showed that use of PABA at a dose of 3g 4 times daily significantly slowed the progression of Peyronie’s disease; it did not, however, reduce pre-existing plaque.
For more information, including dosage and safety issues, see the full
has also been advocated for the treatment of Peyronie’s disease, as well as for the related condition
, but there is as yet no meaningful evidence that it is effective.
is used to treat various conditions in which fibrous scar tissue causes problems, and for that reason it has been advocated for Peyronie’s disease. However, again there is no meaningful evidence that it is effective.
Various herbs and supplements may interact adversely with drugs used to treat Peyronie’s disease. For more information on this potential risk, see the individual drug articles in the
section of this database.
Biagiotti G, Cavallini G. Acetyl-L-carnitine vs tamoxifen in the oral therapy of Peyronie's disease: a preliminary report.
Cavallini G, Biagiotti G, Koverech A, et al. Oral propionyl-l-carnitine and intraplaque verapamil in the therapy of advanced and resistant Peyronie's disease.
Hasche-Klunder R. Treatment of Peyronie’s disease with para-aminobenzoacidic potassium
Carson CC. Potassium para-aminobenzoate for the treatment of Peyronie’s disease: is it effective?
Ludwig G. Evaluation of conservative therapeutic approaches to Peyronie’s disease (fibrotic induration of the penis).
Weidner W, Hauck EW, Schnitker J et al. Potassium Paraaminobenzoate (POTABAtrade mark) in the Treatment of Peyronie's Disease: A prospective, placebo-controlled, randomized study.
Last reviewed September 2014 by EBSCO CAM Review Board
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