Viagra And Peyronie's Disease Is It Safe? Can It Cause Peyronie's?
Erectile dysfunction is common among men with Peyronie's disease. The Association of Peyronie’s Disease Advocates (APDA) estimates that more than two thirds of Peyronie's patients experience erection problems at some point.
This means many Peyronie's patients need assistance to achieve firm enough erection to allow them to have sexual intercourse. Most commonly used are penis vacuum pumps (VED) and PDE5 inhibitors, like Viagra, Cialis, and Levitra.
This article looks at the pros and cons of using Viagra (or any other PDE5 inhibitor) if you have Peyronie's disease and if Viagra can cause Peyronie's.
But first...
What Is Viagra?
Viagra is the brand name of a drug called Sildenafil, which belongs to class of drugs known as PDE5 inhibitors (phosphodiesterase type 5 inhibitor). Other PDE5 inhibitors include Tadalafil (brand name Cialis) and Vardenafil (brand name Levitra).
For simplification, I use Viagra for all PDE5 inhibitors in this article.
PDE5 inhibitors help men to get erection when they are sexually stimulated. Viagra does not cause erection on its own; the man must become sexually aroused for it to work.
How does Viagra work? The simple explanation is that Viagra relaxes muscles and increases blood flow to particular areas in the body. The more detailed explanation is that Viagra works by maintaining the level of cGMP (cyclic guanosine monophosphate) in the smooth muscle cells.
When men get sexually stimulated, the nervous system releases nitric oxide (NO) that stimulates enzyme that produces cGMP that relaxes the smooth muscle cells. This causes the arteries in the penis to dilate, allowing the blood to flow more easily into the penis. It also causes the erectile tissue itself to fill with blood. Together this results in an erection.
cGMP is normally broken down by another chemical in the body (phosphodiesterase type 5). Viagra prevents its action, hence stopping the breakdown of cGMP. This means that the blood vessels are dilated for longer, resulting in improved blood flow to the penis and helping it to maintain an erection.
Is Viagra Safe For Men With Peyronie's Disease?
All PDE5 inhibitors (Viagra, Cialis and Levitra) should be used with caution by men with a physical abnormality of the penis, such as severe curvature, scarring or Peyronie's disease.
Patients with Peyronie's disease should always consult with their doctor or urologist before using any erectile medications.
In his book Understanding Peyronie’s Disease Dr. Laurence Levine says:
“The key point to remember is that if you have Peyronie’s Disease and you use Viagra or another oral erection drug to enhance your erections, it is possible that you could reinjure your penis during sex. It is therefore wise to be careful about your sexual activity in order to reduce the likelihood of recurrent trauma and reactivations of the Peyronie’s process” (Understanding Peyronie’s Disease, page 44)
It does not explain why but it is fair to assume there is a risk of aggravating the Peyronie's condition, which leads us to the next more sensitive question...
Can Viagra Cause Peyronie's Disease?
There is no sustainable evidence that using Viagra can cause Peyronie's disease but there are some reasons for concern.
Study from 2002 into the 'Role of oxidative stress and antioxidants in Peyronie's disease' by S. C. Sikka and W. J. G. Hellstrom found that number of patients with Peyronie's had increased since the advent of Viagra (International Journal of Impotence Research (2002) 14, pages 353-360).
They considered this to be either because more men are becoming manifest and / or not hesitant anymore to come to clinics for such evaluations.
Dr. Drogo Montague, the director of the center for genitourinary reconstruction at the Cleveland Clinic in Ohio, sees it differently.
"Erectile dysfunction medications such as Viagra might protect some men -- and harm others. In men with mild erection problems, the drugs can bring a medium-soft erection up to full strength, "so there's less chance of injury during normal sexual activity," Montague says.
But for men with severe erectile dysfunction, the drugs might make matters worse, by providing an erection that's just about firm enough for penetration but still soft enough to buckle easily during intercourse" (Los Angeles Times, February 09, 2009
)
And we know that penis buckling can result in men developing Peyronie's disease.
This German study from 2002 seems to confirm these suspicions:
"Along these lines, most clinicians note that the number of Peyronie's patients has increased since the advent of oral sildenafil. With more men being successfully treated for erectile dysfunction (ED), an increasing number of Peyronie's cases are becoming manifest and being presented for evaluation" (International Journal of Impotence Research, October 2002
Interesting research (Histopathological effects of sildenafil citrate on rat corpus cavernosum) from 2004 used mice to look at the long term effects of Viagra on the penis and its components. The original article was published in Acta Histochemica (Volume 106, Issue 1, 26 February 2004, Pages 37–45).
This research showed that prolonged use of Sildenafil results in fibrotic changes of the corpus cavernosum in both male and female rats. Cure Peyronie's goes through this research in detail and concludes there is "strong evidence that the prolonged use of sildenafil citrate is related to penile injury and aberrant healing, leading to an increased incidence of PD".
Still, more studies are required in this area. It is though unlikely to be welcome by the big pharmaceutical giants that are making astonishing amount of money from the sale of PDE5 inhibitors worldwide.
The Bottom Line (About Viagra And Peyronie's)
If you have Peyronie's disease, which is quite likely if you are reading this, then don't take Viagra or similar drugs without consulting your doctor first. You may want to investigate other options to improve your erection quality, like using Penis Vacuum Pump.
If you are fortunate enough not to have Peyronie's disease, then take good care of your penis and avoid putting extra strain on it (whether you use Viagra or not).
