Clinical discussions of Peyronie’s disease diagnosis and treatment should include male patients and their female partners, experts recommend.
Their study, published recently in the Journal of Sexual Medicine, is among the few to consider partners in discussions of Peyronie’s disease, the authors noted.
The condition, characterized by fibrosis on the penis, is estimated to affect up to 13% of men. Plaques lead to penile deformity, including a distinct curve that can make intercourse difficult.
Men with Peyronie’s disease may also experience pain, erectile dysfunction (ED), perceived shortening of the penis, performance anxiety, depression, and other forms of distress. Some avoid intimacy and relationship problems can develop.
The study involved 44 heterosexual couples who were attending the male partner’s first evaluation for Peyronie’s disease. Data were collected from July 2018 to February 2020 in one clinic.
All of the men (median age 56) completed the Peyronie’s Disease Questionnaire (PDQ), which assesses symptoms, bother, and pain in men who have had penetrative vaginal intercourse within the previous three months. Researchers also measured the men’s penile length and curvature.
The women (median age 54) completed a female version of the PDQ as well as the Female Sexual Function Index (FSFI).
The men had had Peyronie’s disease for a median time frame of 12 months. At the time of their evaluation, their median curvature was 75 degrees. Almost 80% were in the chronic stage; their deformity had been stable for over six months and they were no longer having painful erections. About 59% of the men had a hinge effect or penile instability.
About 43% of the men reported ED, and 68% said their penis had shortened since their Peyronie’s disease diagnosis.
Based on their FSFI scores, over a quarter of the women met the criteria for a sexual dysfunction diagnosis. Over half said they had “severe” or “very severe” difficulty with sexual positions they had enjoyed in the past, and 29% said they experienced “severe” or “very severe” discomfort.
Severity and direction of the curvature did not seem to affect difficulty or discomfort with sex.
Patients and partners reported similar difficulties with vaginal intercourse, decreased sexual frequency, and more bother related to that change in frequency.
However, more men than women were bothered by the appearance of their erect penis and by their condition in general while having vaginal intercourse. This might have been due to feelings of “inadequacy or embarrassment associated with the deformity,” the authors said.
They recommended that partners be involved with the consultation and treatment plan for men with Peyronie’s disease, adding that they had already started doing so in their own practice. Communication between partners is an important part of this process, they said.
They acknowledged several limitations to their research, including the small sample size and the fact that with a median curvature of 75 degrees, their group may have had more severe cases of Peyronie’s disease than may be found in the general population, limiting their findings’ applicability.
In addition, all of the participants in the study were cisgender individuals in heterosexual partnerships having vaginal intercourse. Future research may include transgender and non-heterosexual participants as well as those who have non-penetrative sex.
The Journal of Sexual Medicine
Farrell, M. Ryan, MD, MPH, et al.
“Peyronie’s Disease and the Female Sexual Partner: A Comparison of the Male and Female Experience”
(Full-text. Published: October 14, 2020)