Anyone Fix Their Peyronies?

[ecstatichamster]

just curious. It is a type of fibrosis.

 

[ecstatichamster]

Ray Peat wrote:

Unopposed estrogen promotes inflammation and fibrosis, pregnenolone, progesterone, and testosterone protect against fibrosis. Hypothyroidism tends to push the ratio toward estrogen.

Int J Urol. 2011 Nov;18(11):796-800.
Does testosterone deficiency exaggerate the clinical symptoms of Peyronie's
disease?
Nam HJ, Park HJ, Park NC.
Department of Urology, Pusan National University School of Medicine, Busan,
Korea.
Serum testosterone (T) influences wound healing and levels are decreased in the
age group at risk of Peyronie's disease (PD). The aim of the present study was to
evaluate the severity of penile deformity in men with PD in relation to T levels.
One-hundred and six patients with PD and T deficiency (serum T <3.5 ng/mL; Group
1) and those with normal T levels (Group 2) were compared according to the
duration of PD, the size and location of the plaques, penile curvature, pain on
erection, and the severity of erectile dysfunction. The mean degree of penile
curvature in Group 1 was significantly greater than in Group 2 (32.0 ± 15.9° vs
21.8 ± 15.4°, respectively). The mean Group 1 score on the International Index of
Erectile Function (IIEF)-5 was lower than the score for Group 2 (7.4 ± 3.7 vs
10.8 ± 4.8, respectively). The percentage of patients who complained of pain on
erection did not differ between the two groups. Plaque size in Group 1 was larger
than in Group 2 (3.0 ± 1.2 vs 2.0 ± 1.2 cm, respectively), whereas there was no
significant difference in plaque location. Although there was a lower percentage
of responders to medical treatment in Group 1, there were no differences in
surgical outcomes between the two groups. These findings suggest that the
presence of T deficiency in patients with PD exaggerates the severity of PD by
affecting penile deformity, plaque size, and erectile dysfunction. Further
studies are needed to confirm this relationship.
© 2011 The Japanese Urological Association.

J Androl. 2012 May-Jun;33(3):381-8.
Association between Peyronie disease and low serum testosterone levels: detection
and therapeutic considerations.
Cavallini G, Biagiotti G, Lo Giudice C.
Andros Italia, Outpatient Clinic of Ferrara, Ferrara, Italy.
[email protected]
The aim of this paper was to find a link between Peyronie disease (PD) and
bioavailable testosterone (bT)/free testosterone (fT) blood levels. Subjects with
no erectile dysfunction were prospectively studied with respect to 3 parameters:
differences in bT/fT between 106 PD patients and 99 healthy controls; differences
in plaque area, penile curvature, and pain between 54 PD patients with low bT/fT
and 52 PD patients with normal bT/fT; and differences in intraplaque verapamil
efficacy between 20 hypogonadal PD patients supplemented with testosterone and 23
hypogonadal PD patients administered a placebo. Medical history, objective
examination, and dynamic duplex scanning of the penis, both before and 8 months
after the end of the therapy (ie, at the end of the study period), were used to
assess PD. Testosterone supplementation was carried out with testosterone buccal
adhesive patches 2 × 30 mg/d for the entire study period. bT and fT were
significantly lower in PD patients than in control patients. The plaque area was
significantly higher in PD patients with low bT/fT than in patients with normal
bT/fT. No significant difference emerged when pain or penile deformity were
examined. Plaque area and penile curvature improved to a greater extent when
intraplaque verapamil injections were associated with testosterone administration
than when associated with a placebo. Men with PD had lower bT/fT than healthy
controls. In these patients, supplementation with testosterone improved the
efficacy of intraplaque verapamil. Plaque area and penile curvature were more
severe in hypogonadal PD.

J Sex Med. 2009 Jun;6(6):1729-35.
Testosterone deficiency and Peyronie's disease: pilot data suggesting a
significant relationship.
Moreno SA, Morgentaler A.
Harvard Medical School, Boston, MA, USA.
INTRODUCTION: As testosterone (T) has been shown to influence wound healing, and
serum T declines in the age group at risk for Peyronie's disease (PD), we
explored the possibility that low serum T may be associated with PD.
AIM: The purpose of this study was to evaluate the relationship between serum T
concentrations and features of PD.
METHODS: Medical records were reviewed for 121 consecutive patients with PD seen
over a 2-year period. All patients were assessed for sociodemographic data,
medical history, comorbid medical conditions, findings on physical examination,
and severity of curvature. Laboratory testing included serum concentrations of
total testosterone (TT) and free testosterone (FT). Testosterone deficiency (TD)
was defined as TT values less than 300 ng/dL and/or FT less than 1.5 ng/dL.
MAIN OUTCOME MEASURES: Prevalence of TD in men with PD and correlation of TT and FT with severity of curvature and plaque size.
RESULTS: Mean patient age was 53.9 +/- 10.6 years (range 28-77). Penile curvature
was 50.2 +/- 23.6 degrees (range 10-120). Mean TT was 411.6 +/- 203.6 ng/dL
(range 69-877), and mean FT was 1.12 +/- 0.58 ng/dL (range 0.13-5.06). Low T was
identified in 29.5% by TT alone and in 74.4% overall. Severity of curvature was
greater for men with TD compared with men with normal T (54.3 vs. 37.1 degrees, P
= 0.006). Men with low FT had greater penile curvature than men with normal FT
(37.5 vs. 55.9 degrees, respectively, P = 0.003). Severity of penile curvature
correlated significantly with FT (r = -0.314, P = 0.016) and estradiol/T (r =
0.476, P = 0.0001) but not TT (r = -0.199, P = 0.138).
CONCLUSIONS: This pilot study suggests a possibly important relationship between
low T and PD. Further prospective studies are needed to confirm this
relationship.

J Sex Med. 2010 Dec;7(12):4011-7.
The relationship between androgens, regulators of collagen metabolism, and
Peyronie's disease: a case control study.
Karavitakis M, Komninos C, Simaioforidis V, Kontos S, Lefakis G, Politis V,
Koritsiadis G, Konstantellou K, Doumanis G.
Department of Urology Laboratory of Hormonology, St Panteleimon General Hospital
of Nikaia, Piraeus, Greece. [email protected]
INTRODUCTION: Changes in collagen metabolism have been postulated to play a
pivotal role in the pathogenesis of Peyronie's Disease (PD). Androgens such as
dehydroepiandrosterone sulfate (DHEA-S) and testosterone influence collagen
metabolism by modulating the activity of matrix metalloproteases (MMP) and tissue
inhibitors of metalloproteases (TIMP).
AIM: The aim of this study was to evaluate the interrelationship between
androgens (DHEA-S and testosterone), key regulators of collagen metabolism such
as insulin-like growth factor (IGF) 1 and IGF Binding Protein 3 (IGF-BP3), the
MMP/TIMP system, and PD.
METHODS: Age matched PD patients (14) and healthy men (10) who acted as controls
were recruited. Blood samples were collected from all subjects in the early
morning hours after an overnight fast.
MAIN OUTCOME MEASURES: Serum levels of testosterone, sex hormone binding
globulin, DHEA-S, 3-α-androstanediol glucuronide, pro-MMP-1, MMP-1, MMP-2,
TIMP-1, TIMP-2, IGF-1 and IGF-BP3 were measured in both groups. Statistical
methods included univariate, bivariate, and multivariate regression models.
RESULTS: Levels of DHEA-S (114.5 vs. 169.5 µg/dL; p = 0.03), IGF-BP3 (2.96 vs.
3.79 µg/mL; p = 0.01), and TIMP-1 (173.1 vs. 195 ng/mL; p = 0.01) were
significantly lower in PD patients. In contrast, the level of TIMP-2 (102 vs. 85
ng/mL; p = 0.001) was significantly lower in the control group. Using stepwise
regression analysis, only TIMP-2 (p < 0.001) and DHEA-S (p = 0.04) were
significantly related to PD in the final model (R(2) = 0.63). TIMP-1 and DHEA-S
(r = 0.55, p < 0.05) were positively correlated in the PD group, whereas IGF-1
and testosterone (r = -0.54, p < 0.05), and IGF-BP3 and testosterone (r = -0.68,
p < 0.05) were negatively correlated in PD patients.
CONCLUSIONS: Our findings suggest that decreased levels of adrenal androgens may
be implicated in the pathogenesis of PD. The mechanism and clinical relevance of
this observation remain to be established.
© 2010 International Society for Sexual Medicine.

 

[Koveras]

Ray Peat wrote:

Unopposed estrogen promotes inflammation and fibrosis, pregnenolone, progesterone, and testosterone protect against fibrosis. Hypothyroidism tends to push the ratio toward estrogen.

Int J Urol. 2011 Nov;18(11):796-800.
Does testosterone deficiency exaggerate the clinical symptoms of Peyronie's
disease?
Nam HJ, Park HJ, Park NC.
Department of Urology, Pusan National University School of Medicine, Busan,
Korea.
Serum testosterone (T) influences wound healing and levels are decreased in the
age group at risk of Peyronie's disease (PD). The aim of the present study was to
evaluate the severity of penile deformity in men with PD in relation to T levels.
One-hundred and six patients with PD and T deficiency (serum T <3.5 ng/mL; Group
1) and those with normal T levels (Group 2) were compared according to the
duration of PD, the size and location of the plaques, penile curvature, pain on
erection, and the severity of erectile dysfunction. The mean degree of penile
curvature in Group 1 was significantly greater than in Group 2 (32.0 ± 15.9° vs
21.8 ± 15.4°, respectively). The mean Group 1 score on the International Index of
Erectile Function (IIEF)-5 was lower than the score for Group 2 (7.4 ± 3.7 vs
10.8 ± 4.8, respectively). The percentage of patients who complained of pain on
erection did not differ between the two groups. Plaque size in Group 1 was larger
than in Group 2 (3.0 ± 1.2 vs 2.0 ± 1.2 cm, respectively), whereas there was no
significant difference in plaque location. Although there was a lower percentage
of responders to medical treatment in Group 1, there were no differences in
surgical outcomes between the two groups. These findings suggest that the
presence of T deficiency in patients with PD exaggerates the severity of PD by
affecting penile deformity, plaque size, and erectile dysfunction. Further
studies are needed to confirm this relationship.
© 2011 The Japanese Urological Association.

J Androl. 2012 May-Jun;33(3):381-8.
Association between Peyronie disease and low serum testosterone levels: detection
and therapeutic considerations.
Cavallini G, Biagiotti G, Lo Giudice C.
Andros Italia, Outpatient Clinic of Ferrara, Ferrara, Italy.
[email protected]
The aim of this paper was to find a link between Peyronie disease (PD) and
bioavailable testosterone (bT)/free testosterone (fT) blood levels. Subjects with
no erectile dysfunction were prospectively studied with respect to 3 parameters:
differences in bT/fT between 106 PD patients and 99 healthy controls; differences
in plaque area, penile curvature, and pain between 54 PD patients with low bT/fT
and 52 PD patients with normal bT/fT; and differences in intraplaque verapamil
efficacy between 20 hypogonadal PD patients supplemented with testosterone and 23
hypogonadal PD patients administered a placebo. Medical history, objective
examination, and dynamic duplex scanning of the penis, both before and 8 months
after the end of the therapy (ie, at the end of the study period), were used to
assess PD. Testosterone supplementation was carried out with testosterone buccal
adhesive patches 2 × 30 mg/d for the entire study period. bT and fT were
significantly lower in PD patients than in control patients. The plaque area was
significantly higher in PD patients with low bT/fT than in patients with normal
bT/fT. No significant difference emerged when pain or penile deformity were
examined. Plaque area and penile curvature improved to a greater extent when
intraplaque verapamil injections were associated with testosterone administration
than when associated with a placebo. Men with PD had lower bT/fT than healthy
controls. In these patients, supplementation with testosterone improved the
efficacy of intraplaque verapamil. Plaque area and penile curvature were more
severe in hypogonadal PD.

J Sex Med. 2009 Jun;6(6):1729-35.
Testosterone deficiency and Peyronie's disease: pilot data suggesting a
significant relationship.
Moreno SA, Morgentaler A.
Harvard Medical School, Boston, MA, USA.
INTRODUCTION: As testosterone (T) has been shown to influence wound healing, and
serum T declines in the age group at risk for Peyronie's disease (PD), we
explored the possibility that low serum T may be associated with PD.
AIM: The purpose of this study was to evaluate the relationship between serum T
concentrations and features of PD.
METHODS: Medical records were reviewed for 121 consecutive patients with PD seen
over a 2-year period. All patients were assessed for sociodemographic data,
medical history, comorbid medical conditions, findings on physical examination,
and severity of curvature. Laboratory testing included serum concentrations of
total testosterone (TT) and free testosterone (FT). Testosterone deficiency (TD)
was defined as TT values less than 300 ng/dL and/or FT less than 1.5 ng/dL.
MAIN OUTCOME MEASURES: Prevalence of TD in men with PD and correlation of TT and FT with severity of curvature and plaque size.
RESULTS: Mean patient age was 53.9 +/- 10.6 years (range 28-77). Penile curvature
was 50.2 +/- 23.6 degrees (range 10-120). Mean TT was 411.6 +/- 203.6 ng/dL
(range 69-877), and mean FT was 1.12 +/- 0.58 ng/dL (range 0.13-5.06). Low T was
identified in 29.5% by TT alone and in 74.4% overall. Severity of curvature was
greater for men with TD compared with men with normal T (54.3 vs. 37.1 degrees, P
= 0.006). Men with low FT had greater penile curvature than men with normal FT
(37.5 vs. 55.9 degrees, respectively, P = 0.003). Severity of penile curvature
correlated significantly with FT (r = -0.314, P = 0.016) and estradiol/T (r =
0.476, P = 0.0001) but not TT (r = -0.199, P = 0.138).
CONCLUSIONS: This pilot study suggests a possibly important relationship between
low T and PD. Further prospective studies are needed to confirm this
relationship.

J Sex Med. 2010 Dec;7(12):4011-7.
The relationship between androgens, regulators of collagen metabolism, and
Peyronie's disease: a case control study.
Karavitakis M, Komninos C, Simaioforidis V, Kontos S, Lefakis G, Politis V,
Koritsiadis G, Konstantellou K, Doumanis G.
Department of Urology Laboratory of Hormonology, St Panteleimon General Hospital
of Nikaia, Piraeus, Greece. [email protected]
INTRODUCTION: Changes in collagen metabolism have been postulated to play a
pivotal role in the pathogenesis of Peyronie's Disease (PD). Androgens such as
dehydroepiandrosterone sulfate (DHEA-S) and testosterone influence collagen
metabolism by modulating the activity of matrix metalloproteases (MMP) and tissue
inhibitors of metalloproteases (TIMP).
AIM: The aim of this study was to evaluate the interrelationship between
androgens (DHEA-S and testosterone), key regulators of collagen metabolism such
as insulin-like growth factor (IGF) 1 and IGF Binding Protein 3 (IGF-BP3), the
MMP/TIMP system, and PD.
METHODS: Age matched PD patients (14) and healthy men (10) who acted as controls
were recruited. Blood samples were collected from all subjects in the early
morning hours after an overnight fast.
MAIN OUTCOME MEASURES: Serum levels of testosterone, sex hormone binding
globulin, DHEA-S, 3-α-androstanediol glucuronide, pro-MMP-1, MMP-1, MMP-2,
TIMP-1, TIMP-2, IGF-1 and IGF-BP3 were measured in both groups. Statistical
methods included univariate, bivariate, and multivariate regression models.
RESULTS: Levels of DHEA-S (114.5 vs. 169.5 µg/dL; p = 0.03), IGF-BP3 (2.96 vs.
3.79 µg/mL; p = 0.01), and TIMP-1 (173.1 vs. 195 ng/mL; p = 0.01) were
significantly lower in PD patients. In contrast, the level of TIMP-2 (102 vs. 85
ng/mL; p = 0.001) was significantly lower in the control group. Using stepwise
regression analysis, only TIMP-2 (p < 0.001) and DHEA-S (p = 0.04) were
significantly related to PD in the final model (R(2) = 0.63). TIMP-1 and DHEA-S
(r = 0.55, p < 0.05) were positively correlated in the PD group, whereas IGF-1
and testosterone (r = -0.54, p < 0.05), and IGF-BP3 and testosterone (r = -0.68,
p < 0.05) were negatively correlated in PD patients.
CONCLUSIONS: Our findings suggest that decreased levels of adrenal androgens may
be implicated in the pathogenesis of PD. The mechanism and clinical relevance of
this observation remain to be established.
© 2010 International Society for Sexual Medicine.

There's a role for pentoxifylline as well

Abern, M. R., Larsen, S., & Levine, L. A. (2012). Combination of penile traction, intralesional verapamil, and oral therapies for Peyronie's disease. J Sex Med, 9(1), 288-295. doi:10.1111/j.1743-6109.2011.02519.x

Alizadeh, M., Karimi, F., & Fallah, M. R. (2014). Evaluation of verapamil efficacy in Peyronie's disease comparing with pentoxifylline. Glob J Health Sci, 6(7 Spec No), 23-30. doi:10.5539/gjhs.v6n7p23

Brant, W. O., Dean, R. C., & Lue, T. F. (2006). Treatment of Peyronie's disease with oral pentoxifylline. Nat Clin Pract Urol, 3(2), 111-115; quiz 116. doi:10.1038/ncpuro0409

Ciociola, F., & Colpi, G. M. (2013). Peyronie's disease: a "triple oxygenant therapy". Arch Ital Urol Androl, 85(1), 36-40. doi:10.4081/aiua.2013.1.36

Dell'Atti, L., & Ughi, G. (2014). Efficacy of pentoxifylline in Peyronie's disease: Clinical case of a young man. Arch Ital Urol Androl, 86(3), 237-238. doi:10.4081/aiua.2014.3.237

Paulis, G., Barletta, D., Turchi, P., Vitarelli, A., Dachille, G., Fabiani, A., & Gennaro, R. (2016). Efficacy and safety evaluation of pentoxifylline associated with other antioxidants in medical treatment of Peyronie's disease: a case-control study. Res Rep Urol, 8, 1-10. doi:10.2147/RRU.S97194

Payton, S. (2010). Therapeutic benefit of pentoxifylline for Peyronie's disease. Nat Rev Urol, 7(5), 237. doi:10.1038/nrurol.2010.53

Safarinejad, M. R., Asgari, M. A., Hosseini, S. Y., & Dadkhah, F. (2010). A double-blind placebo-controlled study of the efficacy and safety of pentoxifylline in early chronic Peyronie's disease. BJU Int, 106(2), 240-248. doi:10.1111/j.1464-410X.2009.09041.x

Shindel, A. W., Lin, G., Ning, H., Banie, L., Huang, Y. C., Liu, G., . . . Lue, T. F. (2010). Pentoxifylline attenuates transforming growth factor-beta1-stimulated collagen deposition and elastogenesis in human tunica albuginea-derived fibroblasts part 1: impact on extracellular matrix. J Sex Med, 7(6), 2077-2085. doi:10.1111/j.1743-6109.2010.01790.x

Smith, J. F., Shindel, A. W., Huang, Y. C., Clavijo, R. I., Flechner, L., Breyer, B. N., . . . Lue, T. F. (2011). Pentoxifylline treatment and penile calcifications in men with Peyronie's disease. Asian J Androl, 13(2), 322-325. doi:10.1038/aja.2010.117

Valente, E. G., Vernet, D., Ferrini, M. G., Qian, A., Rajfer, J., & Gonzalez-Cadavid, N. F. (2003). L-arginine and phosphodiesterase (PDE) inhibitors counteract fibrosis in the Peyronie's fibrotic plaque and related fibroblast cultures. Nitric Oxide, 9(4), 229-244. doi:10.1016/j.niox.2003.12.002

 

[theLaw]

I've fixed some issues with ed and fibrosis by increasing T and lowering estrogen.

Caffeine (anything past 600mg per day) has been the best sup for this in my case, but Pansterone helped as well.

For me I noticed a significant difference when losing fat and increasing muscle mass, which is pretty easy if you eat enough macros.

I always keep in mind what Peat has said about fat producing estrogen and muscle producing T. It's amazing how much fat you can gain below the belt before it becomes obvious to the naked eye.

There's also something in pelvic region that really effected my erection quality that's related to the amount of belly fat I carried. Literally planking had a noticeable effect.

 

[Wagner83]

I think nocturnal erections are important (so hormonal health) , given the role of vitamin C on collagen it could play a part too and same for topical vitamin k2. Pentox and most treatments have been unconvincing AFAIK. Pumping at very low hg with warm water should be a good mechanical help. A member of peyronies forum called "old man" knows more, I don't know if he is still active, there should be existing threads. Exercise like squats, sprints, and some kegels could help indirectly (hormones, blood flow and pelvic floor health).

 

[Peyronies]

somebody?