Does Peyronie's Disease Go Away on Its Own? Active Phase, Stable Phase and What to Expect Early On

A man who noticed pain during erections and a slight bend in his penis a few months ago is left between two extremes by what he reads online: some articles say “wait, it will go away on its own”, others “it will not improve without surgery”. His question is simple: “Will this curvature straighten with time, or get worse while I wait?”

Peyronie's disease is a condition, neither cancer nor contagious, in which a scar-like plaque develops in the sheath surrounding the erectile tissue of the penis (tunica albuginea), causing curvature, a hard area, shortening and sometimes pain. This article covers the natural course of the untreated disease, the active and stable phases, how often curvature improves or worsens in studies, what happens to pain and the plaque over time, what can be done while waiting and when waiting is not appropriate.

What do the active phase and the stable phase mean?

Peyronie's disease is usually assessed in two phases. In the active (acute, inflammatory) phase the plaque is still forming; there may be pain during erection and sometimes in the flaccid state, the curvature may increase, the penis may shorten or a new deformity may develop. In the stable (chronic) phase the pain settles, and the curvature, length and shape no longer change.

According to patient information from the International Society for Sexual Medicine (ISSM), the active phase usually lasts 6 to 12 months and in some men up to 18 months. The American Urological Association (AUA) guideline likewise states that the plaque typically becomes stable 12–18 months after symptoms begin. These are approximate durations. How the phases affect the decision on surgery is covered in a separate article on our site.

How do you know the stable phase has been reached?

The stable phase is recognised not from a single examination but by comparison over time. The AUA guideline defines stable disease as symptoms unchanged for at least 3 months. The European Association of Urology (EAU) guideline likewise lists resolution of pain and a curvature stable for at least 3 months among the accepted criteria of stabilisation.

In practice, this means pain has settled and records taken under the same conditions show no change in curvature over several months. Some analyses and commentaries published in 2026 argue that pain alone is not enough to define the phase; the decision is made by weighing pain, change in shape and time elapsed together.

Without treatment, does the curvature improve, stay the same or worsen?

The answer comes from observational series in which untreated men were re-measured at intervals; results vary with when men presented and how long they were followed:

• Men presenting early: In a 2006 series of 246 men who presented within the first 6 months of symptoms, curvature had improved in 12%, stayed the same in 40% and worsened in 48% at an average of 18 months after onset.
• Men presenting later: In a 2014 series of 176 men who presented after an average of 9 months of disease and were followed for at least 12 months, curvature stayed the same in 67%, improved in 12% and worsened in 21%.
• Men in the active phase: In a 2002 series of 63 men followed in the active phase, after an average follow-up of a little over 8 months the condition was unchanged in about two thirds, had worsened in about 30% and had resolved spontaneously in only about 3%.

The common picture is this: in most men the curvature either stays the same or increases; marked spontaneous improvement is seen in a minority. In the 2014 series, improvement was more likely in those presenting within 6 months and in younger men, and stabilisation in later presenters and older men. These data are not enough to predict any one man's course.

Does the pain go away, and does that mean the curvature has improved?

According to the AUA guideline, pain is the symptom most likely to improve with time without treatment, and in many patients it resolves on its own. In the 2006 series above, pain lessened in every man who had it and had resolved completely in 89% at follow-up.

However, pain going away does not mean the curvature has improved; in the same series, while pain eased in almost everyone, curvature improved in only 12%. Resolution of pain mainly suggests the inflammatory process is settling. The final shape becomes clear only by continuing to monitor the curvature.

Does the plaque (hard area) disappear on its own?

The hard area felt along the shaft of the penis, the plaque, usually does not disappear completely. Even when pain resolves and the curvature stabilises, the plaque generally remains; sometimes its size or firmness changes.

Over time, calcification develops in some plaques; in a 2013 series of more than a thousand patients, it was seen in about a third of those assessed by ultrasound. In some patients it was detected within the first year, so calcification alone does not show that the disease has settled. A calcified plaque may limit the benefit expected from some non-surgical options.

Are shortening, indentation and erection problems also part of the course?

Over time, changes other than curvature may also appear:

• Shortening: In the 2006 series, stretched penile length fell by less than 1 centimetre on average, but significantly, over one year of follow-up.
• Hourglass or indentation deformity: The plaque may narrow the shaft at one point; during erection, thinning or buckling (a hinge effect) may be seen there.
• Change in erection quality: The EAU guideline states that erectile dysfunction is common in men with Peyronie's disease, with reported rates of 30% to 70%. The problem sometimes predates the disease.

These changes may be part of the natural course; however, if they affect intercourse, simply waiting may not be enough.

Does “waiting” mean doing nothing?

No. In the active phase, waiting means recording the course regularly and managing symptoms:

• Regular records: Photographs taken every few weeks at full erection, from the same angles (from above and from the side), together with notes on pain and intercourse, allow the doctor to see any change. Keep the images private.
• Pain management: When needed, pain relievers recommended by the doctor may be used; long-term self-medication is not advised.
• Avoiding strain: Because the disease is thought to be linked to repeated minor strain, forcing penetration when the erection is insufficient and sudden movements that may bend the penis should be reduced.
• Intercourse: If pain allows, giving up sex altogether is usually unnecessary; avoiding uncomfortable positions and talking openly with your partner make things easier.

In selected cases, non-surgical approaches such as oral medicines, traction devices or injections into the plaque can also be discussed with the doctor; their level of evidence is covered in separate articles on our site. Surgery, by contrast, is usually planned once the stable phase has been reached.

“It will go away on its own” versus “surgery as soon as possible”: why do both extremes mislead?

The view “wait, it will go away on its own” draws on pain usually resolving; yet in the series above, marked improvement in curvature remained in the minority.

The view “surgery as soon as possible”, on the other hand, overlooks that a correction made in the active phase, while the shape is still changing, may prove insufficient or excessive once the disease settles. The EAU guideline expects the disease to have been stable for 3–6 months, or more than 9–12 months to have passed since symptoms began, before surgery.

There is a reasonable path between the two extremes. The main situations in which waiting alone may prolong both the problem and the anxiety are an accompanying erection problem, a deformity that prevents intercourse, marked progression over a short time and an uncertain diagnosis. The last point matters: not every hard area felt in the penis is a Peyronie's plaque; a clot in a blood vessel, a previous injury or, very rarely, a tumour can produce a similar finding.

When should you see a doctor?

A urology and andrology assessment is advisable in the following situations:

• If you have noticed a new curvature, a hard area in the penis or pain during erection
• If the curvature has increased markedly within a few weeks or months, or an hourglass appearance or buckling has developed
• If the curvature or deformity makes intercourse difficult or impossible
• If a decline in erection quality accompanies the curvature
• If the hard area is growing, has appeared without curvature, or there is a sore or colour change on the skin over it
• If a cracking sound during intercourse was followed by sudden pain, sudden loss of erection and rapidly developing bruising or swelling (emergency; 112)

In Peyronie's disease, pain usually resolves with time, whereas the curvature stays the same or increases in most men and marked spontaneous improvement is seen in a minority. Waiting in the active phase is therefore an active process with regular records and medical follow-up, and the move to the stable phase is judged by the settling of pain and a shape unchanged for at least 3 months. Assoc. Prof. Zülfü Sertkaya practises in urology and andrology in Istanbul; Peyronie's disease course and follow-up assessment is carried out on an individual basis and in confidence.

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