Drug Treatment for Peyronie's Disease: How Effective Are Oral Medicines and Injections into the Plaque?

Many men who notice a curve in the penis read about supportive products taken by mouth and injections into the plaque, and are left with one question: “Will a pill or an injection straighten this?” Most do not know which information to trust.

Peyronie's disease is a condition in which a scar-like plaque forms in the lining of the erectile tissue inside the penis, causing curvature, hardness, shortening and sometimes pain; it is not contagious and it is not cancer. This article covers what oral drugs and injections into the plaque (intralesional injections) can and cannot do, the level of evidence, in whom and at which stage they are considered, their risks, and their place alongside surgery and other methods. It is informational and does not recommend any particular drug or procedure.

What should be expected from drug treatment?

The aim of drug treatment in Peyronie's disease is usually to limit progression of the plaque and curvature, reduce pain and, if possible, reduce the curve somewhat. The disease course varies greatly between people, so a treatment's effect is hard to separate from the natural course, and an “improvement” in small, uncontrolled studies does not always mean the drug contributed.

The honest summary is this: today's drugs are not a way of removing the plaque or of correcting marked curvature in a predictable manner. If the curve is mild, there is no pain and intercourse is unaffected, treatment may not be needed; monitoring alone is a reasonable option. The effect of the disease on mood and relationships is covered in a separate article on our site.

What is the evidence for substances taken by mouth?

Many substances taken by mouth have been tried over the years. The main groups can be summarised as follows:

• Vitamin and antioxidant supplements: Tried in the hope of reducing tissue damage; studies are small and an effect on curvature has not been shown consistently.
• Anti-inflammatory drugs: May ease pain; the evidence that they reduce curvature is weak.
• Hormone-receptor-acting drugs: Suggested to influence plaque formation; results are conflicting.

The common problem is that most studies are small, with missing or weak comparison groups, short follow-up and results that disagree with one another. For this reason most international guidelines do not recommend these substances as routine treatment; in selected cases they may be discussed with a doctor, knowing that the evidence is limited. They may cause side effects and interact with other medicines; use follows the doctor's advice and should not be started alone.

Do PDE5 inhibitors correct the curvature?

PDE5 inhibitors are a group of drugs widely used for erectile dysfunction, and erection problems often accompany Peyronie's disease. If such a problem is present, these drugs are used for that purpose according to the doctor's advice; adequate rigidity can make intercourse easier.

Small studies have suggested that this group may also affect plaque biology, but there is no strong evidence that they correct curvature. In short, a PDE5 inhibitor is an erection medicine, not a proven curvature medicine. How these drugs work is described in a separate article on our site.

What are injections into the plaque, and how effective are they?

In an intralesional injection, the medicine is given by a doctor with a needle directly into the plaque. This differs from the injection given to produce an erection (intracavernosal injection), which has its own article on our site. Three main groups of injections have been tried in Peyronie's disease:

• Enzyme-based injection: Aims to break down the fibrous tissue of the plaque; the amount of controlled study data is wider than for the other groups.
• Calcium-channel-acting injection: Aims to reduce the cell activity and tissue build-up involved in plaque formation; the evidence is more limited and inconsistent.
• Immune-modulating protein injection: Aims to influence the inflammatory response in the plaque; studies are small.

The effect of all of them is limited. The average improvement is mild to moderate; in most people the curve does not straighten completely and the plaque does not disappear. Individual response varies widely: in some men there is a visible reduction, in others no change at all. Licensing and availability vary by country and over time.

What are the risks of the injections?

Like any injection, these have side effects:

• Pain and tenderness: At the injection site and around the plaque, possibly lasting days.
• Bruising and swelling: Common, usually settling.
• Rare but serious complications: Particularly with enzyme-based injection, tearing of the lining of the erectile tissue (penile fracture) or a large haematoma has been reported; it is therefore important to follow the doctor's advice on intercourse and care after the procedure.
• Other: Skin changes, infection, allergic reaction; rarely, effects on the curvature or on erection quality.

A bleeding tendency, blood-thinning medicines or previous penile surgery should be reported beforehand. If, after an injection, there is a cracking sound during an erection followed by sudden pain, rapid swelling or marked bruising, this may be an emergency; go to an emergency department without delay or call 112.

At which stage and in whom are they considered?

The distinction between the active phase (pain is present, the curve is still changing) and the stable phase (pain has settled, the curve has not changed for months) is described in detail in other articles on our site. For drug decisions it means this: in the active phase the task is to relieve pain and watch the course, anti-inflammatory drugs may be used for pain, and injections into the plaque are usually deferred. An injection is mostly discussed in the stable phase, when the curve has stayed constant on repeated measurements and lies in a moderate range.

Situations in which the place of injection into the plaque is limited include:

• Hourglass deformity: A notch or narrowing of the shaft at which the penis folds; the benefit of injection is limited.
• Calcified plaque: In a plaque as hard as bone, no benefit is expected from injection.
• Very severe curvature: The average improvement may not be enough to remove a curve that prevents intercourse.

New but not conclusive: a 2026 observational audit

An observational clinical study announced in 2026 looked at men in the active phase who took a hormone-receptor-acting drug together with a PDE5 inhibitor for about three months. The proportion of men reporting improvement in curvature was reported as roughly 43 percent in this group and roughly 15 percent in the standard-care group.

These figures are interesting, but they are preliminary, observational and not conclusive. The study was not randomised; because the groups were not formed by chance, part of the difference may reflect patients who differed to begin with. The comparison group is small, and how improvement was defined, how long the effect lasts and long-term safety are not yet clear. For this reason the results do not amount to a routine treatment recommendation; they need to be confirmed in larger randomised studies.

If drugs are not enough: surgery and other methods

Non-surgical options (shockwave therapy, stem cell applications, traction and vacuum devices) and the timing and options of surgery are described in separate articles on our site. Drugs and non-surgical methods mostly target mild to moderate changes; they do not correct marked curvature in a predictable way.

Surgery is discussed in the stable phase when the curve is marked, when it prevents intercourse, or when drug and injection options have proved insufficient or unsuitable (for example, hourglass deformity or calcified plaque). Surgery corrects the curve more predictably than drugs, but has risks of its own: shortening, changes in sensation and changes in erection. Trying drugs for months where surgery may be needed can, however, delay treatment unnecessarily.

When should a doctor be consulted?

• A newly developed penile curve, a hard area (plaque) in the shaft, or pain with erection
• A curve that keeps increasing, intercourse becoming difficult or the penis becoming shorter
• Before trying a drug, supplement or injection you have heard about
• A cracking sound, sudden pain, rapid swelling or marked bruising after an injection into the plaque (emergency; go to an emergency department or call 112)
• Painful erection lasting more than 4 hours after any medicine (emergency; call 112)
• Reduced erection quality, or a curve that causes anxiety and tension in the relationship

In Peyronie's disease the evidence for substances taken by mouth is mostly weak; injections into the plaque give a limited and variable effect and are considered at certain stages and with certain features of the curve. New preliminary data are not conclusive; surgery is discussed when the curve is marked and prevents intercourse. Assoc. Prof. Zülfü Sertkaya practises in urology and andrology in Istanbul; assessment and treatment planning for Peyronie's disease are carried out with individual assessment and confidentiality.

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