Peyronie’s disease (PD) is a medical condition in which scar tissue develops on the penis, causing curved, sometimes painful erections. Depending on the severity of a patient’s PD, penetrative sex may become difficult or even impossible to achieve.
Certainly, PD can have serious implications for a patient’s sexual health, but it can also have a deep impact on the patient’s psychological/mental health. Positive sexual expression and healthy sexual relationships can improve a person’s quality of life. In contrast, when an individual experiences a sexual dysfunction such as PD, it can detract from a person’s overall happiness and emotional well-being.
Multiple studies have explored the psychological impact of PD on patients, and most indicate an association between PD and a measure of psychological distress. For example, a 1990 study of 97 men with PD found negative psychological effects in 77% of the respondents.
The psychological effects associated with PD could be related to concerns about one’s physical appearance, changes in sexual self-image, a lack of sexual confidence, sexual dysfunction, worries or fears about not being able to satisfy a sexual partner, and/or social stigmatization or isolation.
A similar study of 92 patients with PD in 2008 found high rates of depression among the participants, with 26% reporting moderate depression and 21% reporting severe depression based on the results of the validated Center for Epidemiologic Studies Depression Scale (CES-D).
Patterns of emotional problems associated with PD were evident in larger samples as well. When 245 PD patients responded to a PD-specific questionnaire that inquired about their emotional and relational well-being, 81% indicated that they experienced emotional problems as a result of their PD, and 54% shared that they experienced relationship problems because of their PD. The inability to have intercourse and losing penile length were two major predictors of these problems.
Clearly, PD can have a big emotional impact on the people who it affects. Therefore, as health care providers, it is extremely important to not only address the patient’s physical symptoms, but also their psychological wellness. While providing patients with mental health resources is a good start, in many cases, it is prudent to refer patients to a trained sex therapist or counselor who can offer ongoing support and practical advice for maintaining their mental and sexual health.
References:
Gelbard, M.K., Dorey, F., & James, K. (1990). The natural history of Peyronie’s disease. The Journal of Urology, 144(6), 1376-1379. https://doi.org/10.1016/S0022-5347(17)39746-X
Nelson, C.J., Diblasio, C., Kendirci, M., Hellstrom, W., Guhring, P., & Mulhall, J.P. (2008). The chronology of depression and distress in men with Peyronie's disease. The Journal of Sexual Medicine, 5(8), 1985-1990. https://doi.org/10.1111/j.1743-6109.2008.00895.x
Nelson, C.J., & Mulhall, J.P. (2013). Psychological impact of Peyronie's disease: a review. The journal of sexual medicine, 10(3), 653-660. https://doi.org/10.1111/j.1743-6109.2012.02999.x
Smith, J.F., Walsh, T.J., Conti, S.L., Turek, P., & Lue, T. (2008). Risk factors for emotional and relationship problems in Peyronie's disease. The Journal of Sexual Medicine, 5(9), 2179-2184. https://doi.org/10.1111/j.1743-6109.2008.00949.x
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