There’s no guaranteed way to prevent Peyronie’s disease, but you can meaningfully reduce your risk by addressing the two main factors that drive it: physical trauma to the penis and the vascular health that affects how your body heals that trauma. Peyronie’s develops when scar tissue (plaque) forms inside the tough outer layer of the penis after injury, and it affects somewhere between 0.7% and 11% of adult men in the United States, with the wide range largely due to underreporting.
Understanding what causes that scar tissue to form, and which risk factors you can actually control, gives you the best shot at avoiding it.
How Peyronie’s Disease Develops
The penis contains two cylindrical chambers of spongy tissue wrapped in a thick, fibrous sheath. During an erection, blood fills those chambers and the sheath stretches to accommodate the pressure. When that sheath sustains small tears, whether from a single forceful bend or repeated minor stress over time, the body repairs the damage with scar tissue. In most men, these micro-injuries heal cleanly. In some, the repair process goes wrong: inflammation leads to a hard plaque forming inside the sheath, and that plaque doesn’t stretch the way normal tissue does. The result is a curve, pain, or both.
The condition has two phases. In the acute phase, which lasts roughly 6 to 18 months, inflammation is active, the plaque is still forming, the curve may be changing, and erections are often painful. Once the plaque stabilizes and the pain fades, you’ve entered the chronic phase, where the curvature is fixed but no longer worsening.
Reduce the Risk of Penile Trauma
Since physical injury is the primary trigger, the most direct form of prevention is minimizing the kind of forceful bending that tears the tissue inside the penis. This doesn’t mean avoiding sex. It means being aware of how injuries happen.
A systematic review comparing sexual positions and penile fracture risk found that positions where the man controls the thrusting, specifically man-on-top and rear-entry (doggy style), carried a significantly higher risk of penile fracture. The proposed mechanism is straightforward: vigorous thrusting increases the chance of the penis slipping out and striking the partner’s body at an angle. The woman-on-top position, despite its reputation, did not show a statistically significant association with fracture in the pooled data. While a penile fracture is a more dramatic injury than the micro-tears that cause Peyronie’s, the physics are the same. Forceful bending of an erect penis is the core problem.
Practical steps that reduce this risk:
- Use adequate lubrication. Friction increases the chance of the penis catching at an awkward angle during penetration.
- Slow down during vigorous intercourse. The highest-risk moment is when the penis fully exits and strikes the perineum or pubic bone on a missed thrust.
- Be cautious with positions involving deep, fast thrusting. This applies especially as you get older and the tissue becomes less elastic.
- Avoid bending an erect penis forcefully. This includes during masturbation or any activity that puts lateral pressure on the shaft.
Quit Smoking
Smoking is one of the strongest modifiable risk factors identified in population studies. A multicenter study of men aged 50 to 69 found that smokers had an odds ratio of 4.6 for developing Peyronie’s compared to nonsmokers. When smoking was analyzed as a standalone variable, that number jumped to 7.2, meaning smokers were roughly seven times more likely to develop the condition.
The connection is vascular. Nicotine damages blood vessel walls and reduces blood flow, which impairs the body’s ability to heal micro-injuries cleanly. Poor blood supply to the tissue means the repair process is more likely to produce disorganized scar tissue rather than healthy, flexible tissue. If you smoke and are concerned about Peyronie’s, quitting is the single most impactful thing you can do.
Manage Diabetes and Vascular Health
Men with diabetes have about a 50% higher odds of developing Peyronie’s disease compared to men without it, with poorly controlled blood sugar being the key factor. Diabetes damages small blood vessels throughout the body, including those in the penis, creating the same kind of impaired healing environment that smoking does.
Keeping blood sugar well controlled, maintaining healthy blood pressure, and staying physically active all support the vascular health that helps penile tissue recover normally from everyday wear. These aren’t Peyronie’s-specific interventions. They’re the same cardiovascular basics that protect against erectile dysfunction, heart disease, and other conditions tied to blood vessel damage.
Know If You’re at Higher Risk
Some risk factors for Peyronie’s are outside your control, but knowing about them helps you stay alert to early signs.
Genetics play a role. Peyronie’s can run in families, following an autosomal dominant inheritance pattern in some cases. Men with a family history of Dupuytren’s contracture, a condition where scar tissue forms in the hand and curls the fingers inward, are at elevated risk. In one study of families with inherited Peyronie’s, 78% of affected individuals also had Dupuytren’s contracture, suggesting the same gene drives both conditions. If your father, brother, or uncle had either condition, your risk is higher than average.
Prostate surgery is another significant risk factor. Among men who underwent radical prostatectomy, 15.9% developed Peyronie’s disease, with the average onset about 14 months after surgery. The combination of surgical trauma, temporary erectile dysfunction, and changes in penile blood flow during recovery creates conditions that favor abnormal scarring. If you’re facing prostate surgery, this is worth discussing with your surgeon beforehand.
Age matters too. Peyronie’s becomes more common in your 50s and 60s, when tissue elasticity decreases and vascular health typically declines. The condition can occur at any age, but the combination of less flexible tissue and slower healing makes older men more vulnerable.
Skip the Vitamin E
Vitamin E supplements have been recommended for Peyronie’s for over seven decades, but the evidence is clear at this point: they don’t work. Multiple placebo-controlled trials, including one with 236 men, have found no significant improvement in penile curvature, plaque size, pain, or ability to have intercourse. The American Urological Association explicitly recommends against using vitamin E, tamoxifen, omega-3 fatty acids, or vitamin E combined with L-carnitine for Peyronie’s disease.
One oral supplement with modest evidence is potassium para-aminobenzoate (POTABA). A randomized, placebo-controlled trial found that men taking it for 12 months had reduced plaque size, while those on placebo saw their curvature worsen. The catch: POTABA is used to stabilize existing disease rather than prevent new cases, it requires taking large doses four times daily, and no further randomized trials have confirmed the results. The International Consultation on Sexual Medicine does not support routine use of oral agents for Peyronie’s.
Recognize the Early Signs
Prevention also means catching the disease early, when treatment options are most effective. During the acute phase, the warning signs include a small, hard lump you can feel under the skin of the penis, pain during erections or even without them, and a new or worsening curve. Many men dismiss mild pain or a slight bend as normal variation, which delays treatment during the window when intervention can prevent the curvature from becoming permanent.
If you notice any of these changes, especially a palpable lump or pain that persists over several weeks, early evaluation gives you the widest range of treatment options before the plaque hardens and the curve stabilizes.