What Causes Peyronie’s Disease?

• 15 June 2026
• Mr. Leon Almashan

Last updated on June 15, 2026

Peyronie’s disease is thought to develop when scar tissue forms inside the penis, although the exact cause is not always clear and may involve several contributing factors.

For many men, the condition appears gradually rather than after one obvious injury. A slight bend during erections may slowly become more noticeable over time. Others first recognise pain, shortening, narrowing or changes in erectile function before understanding that plaque or scar tissue may be developing beneath the surface.

One of the most frustrating aspects of Peyronie’s disease is uncertainty. Some men can identify a possible trigger, such as injury during sex or a period of repeated soreness. Others cannot remember any specific event at all.

Current understanding suggests the condition is often multifactorial. Tissue injury, inflammation, healing responses, genetics, vascular health and age-related changes may all contribute to varying degrees in different people.

Understanding possible causes can help men make sense of symptoms without automatically assuming severe disease or permanent damage. It may also help explain why Peyronie’s disease symptoms sometimes appear gradually and unpredictably.

Repeated Micro Trauma to the Penis

Repeated minor injury or stress to penile tissue is widely thought to play a role in Peyronie’s disease development in some men.

This theory centres on “microtrauma”, meaning small areas of tissue stress or bending that occur repeatedly over time. Unlike a dramatic injury, these smaller stresses may pass unnoticed initially.

During erections, penile tissue is under tension. If part of the penis bends awkwardly during intercourse or physical activity, tiny areas of tissue damage may develop. In some men, the healing response appears to produce excess scar tissue rather than normal flexible tissue repair.

Over time, this may reduce elasticity in one area of the penis. During erections, the surrounding tissue expands unevenly, potentially leading to curvature or narrowing.

The process often develops gradually:

• minor tissue stress occurs
• healing responses are triggered
• scar tissue begins forming
• flexibility changes over time
• curvature becomes more noticeable

A man may remember occasional soreness after intercourse but not consider it significant at the time. Months later, he may begin noticing upward curvature or reduced flexibility during erections.

Importantly, microtrauma is thought to contribute in some men, not all. Many people experience similar tissue stress without ever developing Peyronie’s disease.

Penile Injury During Sexual Activity

A more noticeable penile injury during sex may occasionally precede Peyronie’s disease symptoms, although not every man recalls a specific event.

In some cases, men describe a sudden bending injury during intercourse followed by pain, bruising or swelling. Others report discomfort that settled initially before curvature appeared gradually later.

When Symptoms Develop Gradually Afterwards

Symptoms do not always appear immediately after injury. Some men notice changes weeks or months later as scar tissue develops during healing.

For example, a man may experience soreness after awkward intercourse and assume the problem is resolved. Over time, however, erections may begin curving toward the affected area as tissue flexibility changes.

This delayed onset is one reason Peyronie’s disease can feel confusing. The triggering event, if there was one, may no longer seem important by the time curvature develops.

Why Some Men Never Notice a Definite Injury

Many men with Peyronie’s disease cannot identify one clear injury at all.

This may reflect repeated low-grade tissue stress rather than a single major trauma. It may also relate to differences in healing response, tissue resilience or genetic susceptibility.

The absence of a remembered injury does not make symptoms less real or less consistent with Peyronie’s disease.

Genetic Predisposition to Scar Tissue Disorders

Some men may have a genetic tendency toward abnormal scar tissue formation, which could increase susceptibility to Peyronie’s disease.

Researchers have identified associations between Peyronie’s disease and conditions involving excessive or disorganised scar tissue formation elsewhere in the body. This suggests some men may be biologically more prone to fibrotic healing responses.

That does not mean Peyronie’s disease is directly inherited in a simple or predictable way. Having a family history of scar tissue disorders does not guarantee penile curvature will develop. Equally, many men with Peyronie’s disease have no known family history at all.

Genetics may simply help explain why some men develop significant plaque formation after relatively minor tissue stress while others do not.

Inflammation That Leads to Plaque Formation

Inflammation during tissue healing may contribute to the development of plaque inside the penis in Peyronie’s disease.

Inflammation is part of the body’s normal repair process. After tissue stress or injury, the immune system helps coordinate healing. In some men, however, this process may become exaggerated or poorly regulated.

Instead of flexible tissue repair, excess collagen and scar tissue may accumulate in one area. Over time, this forms plaque — a firmer section of tissue that does not stretch normally during erections.

A simple way to visualise this is to imagine one section of elastic material becoming stiff while the surrounding area remains flexible. As pressure builds, the less flexible section restricts expansion and curvature develops toward that side.

Inflammation may also help explain why some men experience pain during the earlier active phase of Peyronie’s disease before the condition later stabilises.

Understanding the stages of Peyronie’s disease can help explain why symptoms often change over time.

Age Related Changes in Penile Tissue

Age-related changes in tissue elasticity and healing may increase the likelihood of Peyronie’s disease developing over time.

As men age, tissue flexibility and vascular health can gradually change. Healing responses may also become less predictable. These changes may increase vulnerability to scar tissue formation after repeated stress or minor injury.

Peyronie’s disease is more commonly recognised in middle-aged and older men, although younger men can also develop the condition.

Ageing itself does not automatically cause Peyronie’s disease. Rather, age-related tissue changes may increase susceptibility in men who are already vulnerable because of genetics, vascular factors or repeated tissue stress.

Connective Tissue Disorders Such as Dupuytren’s Disease

Certain connective tissue disorders appear more commonly in men with Peyronie’s disease, suggesting shared scar tissue mechanisms.

One of the best-known associations is Dupuytren’s contracture, a condition affecting connective tissue in the hand that can cause fingers to curl inward over time.

Both conditions involve abnormal fibrotic or scar tissue formation, which is why researchers believe they may share underlying biological pathways.

Not every man with Peyronie’s disease develops Dupuytren’s disease, and vice versa. The relationship is an association rather than proof of direct causation.

Still, these links reinforce the idea that Peyronie’s disease is often related to broader healing and connective tissue processes rather than a single isolated event.

Medical Conditions That Affect Blood Flow

Conditions affecting blood vessels and tissue healing may increase susceptibility to Peyronie’s disease in some men.

Researchers have explored possible associations between Peyronie’s disease and:

• diabetes
• cardiovascular disease
• high blood pressure
• erectile dysfunction
• vascular-health problems

These conditions may influence circulation, tissue oxygenation and healing response, potentially affecting how penile tissue recovers after stress or injury.

There is also overlap between Peyronie’s disease and erectile dysfunction. Some men develop both conditions together, although the relationship varies considerably between individuals.

Having vascular-health problems does not mean someone will definitely develop Peyronie’s disease. However, overall tissue health may influence susceptibility and recovery.

Smoking and Lifestyle Factors

Lifestyle factors such as smoking may influence blood flow and tissue healing, which could contribute to Peyronie’s disease risk in some cases.

Smoking affects circulation and vascular function throughout the body. Researchers believe this may influence healing responses and tissue resilience, particularly where repeated stress or inflammation is involved.

Broader health factors may also play a role, including:

• cardiovascular health
• diabetes management
• alcohol moderation
• weight management
• general vascular health

This should not be viewed as blame or proof of preventability. Many healthy men still develop Peyronie’s disease, while others with multiple risk factors never do.

Lifestyle discussions are generally most useful when framed around supporting overall vascular and erectile health rather than searching for a single “cause”.

Additional Situations Associated With Peyronie’s Disease Development

Some men develop Peyronie’s disease symptoms after medical procedures or repeated penile manipulation, although not every case has a clearly identifiable trigger.

Prostate Surgery and Post Surgical Changes

Some studies have explored possible associations between Peyronie’s disease and prostate surgery or pelvic procedures.

The reasons are not fully understood but may involve tissue healing responses, erectile-function changes or altered blood flow during recovery. This does not mean surgery directly causes Peyronie’s disease in most men, nor does it imply procedural error.

Catheterisation and Penile Instrumentation

Catheterisation and other forms of penile instrumentation have also been discussed as possible contributors in some cases.

Mechanical irritation or localised tissue stress may occasionally play a role during healing, although significant curvature following catheter use appears uncommon.

Again, these associations should be viewed cautiously and not interpreted as evidence of negligence or inevitable complication.

Jelqing and Repetitive Penile Stretching Practices

Repetitive penile stretching or manipulation practices, including jelqing, have also been discussed as potential sources of repeated microtrauma.

Jelqing refers to manual stretching exercises intended to alter penile size or shape. Some specialists believe repeated manipulation may increase tissue stress and contribute to abnormal healing responses in susceptible individuals.

Evidence in this area remains limited, and not everyone engaging in these practices develops Peyronie’s disease. The discussion is most useful as part of broader education around tissue stress and healing rather than blame or sensationalism.

Why Peyronie’s Disease Can Develop Without a Clear Cause

Many men with Peyronie’s disease cannot identify one specific event or cause, which is why the condition is often considered multifactorial.

A combination of factors may contribute:

• subtle repeated tissue stress
• genetic susceptibility
• vascular-health changes
• inflammation and healing variation
• age-related tissue changes

In some men, symptoms appear gradually enough that the underlying process becomes difficult to trace.

This uncertainty can feel frustrating, particularly for men trying to understand whether something they did “caused” the condition. In reality, Peyronie’s disease is rarely explained by one simple answer.

For many patients, understanding that the condition often develops through overlapping biological processes can help reduce unnecessary self-blame.

When to Speak to a Specialist About Symptoms

It may be worth seeking medical advice if penile curvature, pain or erection changes are developing or becoming more noticeable over time.

Signs that may justify further assessment include:

• worsening curvature
• pain during erections
• palpable lumps or plaque
• shortening or narrowing
• worsening erectile function
• difficulty with intercourse
• increasing anxiety about symptoms

Many men delay seeking help because symptoms feel embarrassing or difficult to discuss. Others hope the changes will settle naturally. In practice, some men seek reassurance as much as treatment guidance.

An assessment may help clarify whether symptoms are consistent with Peyronie’s disease, whether the condition appears stable and whether any treatment discussion is appropriate.

If you are concerned about symptoms or progression, it may help to speak to a specialist for more personalised guidance.