Welcome to the Peyronie’s support subreddit, brought to you buy the same guys behind the Peyronie’s Support Group Discord server. We make no money from this and run this out of our free time, we do this to help cultivate a community and conversation around Peyronie’s for the sufferers by the sufferers. Our stories, ages and severity all vary but that doesn’t stop us from trying to prosper and we want the same for anyone else who sufferers with this disease. Life is a war we all lose but we want you to win some battles.
The Mod Team u/Duminance_PSG_2 -Co-founder of the PSG Discord u/BackgroundFault3-moderator amongst other things
Our Discord https://discord.gg/nQxwykDfjj The Peyronie’s disease society forum https://www.peyroniesforum.net/index.php
[This is a just a slightly updated version of the old welcome post, I’ll do a better revised version at a later date with some updated information]
So now that we’ve gotten past the introduction to the sub Reddit let’s talk about what may be going on.
What is Peyronie’s Disease? Well here are some overviews from various sources.
Peyronie's disease - Symptoms and causes - Mayo Clinic
https://www.urologyhealth.org/urology-a-z/p/peyronies-disease
https://my.clevelandclinic.org/health/diseases/10044-peyronies-disease
https://www.hopkinsmedicine.org/health/conditions-and-diseases/peyronie-disease
https://www.niddk.nih.gov/health-information/urologic-diseases/penile-curvature-peyronies-disease
https://www.drlevinemenshealth.com/Portals/2754/web-content/files/PDContemporaryReviewofNonsurgicaltreatment.pdf 
Peyronie’s Disease (Curvature) San Diego,CA
https://youtu.be/5CJBDBIAy90
https://youtu.be/vCtQTQ-l_bA ^My personal favorite
https://youtu.be/XP958Py0Re0
I’m sure these sum it up better than I can but I’ll do my best to give you an explanation to help conceptualize what Peyronie’s disease is. Peyronie’s disease is a non-cancerous condition where fiberous scar tissue has developed in a part of the penis called the tunica albuginea, this is a elastic like structure in the penis that contains the erectile tissues known as the corpora cavernosa and corpus spongiosum which is what contains your urethra. The tunica is bi-layered and includes an outer longitudinal layer and an inner circular layer. It is 5% elastin which is a protein that is highly elastic in nature hence the name and 95% collagen, understand there are 28 identified types of collagen. Now what happens with Peyronie’s disease is that parts of that highly elastic healthy tissue get replaced by what’s called a plaque, this isn’t to be confused with arterial plaque or anything like that, this is fibrous scar tissue that lacks the elasticity of the native tissue. It’s stiffer and often harder to the touch. Hawk, the founder of the Peyronie’s forum (PDS) described it as “like putting a piece of Scotch tape on a balloon and then blowing it up”. The resulting deformity can vary from a curve or bend to a dent or divot to loss of length and/or girth (penile circumference) to loss of rigidity. Another way to think about Peyronie’s using a balloon analogy is with a magician making balloon animals and by tying the balloons latex is layered changing the shape of the balloon from just a long ironically penis like tube to all sorts of bends and such. This translates to what some men with PD get thats referred to as hour glassing also known as narrowing. This is basically where girth is lost as a result of scar tissue on multiple sides preventing proper engorgement and in turn partial loss of penile girth along partial length of the shaft. Some men also get rings of scar tissue causing narrowing on a smaller but arguably as bad or worse scale, this almost always creates a weak spot susceptible to buckling where when force is applied the penis tends to bend and this is very painful.
Do I have Peyronies Disease? First and foremost, we are not doctors. We cannot diagnose you with Peyronies Disease (PD) over the internet. Prolonged pain is not normal and must be looked at by a doctor. The best we can do is hear your symptoms/story and let you know where we think you land by comparing experiences. Believe it or not, there can be other conditions that have similar symptoms but First off if you believe you have Peyronie’s but have not been diagnosed by a doctor then that should be your first official step. Get an appointment with a urologist, preferably one who specializes in Peyronie’s as a major part of their practice, unfortunately the vast majority of us this isn’t practical though because there just aren’t that many Peyronie’s specialists, so the next best option will be to find a urologist with advanced andrology training, these doctors will specialize in men’s sexual health exclusively unlike general urologist who may treat a wide variety of conditions in both men and women. Unlike some of the better known specialists, these doctors may have a fairly decent understanding of Peyronie’s but likely won’t be 100% up to date on all the current data on Peyronie’s but they’ll still be able to help you get a foundational treatment and a sound diagnosis and once established as a patient they’ll be able to help you pursue further treatments if need be.
Just because you have a curved penis when erect does not mean you have Peyronie’s disease, many men naturally have curvature just like how most people have facial asymmetry, there’s tons of variation in size and shape. Some men even have curvature as a result of uneven circumcision.
What is the cause of Peyronie’s disease?Unfortunately, that’s isn’t entirely known at this time. It’s safe to basically attribute to three things. First, trauma to the penis, this is most likely to occur during sex or masturbation, maybe you and your partner tend to get a little carried away and next thing you know your penis is sore the following day and for weeks if not months after, maybe you have a tendency to masturbate frequently for whatever reason it doesn’t really matter how the injury occurred, what matters is that it did occur and it’s healed improperly which brings up the second part. Genetics, why is your body forming fibrosis in your penis when these traumas occur naturally in most men but heal fine with healthy tissue? It would be silly too not possibly attribute this to genetics and there is data that does exactly that, in one study the research team found over 85% of patients that had either Peyronie’s or dupuytren's contracture (identical disease in the hands) had either a deletion or mutation of of the NELL1 gene on the 11th chromosome. Third is metabolic, the data isn’t clear on this but we do know diabetes is risk factor for Peyronie’s, also we do see anecdotal reports of fasting and low carb diets helping to improve the condition for some, regardless improving your metabolic health is probably a good idea from a longevity perspective anyways.
How to treat Peyronie’s? Unfortunately there is no definitive cure for Peyronie’s and everyone responds differently to treatment but there some ways to possibly stabilize and even reverse some of the disease development. When deciding what treatments to pursues there’s a few things you should consider: Efficacy (likelihood of working) Risk (Peyronie’s or overall health) Cost How invasive (most patients and providers start at the least invasive and progressively increase as needed) The severity of your symptoms
The reality of this disease is unless you do something to improve your symptoms there’s a very low chance of spontaneous improvement (<13%) and even less of total resolution (<5%) and I’d even be willing to bet that many of this patients either had very minor Peyronie’s to begin with or didn’t have at all in the first place and were misdiagnosed. The vast majority of men have the disease will stay the same or worsen, in fact in about 48% of men it will progressively worsen.
Peyronie’s is often considered easier to treat the earlier in the disease progression so the sooner you get started the better. For initial treatment I’d recommend a combination of OTC supplements and lifestyle changes. Both come with few if any side effects and will improve your overall health. The supplements are recommended by Urologist and back by data. CoQ10: 200-400mg per day (If over 40 yrs old, consider substituting for Ubiquinol, both can be a bit pricey tho) Acetyl/L-Carnitine: 4500-5000mg (very low bioavailability, 10-15%, trying to achieve around 500mg after first pass metabolism) L-Citrulline: 4000-6000mg (feel free to work up from 2000mg as that’s what Dr.Levine recommends in conjunction with Pentoxifylline)
If your going to masturbate use lubricant and if you really want to then possibly consider using castor oil, it works well and is anti-inflammatory.
If your circumcised you may want to consider also using some sort of skin moisturizer to soften and improve skin sensitivity. There are moisturizer’s specifically designed for this that I’m sure work but are a bit on the expensive side so I’d just recommend something fragrance free, I like the standard CeraVe cream that comes in a tub.
Traction therapy, you don’t need a prescription to buy a traction device and there are multiple types and options. Traction is very low risk to do and as long as you follow the instructions you should be fairly safe, you can even modify the devices at home to make them more comfortable. I’ve written an entire Traction guide on our discord and I’ll repost it on Reddit but to summarize it for this post I’ll say this, Traction is the most proven and effective non-invasive option we have, it’s also the most cost effective. It’s worth exploring regardless of where your at in this disease with the exception of already having a penile prosthesis, whether you think you’ve just started to develop PD or have had it for years and live with severe curvature, Traction can help even if used as mono therapy but it will work better when combined with other treatments like heat and VED.
The most recommended traction devices on the market currently are the Penimaster Pro and the RestoreX, the former being quite comfortable to wear and follows the mantra of duration>tension, meaning it’s meant to be worn for multiple hours per day with lower tension and can be done easily, even under clothing (not super tight tho), this is probably best for early and more mild cases but will work regardless. The restoreX is the opposite short duration, high tension, less time, it’s also widely viewed as less comfortable but this can be improved through at home modification, this device is probably better suited for more severe cases that are chronic.
Heat: heat therapy is something that’s gained some support in the Peyronie’s space, especially after a video by a YouTube named Neoman made a few videos about it (https://youtu.be/gPfsF4KQPRg) where he discusses heat therapy for Peyronie’s and references some studies on the topic, this is something that is still debated but what I can tell you is it it something that’s affordable for most, low risk (just try to stay around 40 degrees Celsius and below) and generally helps with pain, In fact most guys I’ve talked to who’ve tried say it feels quite good as well. It also aids with blood flow and can help thin your blood, this aids with hematoma, this is basic stuff frankly. There’s another element of heat that’s quite sound in science but I’ve never seen discussed in a Peyronie’s context and that’s cell growth and cell health, temperature effects cell growth and in mammals 37-40 degrees Celsius is an ideal range for cell growth, this basically means that heat + traction is going be more conducive to cell growth than traction alone.
For pain management you can use OTC NSAIDs such as ibuprofen. Topical NSAIDs like Voltaren can be used too, just be cautious of using both oral and topical NSAIDs at the same time. If your taking Pentoxifylline and have a prescription for meloxicam be careful mixing the two as it’s recommended to not take both at the same time.
If you smoke cigarettes or use other products that contain nicotine it may be a good idea to stop as nicotine is vasoconstrictive which is antagonistic to healing and erection quality.
If you consume a lot of caffeine or a lot of stimulants be aware of possible vasoconstriction, caffeine can help with vasodilation but within limits, after a certain point it can’t actually do the opposite and cause vasoconstriction so mindlessly consuming stimulants throughout the day is not advisable. If you have a hard time getting through the day without caffeine maybe consider something like the Keto diet that will help stabilize blood sugar concentrations limiting highs and lows and creating more of a steady state.
Before you start any treatments it is a good idea to establish a baseline, this is how you can monitor progress of the disease or the effectiveness of the treatment. Start by getting a measuring tape (like what a Taylor would use, not a metal one like what would be used by a carpenter) and a ruler. Once you have a means to measure press it into your body until it’s up against your pubic bone aka the pubis, if your overweight you may have a harder time but you can still do it, you just might have to press harder the compress 1-3 inches of fat or you can measure your exposed penis then measure your fat pad. Try to do this in the same position too, If you have pelvic rotation it may be best to do this while laying flat on your back because otherwise your length may be less than it actually is due to poor posture or pelvic floor issues. Once you’ve measure length move on to girth, this may include measuring multiple points on the shaft especially if there is clear visual hour glassing. Make sure if you are measuring multiple points you can recreate them which is why I’d recommend taking notes of your measurements and including these details that way it’s not left to memory as details may fade over time. Next you may want to measure angle of curvature, this can be done by either using a protractor on directly or by taking a photo while erect and measuring it then (the latter will probably be easier). You can print off a protractor from the internet.
Improve sleep hygiene and try maximize restful Sleep, this will increase testosterone production especially after the age of the thirty because pulsatile testosterone production decreases as you age meaning the only meaningful production will occur during sleep. Reducing cortisol levels aka the stress hormone helps too because your body can only make testosterone or cortisol at any given time but not both. Reducing body fat and not drinking alcohol will also increase testosterone by reducing estrogen which is what triggers negative feedback for the HPTA, basically when our estrogen gets high enough it tells our body through negative feedback to quit making testosterone and it does so. This is because testosterone is converted to estrogen via aromatase which happens in via aromatase enzyme which is found in adipose tissue (body fat). Alcohol lowers testosterone through a variety of means which I won’t detail but a quick google search will explain the why. Having higher testosterone has a variety of benefits for male health but in a PD context but two that matter the most are the metabolic benefits and even more so the sexual function benefits, testosterone is a potent vasodilator and will improve erection quality on that alone, especially when the higher the testosterone to estrogen ratio (estrogen does have health benefits though). Besides improving erectile quality, the better blood flow will aid in healing and reducing the severity of the micro-traumas that cause PD.
So what’s the first official step? Well hopefully you followed someone’s advice on going to a Doctor, specifically a urologist, again one who specializes in men’s sexual function and ideally Peyronie’s but obviously sometimes the cards we’re dealt. Depending on where you live, your insurance, so on you will likely need a referral from you primary care provider but some specialists don’t require that and some even offer online telemedicine consultations. Here are a few things you want accomplish during an in person visit. The first is a hands on exam, frankly for some this may be all that’s needed to procure a diagnosis but it may miss out of some of the less obvious details. Second is a duplex Doppler ultrasound to actually visually see the plaque(s) in question as well as blood flow. Thirdly is a prescription of pentoxifylline (400mg, 3x per day with food) and some sort of erectile dysfunction drug, Cialis(tadalafil) seems to be the more popular one compared to viagra (acquiring a prescription can be done online via telemedicine, especially for ED)then you would then add an over the counter nitrate such as L-Arginine or L-Citrulline and you would take this with your Pentoxifylline, this is basically a modernized version of the PAV cocktail which is Pentox, Arginine and viagra. They will likely be supportive to the idea using traction and likely VED as well. After a year or more of this protocol they may recommend considering surgery suggesting less invasive treatments were ineffective or your unable to have satisfactory sexual intercourse. They would advise waiting until after the acute/active phase to administer Xiaflex injections
Understand if you have dents/divots and/or axial instability/hinge effect, surgery may be the only solution but with a skilled surgeon the outcome has a high likelihood of success and equally as high satisfaction if not higher. There are a variety surgical options available through a some highly skilled surgeons who specialize in Peyronie’s disease and erectile function. Their success and satisfaction rates reflects this with their patients often regretting to not pursuing surgery sooner and suffering for longer than necessary. Implants are becoming quite popular for a reason as some argue that it’s basically an enhancement compared to a natural penis. The only major downsides currently being if your surgeon isn’t that confident they may undersized you and the fact that you may need revision to replace a worn out implant every 10-15 years on average but luckily implants have a lifetime warranty so buy once, cry once. Implants also stop the progression of the disease in the tracks. If you want to know more about implants and other surgical options I highly recommend checking out the https://www.peyroniesforum.net/index.php as it has a ton of great information in general as well as some very knowledgeable members and journals from actual implant patients. The founder, Hawk is very knowledgeable having an implant himself and regularly replies on posts. He asks that you don’t message him directly but instead post on the open forum under whatever section is relevant to the topic you wish to discuss as to cultivate informative discussion around said topic.
Preparing for your doctors visit: 1. Don’t be shy, the doctor deals with personal stuff all the time, it’s their job. 2. If possible provide a picture of your erect penis post development of this condition (who knows, maybe you have a collection) 3. If your have a spouse/partner bring them along if possible, they can take notes or remind you of questions, also the doctor may be able to help them understand what’s going on if needed 4. Take some studies, especially on pentoxifylline Pentoxifylline Attenuates Transforming Growth Factor- β1-Stimulated Elastogenesis in Human Tunica Albuginea-Derived Fibroblasts Part 2: Interference in a TGF- β1/Smad-Dependent Mechanism and Downregulation of AAT1 Pentoxifylline treatment and penile calcifications in men with Peyronie's disease Efficacy and safety evaluation of pentoxifylline associated with other antioxidants in medical treatment of Peyronie’s disease: a case-control study 5. Ask for full blood panel including total and free testosterone, estradiol, prostate-specific antigen and insulin. This can give insight for treatment and possibly find the cause of some issues
Post diagnosis: Well hopefully your experience was positive, your doctor was polite and knowledgeable. So if you were diagnosed with Peyronie’s after adequate and thorough examination you should now have a few prescriptions including pentoxifylline, this is probably the single best oral treatment you can get and I know some guys are curious to the side effects and get a big obsessive, understanding pentox is a cheap and widely available drug with a long lineage of deployment, it’s well tolerated and people rarely report notable side effects when taken in recommence doses, also 3x per day can be a bit tough to achieve, don’t worry, just do the best you can even if that means 2 most days, 3 some days and 1 here and there; it’s better than nothing.
Now if you haven’t gotten a traction device at this point, you really should because now that you actively trying to stop the disease you might as well try to reverse it too and remember it’s a marathon, not a sprint or a relay, your going to be responsible for most of your success or failure and nothing is going work overnight.
Psychological: Just like how we aren’t urologist, we aren’t psychologist either but we do know what it’s like to live with Peyronie’s disease and we know it’s not always strawberries and rainbows, it’s a major challenge that comes with the disease and it absolutely tears some guys apart. There are guys who have severe PD who date, marry and make babies while suffering with PD and on the flip side there are guys who’s lives fall apart. You attitude will define your outcome. As I said earlier “life is war we all lose but I want you to win some battles” and this is a battle that will inflict some damage but you can still win, just depends on what your willing to do but remember all is not lost.
When it comes to women, a commonly expressed complaint is that their partner who suffers from PD tend to shut them out and become less intimate, they refuse to actually discuss the condition. i understand some may become frustrated because it may seem like your partner doesn’t understand Peyronie’s disease but you have to remember if your partner is biologically female they don’t know what it’s like to even have a penis in the same way you don’t understand what it’s like to have a vagina, they can’t understand the pain of having this disease, both psychologically and physiologically, women don’t have to worry about their genitals becoming smaller and this then having an undesirable effect so they likely can’t conceptualize that very well and likely they may not really care about that .5-1 inch loss, just depends but you shouldn’t blame them, we can’t understand what it’s like to give birth or have some guy play “pin the dick on the cervix”. This is why communication is key, help them understand, help them conceptualize what’s going and why it matters. Give them the tools to understand and empathize, if your partner is decent at all once you do this they’ll likely have your back 1000% and you can become the Peyronie’s fighting duo you were destined to be. In all likelihood your Peyronie’s won’t be the downfall of any relationship as long as both parties care but a lack of communication and loss of intimacy will be.
With all that said I’ve only ever seen one example where someone’s partner was anything other than supportive although I’m sure other stories do exist but in this case it was on Reddit and the guy said his girlfriend mocked his Peyronie’s and when he expressed this on Reddit, on my other account I replied something along lines of “I’m sorry to hear that and your girlfriends a cunt” this message was rather well received and others iterated something similar on said post. If your in a similar situation with your partner or anyone else in your life it may be a good idea to remove them from your life, there are plenty of better people out there who will respect and support you and never forget there are millions of men worldwide with this disease, your not in this alone and you never will be, just open your eyes and know where to look.
Sincerely, Duminance, Co-founder of the Peyronie’s support group discord server and PeyroniesSupport subreddit.
This post shares a lot of similarities with this post on the PDS by Hawk https://www.peyroniesforum.net/index.php?topic=3180.0 and that’s on purpose, it’s great post, I was inspired basically just gave my modernized take on it.
P.S. Please don’t message moderators directly about Peyronie’s disease, Reddit is an open forum and should be treated as such, it will be much better as that way you can get multiple opinions and cross pollination and sufferers down the road may be helped by your post. Please reserve messaging moderators for subreddit related issues such as post violations, etc.
Email us at peyroniessg@gmail.com

Random parts that someone's bound to want/need. All prices shipped via paypal F&F or venmo only.

• Hiperfire HPTA Hipertouch Auto - Comes with both of the spring sets and all parts (except the pin starter). Minor test fitting/dry fire marks, otherwise unfired. $190
• YHM 3 lug assembly - Some wear. $85 sold
• YHM Booster assembly - Mild weause. Includes a rugged 13.5x1LH piston. Selling both for $100 sold

Pictures

Random parts that someone's bound to want/need. All prices shipped via paypal F&F or venmo only.

• Hiperfire HPTA Hipertouch Auto - Comes with both of the spring sets and all parts (except the pin starter). Minor test fitting/dry fire marks, otherwise unfired. $190
• YHM Booster assembly - Mild weause. For 1.375x24/HUB threaded cans like the R9 or MG7K. Includes a rugged 13.5x1LH piston. Selling both for $110

Pictures

Random parts that someone's bound to want/need. All prices shipped via paypal F&F or venmo only.

• Hiperfire HPTA Hipertouch Auto - Comes with both of the spring sets and all parts (except the pin starter). Minor test fitting/dry fire marks, otherwise unfired. $190
• YHM Booster assembly - Mild weause. For 1.375x24 threaded cans like the R9 or MG7K. Includes a rugged 13.5x1LH piston. Selling both for $110

Pictures

Random parts that someone's bound to want/need. All prices shipped via paypal F&F or venmo only.

• Hiperfire HPTA Hipertouch Auto - Comes with both of the spring sets and all parts (except the pin starter). Minor test fitting/dry fire marks, otherwise unfired. $195
• YHM Booster assembly - Mild weause. For 1.375x24 threaded cans like the R9 or MG7K. Includes a rugged 13.5x1LH piston. Selling both for $110

Pictures

Random parts that someone's bound to want/need. All prices shipped via paypal F&F or venmo only.

• Hiperfire HPTA Hipertouch Auto - Comes with both of the spring sets and all parts (except the pin starter). Minor test fitting/dry fire marks, otherwise unfired. $200
• YHM Booster assembly - Mild weause. For 1.375x24 threaded cans like the R9 or MG7K. Includes a rugged 13.5x1LH piston. Selling both for $110

Pictures

Random parts that someone's bound to want/need. All prices shipped via paypal F&F or venmo only.

• Primary Arms SLX 5x Prism Scope - Gen 2 with midwest industries QD mount. Has both red/green reticle illumination. I don't have the original box/mount. $220 sold
• Hiperfire HPTA Hipertouch Auto - Comes with both of the spring sets and all parts (except the pin starter). Minor test fitting/dry fire marks, otherwise unfired. $200
• YHM Booster assembly - Mild weause. For 1.375x24 threaded cans like the R9 or MG7K. Includes a rugged 13.5x1LH piston. Selling both for $110

Pictures

Clearing out some unneeded parts. All prices shipped via F&F or venmo only.

• Primary Arms 5x Prism Scope: Gen 2 with 5.56 ACSS reticle. Has a Midwest QD mount, I don't have the original mount or box/accessories. Scope only. $220
• Hiperfire HPTA Hipertouch Auto: Comes with both of the spring sets and all parts (except the pin starter). Minor test fitting/dry fire marks, otherwise unfired. $205
• SIG MCX/MPX iron sights: Taken from MPX in good condition. Added new picture for how they co-witness. Green dot in pic is a Swampfox liberator (not for sale). $60 sold

Scope/trigger
Iron sights

Clearing out some unneeded parts. All payments via paypal F&F or venmo only. All prices shipped.

• 8x Lancer Alien Green Mags: All new in pacakge. - $120
• Primary Arms 5x prism scope: Gen 2 with a midwest QD mount. I don't have the original mount or box/accessories. Scope only $220
• Hiperfire HPTA Hipertouch Auto: Comes with everything you see except the pin starter thingy. Minor test fitting/dry fire marks, otherwise unfired. $210

Picture album

Clearing out some unneeded parts. All payments via paypal F&F or venmo only. All prices shipped.

• 8x Lancer Alien Green Mags: All new in pacakge. - $120
• Single OEM MPX mag: Light use. - $40sold
• Primary Arms 5x prism scope: Gen 2 with a midwest QD mount. I don't have the original mount or box/accessories. Scope only $230
• Hiperfire HPTA Hipertouch Auto: Comes with everything you see except the pin starter thingy. Minor test fitting/dry fire marks, otherwise unfired. $220

Picture album
Won't be shipping until Friday, just a heads up.

Welcome to the Peyronie’s support subreddit, brought to you buy the same guys behind the Peyronie’s Support Group Discord server. We make no money from this and run this out of our free time, we do this to help cultivate a community and conversation around Peyronie’s for the sufferers by the sufferers. Our stories, ages and severity all vary but that doesn’t stop us from trying to prosper and we want the same for anyone else who sufferers with this disease. Life is a war we all lose but we want you to win some battles.
The Mod Team u/BubbaFett_PSG: Founder of the PSG discord u/Duminance_PSG: Co-founder of the PSG Discord u/_007__: Administrator u/BackgroundFault3:moderator amongst other things
Our discord: https://discord.gg/bQAwNxkwxX The Peyronie’s Forum/PDS: https://www.peyroniesforum.net/index.php
If you post a photo please tag as NSFW
So now that we’ve gotten past the introduction to the sub Reddit let’s talk about what may be going on.
What is Peyronie’s Disease? Well here are some official overviews.
https://www.mayoclinic.org/diseases-conditions/peyronies-disease/symptoms-causes/syc-20353468
https://www.drlevinemenshealth.com/Portals/2754/web-content/files/PDContemporaryReviewofNonsurgicaltreatment.pdf 
http://sandiegosexualmedicine.com/male-issues/peyronies-disease-curvature
https://youtu.be/5CJBDBIAy90
https://youtu.be/vCtQTQ-l_bA ^My personal favorite video^
https://youtu.be/QqWbkQLG44g ^For those short on time^
https://youtu.be/XP958Py0Re0
I’m sure these sum it up better than I can but I’ll do my best to give you an explanation to help conceptualize what Peyronie’s disease is. Peyronie’s disease is a non-cancerous condition where fiberous scar tissue has developed in a part of the penis called the tunica albuginea, this is a elastic like structure in the penis that contains the erectile tissues known as the corpora cavernosa and corpus spongiosum which is what contains your urethra. The tunica is bi-layered and includes an outer longitudinal layer and an inner circular layer. It is 5% elastin which is a protein that is highly elastic in nature hence the name and 95% collagen, understand there are 28 identified types of collagen. Now what happens with Peyronie’s disease is that parts of that highly elastic healthy tissue get replaced by what’s called a plaque, this isn’t to be confused with arterial plaque or anything like that, this is fibrous scar tissue that lacks the elasticity of the native tissue. It’s stiffer and often harder to the touch. Hawk, the founder of the Peyronie’s forum (PDS) described it as “like putting a piece of Scotch tape on a balloon and then blowing it up”. The resulting deformity can vary from a curve or bend to a dent or divot to loss of length and/or girth (penile circumference) to loss of rigidity. Another way to think about Peyronie’s using a balloon analogy is with a magician making balloon animals and by tying the balloons latex is layered changing the shape of the balloon from just a long ironically penis like tube to all sorts of bends and such. This translates to what some men with PD get thats referred to as hour glassing also known as narrowing. This is basically where girth is lost as a result of scar tissue on multiple sides preventing proper engorgement and in turn partial loss of penile girth along partial length of the shaft. Some men also get rings of scar tissue causing narrowing on a smaller but arguably as bad or worse scale, this almost always creates a weak spot susceptible to buckling where when force is applied the penis tends to bend and this is very painful.
Do I have Peyronies Disease? First and foremost, we are not doctors. We cannot diagnose you with Peyronies Disease (PD) over the internet. Prolonged pain is not normal and must be looked at by a doctor. The best we can do is hear your symptoms/story and let you know where we think you land by comparing experiences. Believe it or not, there can be other conditions that have similar symptoms but First off if you believe you have Peyronie’s but have not been diagnosed by a doctor then that should be your first official step. Get an appointment with a urologist, preferably one who specializes in Peyronie’s as a major part of their practice, unfortunately the vast majority of us this isn’t practical though because there just aren’t that many Peyronie’s specialists, so the next best option will be to find a urologist with advanced andrology training, these doctors will specialize in men’s sexual health exclusively unlike general urologist who may treat a wide variety of conditions in both men and women. Unlike some of the better known specialists, these doctors may have a fairly decent understanding of Peyronie’s but likely won’t be 100% up to date on all the current data on Peyronie’s but they’ll still be able to help you get a foundational treatment and a sound diagnosis and once established as a patient they’ll be able to help you pursue further treatments if need be.
Just because you have a curved penis when erect does not mean you have Peyronie’s disease, many men naturally have curvature just like how most people have facial asymmetry, there’s tons of variation in size and shape. Some men even have curvature as a result of uneven circumcision.
What is the cause of Peyronie’s disease? Unfortunately, that’s isn’t entirely known at this time. It’s safe to basically attribute to three things. First, trauma to the penis, this is most likely to occur during sex or masturbation, maybe you and your partner tend to get a little carried away and next thing you know your penis is sore the following day and for weeks if not months after, maybe you have a tendency to masturbate frequently for whatever reason it doesn’t really matter how the injury occurred, what matters is that it did occur and it’s healed improperly which brings up the second part. Genetics, why is your body forming fibrosis in your penis when these traumas occur naturally in most men but heal fine with healthy tissue? It would be silly too not possibly attribute this to genetics and there is data that does exactly that, in one study the research team found over 85% of patients that had either Peyronie’s or dupuytren's contracture (identical disease in the hands) had either a deletion or mutation of of the NELL1 gene on the 11th chromosome. Third is metabolic, the data isn’t clear on this but we do know diabetes is risk factor for Peyronie’s, also we do see anecdotal reports of fasting and low carb diets helping to improve the condition for some, regardless improving your metabolic health is probably a good idea from a longevity perspective anyways.
How to treat Peyronie’s? Unfortunately there is no definitive cure for Peyronie’s and everyone responds differently to treatment but there some ways to possibly stabilize and even reverse some of the disease development. When deciding what treatments to pursues there’s a few things you should consider: Efficacy (likelihood of working) Risk (Peyronie’s or overall health) Cost How invasive (most patients and providers start at the least invasive and progressively increase as needed) The severity of your symptoms
The reality of this disease is unless you do something to improve your symptoms there’s a very low chance of spontaneous improvement (<13%) and even less of total resolution (<5%) and I’d even be willing to bet that many of this patients either had very minor Peyronie’s to begin with or didn’t have at all in the first place and were misdiagnosed. The vast majority of men have the disease will stay the same or worsen, in fact in about 48% of men it will progressively worsen.
Peyronie’s is often considered easier to treat the earlier in the disease progression so the sooner you get started the better. For initial treatment I’d recommend a combination of OTC supplements and lifestyle changes. Both come with few if any side effects and will improve your overall health. The supplements are recommended by Urologist and back by data. CoQ10: 200-400mg per day (If over 40 yrs old, consider substituting for Ubiquinol, both can be a bit pricey tho) Acetyl/L-Carnitine: 4500-5000mg (very low bioavailability, 10-15%, trying to achieve around 500mg after first pass metabolism) L-Arginine or L-Citrulline: 4000-6000mg (feel free to work up from 2000mg as that’s what Dr.Levine recommends in conjunction with Pentoxifylline)
If your going to masturbate use lubricant and if you really want to then possibly consider using castor oil, it works well and is anti-inflammatory.
If your circumcised you may want to consider also using some sort of skin moisturizer to soften and improve skin sensitivity. There are moisturizer’s specifically designed for this that I’m sure work but are a bit on the expensive side so I’d just recommend something fragrance free, I like the standard CeraVe cream that comes in a tub.
Traction therapy, you don’t need a prescription to buy a traction device and there are multiple types and options. Traction is very low risk to do and as long as you follow the instructions you should be fairly safe, you can even modify the devices at home to make them more comfortable. I’ve written an entire Traction guide on our discord and I’ll repost it on Reddit but to summarize it for this post I’ll say this, Traction is the most proven and effective non-invasive option we have, it’s also the most cost effective. It’s worth exploring regardless of where your at in this disease with the exception of already having a penile prosthesis, whether you think you’ve just started to develop PD or have had it for years and live with severe curvature, Traction can help even if used as mono therapy but it will work better when combined with other treatments like heat and VED.
The most recommended traction devices on the market currently are the Penimaster Pro and the RestoreX, the former being quite comfortable to wear and follows the mantra of duration>tension, meaning it’s meant to be worn for multiple hours per day with lower tension and can be done easily, even under clothing (not super tight tho), this is probably best for early and more mild cases but will work regardless. The restoreX is the opposite short duration, high tension, less time, it’s also widely viewed as less comfortable but this can be improved through at home modification, this device is probably better suited for more severe cases that are chronic.
Heat: heat therapy is something that’s gained some support in the Peyronie’s space, especially after a video by a YouTube named Neoman made a few videos about it (https://youtu.be/gPfsF4KQPRg) where he discusses heat therapy for Peyronie’s and references some studies on the topic, this is something that is still debated but what I can tell you is it it something that’s affordable for most, low risk (just try to stay around 40 degrees Celsius and below) and generally helps with pain, In fact most guys I’ve talked to who’ve tried say it feels quite good as well. It also aids with blood flow and can help thin your blood, this aids with hematoma, this is basic stuff frankly. There’s another element of heat that’s quite sound in science but I’ve never seen discussed in a Peyronie’s context and that’s cell growth and cell health, temperature effects cell growth and in mammals 37-40 degrees Celsius is an ideal range for cell growth, this basically means that heat + traction is going be more conducive to cell growth than traction alone.
For pain management you can use OTC NSAIDs such as ibuprofen. Topical NSAIDs like Voltaren can be used too, just be cautious of using both oral and topical NSAIDs at the same time. If your taking Pentoxifylline and have a prescription for meloxicam be careful mixing the two as it’s recommended to not take both at the same time.
If you smoke cigarettes or use other products that contain nicotine it may be a good idea to stop as nicotine is vasoconstrictive which is antagonistic to healing and erection quality.
If you consume a lot of caffeine or a lot of stimulants be aware of possible vasoconstriction, caffeine can help with vasodilation but within limits, after a certain point it can’t actually do the opposite and cause vasoconstriction so mindlessly consuming stimulants throughout the day is not advisable. If you have a hard time getting through the day without caffeine maybe consider something like the Keto diet that will help stabilize blood sugar concentrations limiting highs and lows and creating more of a steady state.
Before you start any treatments it is a good idea to establish a baseline, this is how you can monitor progress of the disease or the effectiveness of the treatment. Start by getting a measuring tape (like what a Taylor would use, not a metal one like what would be used by a carpenter) and a ruler. Once you have a means to measure press it into your body until it’s up against your pubic bone aka the pubis, if your overweight you may have a harder time but you can still do it, you just might have to press harder the compress 1-3 inches of fat or you can measure your exposed penis then measure your fat pad. Try to do this in the same position too, If you have pelvic rotation it may be best to do this while laying flat on your back because otherwise your length may be less than it actually is due to poor posture or pelvic floor issues. Once you’ve measure length move on to girth, this may include measuring multiple points on the shaft especially if there is clear visual hour glassing. Make sure if you are measuring multiple points you can recreate them which is why I’d recommend taking notes of your measurements and including these details that way it’s not left to memory as details may fade over time. Next you may want to measure angle of curvature, this can be done by either using a protractor on directly or by taking a photo while erect and measuring it then (the latter will probably be easier). You can print off a protractor from the internet.
Improve sleep hygiene and try maximize restful Sleep, this will increase testosterone production especially after the age of the thirty because pulsatile testosterone production decreases as you age meaning the only meaningful production will occur during sleep. Reducing cortisol levels aka the stress hormone helps too because your body can only make testosterone or cortisol at any given time but not both. Reducing body fat and not drinking alcohol will also increase testosterone by reducing estrogen which is what triggers negative feedback for the HPTA, basically when our estrogen gets high enough it tells our body through negative feedback to quit making testosterone and it does so. This is because testosterone is converted to estrogen via aromatase which happens in via aromatase enzyme which is found in adipose tissue (body fat). Alcohol lowers testosterone through a variety of means which I won’t detail but a quick google search will explain the why. Having higher testosterone has a variety of benefits for male health but in a PD context but two that matter the most are the metabolic benefits and even more so the sexual function benefits, testosterone is a potent vasodilator and will improve erection quality on that alone, especially when the higher the testosterone to estrogen ratio (estrogen does have health benefits though). Besides improving erectile quality, the better blood flow will aid in healing and reducing the severity of the micro-traumas that cause PD.
So what’s the first official step? Well hopefully you followed someone’s advice on going to a Doctor, specifically a urologist, again one who specializes in men’s sexual function and ideally Peyronie’s but obviously sometimes the cards we’re dealt. Depending on where you live, your insurance, so on you will likely need a referral from you primary care provider but some specialists don’t require that and some even offer online telemedicine consultations. Here are a few things you want accomplish during an in person visit. The first is a hands on exam, frankly for some this may be all that’s needed to procure a diagnosis but it may miss out of some of the less obvious details. Second is a duplex Doppler ultrasound to actually visually see the plaque(s) in question as well as blood flow. Thirdly is a prescription of pentoxifylline (400mg, 3x per day with food) and some sort of erectile dysfunction drug, Cialis(tadalafil) seems to be the more popular one compared to viagra (acquiring a prescription can be done online via telemedicine, especially for ED)then you would then add an over the counter nitrate such as L-Arginine or L-Citrulline and you would take this with your Pentoxifylline, this is basically a modernized version of the PAV cocktail which is Pentox, Arginine and viagra. Understand that it can be unsafe to take nitrates while also taking tadalafil as this can lower blood pressure too much so I would suggest sticking to tadalafil (cialis) over a nitrate but if you don’t respond well or have intolerable side effects then switching to nitrates in an efficacious dose may be wise. They will likely be supportive to the idea using traction and likely VED as well. After a year or more of this protocol they may recommend considering surgery suggesting less invasive treatments were ineffective or your unable to have satisfactory sexual intercourse. They would advise waiting until after the acute/active phase to administer Xiaflex injections
Understand if you have dents/divots and/or axial instability/hinge effect, surgery may be the only solution but with a skilled surgeon the outcome has a high likelihood of success and equally as high satisfaction if not higher. There are a variety surgical options available through a some highly skilled surgeons who specialize in Peyronie’s disease and erectile function. Their success and satisfaction rates reflect this with their patients often regretting to not pursuing surgery sooner and suffering for longer than necessary. Implants are becoming quite popular for a reason as some argue that it’s basically an enhancement compared to a natural penis. The only major downsides currently being if your surgeon isn’t that confident they may undersized you and the fact that you may need revision to replace a worn out implant every 10-15 years on average but luckily implants have a lifetime warranty so buy once, cry once. Implants also stop the progression of the disease in the tracks. If you want to know more about implants and other surgical options I highly recommend checking out the https://www.peyroniesforum.net/index.php as it has a ton of great information in general as well as some very knowledgeable members and journals from actual implant patients. The founder, Hawk is very knowledgeable having an implant himself and regularly replies on posts. He asks that you don’t message him directly but instead post on the open forum under whatever section is relevant to the topic you wish to discuss as to cultivate informative discussion around said topic.
Preparing for your doctors visit: 1. Don’t be shy, the doctor deals with personal stuff all the time, it’s their job. 2. If possible provide a picture of your erect penis post development of this condition (who knows, maybe you have a collection) 3. If your have a spouse/partner bring them along if possible, they can take notes or remind you of questions, also the doctor may be able to help them understand what’s going on if needed 4. Take some studies, especially on pentoxifylline Pentoxifylline Attenuates Transforming Growth Factor- β1-Stimulated Elastogenesis in Human Tunica Albuginea-Derived Fibroblasts Part 2: Interference in a TGF- β1/Smad-Dependent Mechanism and Downregulation of AAT1 Pentoxifylline treatment and penile calcifications in men with Peyronie's disease Efficacy and safety evaluation of pentoxifylline associated with other antioxidants in medical treatment of Peyronie’s disease: a case-control study 5. Ask for full blood panel including total and free testosterone, estradiol, prostate-specific antigen and insulin. This can give insight for treatment and possibly find the cause of some issues
Post diagnosis: Well hopefully your experience was positive, your doctor was polite and knowledgeable. So if you were diagnosed with Peyronie’s after adequate and thorough examination you should now have a few prescriptions including pentoxifylline, this is probably the single best oral treatment you can get and I know some guys are curious to the side effects and get a big obsessive, understanding pentox is a cheap and widely available drug with a long lineage of deployment, it’s well tolerated and people rarely report notable side effects when taken in recommence doses, also 3x per day can be a bit tough to achieve, don’t worry, just do the best you can even if that means 2 most days, 3 some days and 1 here and there; it’s better than nothing.
Now if you haven’t gotten a traction device at this point, you really should because now that you actively trying to stop the disease you might as well try to reverse it too and remember it’s a marathon, not a sprint or a relay, your going to be responsible for most of your success or failure and nothing is going work overnight.
Psychological: Just like how we aren’t urologist, we aren’t psychologist either but we do know what it’s like to live with Peyronie’s disease and we know it’s not always strawberries and rainbows, it’s a major challenge that comes with the disease and it absolutely tears some guys apart. There are guys who have severe PD who date, marry and make babies while suffering with PD and on the flip side there are guys who’s lives fall apart. You attitude will define your outcome. As I said earlier “life is war we all lose but I want you to win some battles” and this is a battle that will inflict some damage but you can still win, just depends on what your willing to do but remember all is not lost.
When it comes to women, a commonly expressed complaint is that their partner who suffers from PD tend to shut them out and become less intimate, they refuse to actually discuss the condition. i understand some may become frustrated because it may seem like your partner doesn’t understand Peyronie’s disease but you have to remember if your partner is biologically female they don’t know what it’s like to even have a penis in the same way you don’t understand what it’s like to have a vagina, they can’t understand the pain of having this disease, both psychologically and physiologically, women don’t have to worry about their genitals becoming smaller and this then having an undesirable effect so they likely can’t conceptualize that very well and likely they may not really care about that .5-1 inch loss, just depends but you shouldn’t blame them, we can’t understand what it’s like to give birth or have some guy play “pin the dick on the cervix”. This is why communication is key, help them understand, help them conceptualize what’s going and why it matters. Give them the tools to understand and empathize, if your partner is decent at all once you do this they’ll likely have your back 1000% and you can become the Peyronie’s fighting duo you were destined to be. In all likelihood your Peyronie’s won’t be the downfall of any relationship as long as both parties care but a lack of communication and loss of intimacy will be.
With all that said I’ve only ever seen one example where someone’s partner was anything other than supportive although I’m sure other stories do exist but in this case it was on Reddit and the guy said his girlfriend mocked his Peyronie’s and when he expressed this on Reddit, on my other account I replied something along lines of “I’m sorry to hear that and your girlfriends a cunt” this message was rather well received and others iterated something similar on said post. If your in a similar situation with your partner or anyone else in your life it may be a good idea to remove them from your life, there are plenty of better people out there who will respect and support you and never forget there are millions of men worldwide with this disease, your not in this alone and you never will be, just open your eyes and know where to look.
Sincerely, Duminance, Co-founder of the Peyronie’s support group discord server and PeyroniesSupport subreddit.
This post shares a lot of similarities with this post on the PDS by Hawk https://www.peyroniesforum.net/index.php?topic=3180.0 and that’s on purpose, it’s great post, I was inspired basically just gave my modernized take on it.
P.S. Please don’t message moderators directly about Peyronie’s disease, Reddit is an open forum and should be treated as such, it will be much better as that way you can get multiple opinions and cross pollination and sufferers down the road may be helped by your post. Please reserve messaging moderators for subreddit related issues such as post violations, etc.
Email us at peyroniessg@gmail.com

Artist: SeeYouSpaceCowboy / If I Die First
Album: A Sure Disaster
Release Date: 14th May 2021
Cover Art: Here

Track Listing

Track	Title	Length
1	SeeYouSpaceCowboy - Painting A Clear Picture From A Unreliable Narrator	03:20
2	SeeYouSpaceCowboy - Modernizing The Myth Of Sisyphus	01:47
3	bloodstainedeyes	05:00
4	If I Die First - Mirror, Mirror This Is Nothing Like You Promised	02:21
5	If I Die First - My Nightmares Would Do Numbers As Horror Movies	03:14

Total length: 15min

Stream/Support:
bandcamp Spotify Youtube

Skippable Personal Story (TLDR at bottom)
When I was 20 years old I was a really skinny guy at 6'2 140 lbs. I didn't feel great about my body at all. I was self conscious, and even nervous of other people. I had gotten to be so skinny after terrible bouts of stress related IBS as a teen. Prior to that I was a gymnast, martial artist (judo), sponsor-able skateboarder, and was in really decent shape.
At some point I started wanting to do something about my body. So I started Googling how to gain muscle, long before fitness YouTubers mind you. I would come across all sorts of 3 month plans and diets on how to get into shape. Eventually I settled on one that was about $200 at the time. It had all the standards of modern day bullshit like radical before and after pictures.After a quick Google search I found the book for you guys. The program itself was not a bad program. It had mostly proper advice on diet and lifting for beginners. The problem is the promises. In the program it essentially made it out to seem like I could build up to have a movie star body in just 3 months. I did everything properly. I ate 6 meals a day as cleanly as I possibly could. I would hit up the gym 5 times a week and stick to my routine religiously. After 4 months I didn't look like how I wanted too, and I blamed myself for every bit of it. "I wasn't training hard enough", "I probably fucked up my diet in some way", etc. Nothing was farther from the truth, I put in my work, and it wasn't really till a year or so that I started seeing okay results.
After 3.5 years of 5 to 6 meals a day and training 5x a week, I would finally make it to 173 lbs 10% body fat, but I still wasn't happy with myself. I didn't look like the movie stars still. For the first year or two the amount of self blame I had was pretty much making me obsessive compulsive about training, diet, and sleep. And I'm not using the OCD term lightly, I never missed a meal or ate like shit. I actually didn't eat fast food or even at a restaurant for the first two years at all. After two years of watching people in the gym surpass me, countless stories of those who got what they wanted in a year or two, not feeling like I was working hard enough and actors getting buff for roles, I was finally approached at my local gym by one of my many training friends to buy some Dianabol (steroids). He was with a group of about 3 guys and openly stated "we're all on it. Watch the documentary Bigger, Stronger, Faster. The health risks are over exaggerated". After that people would start just talking openly around me about it at the gym, guys training for contests, power lifters, and it would lead me down a pretty big hole of understanding anabolic androgenic steroids and the hidden epidemic of male body dysmorphia in Western culture.
I was pretty sure that I was going to use Anabolic steroids (AAS), but never did. My hairline had receded the tiniest bit, and I didn't want to risk it. I would still try and come up with cycle idea that wouldn't impact my hairline, which would lead me down rabbit holes of steroid forums, and know it all bro scientists "dat spoke at u like dis", thought they were smarter than medical doctors, and would gatekeep the fuck out of AAS use.
After an event happening to my health taking away all of my muscle gains I would go deeper and deeper down the hole of AAS use. I even ordered roids, that I never used, off a guy on some local steroid forum. Given that I'm fascinated with politics, social structures, economics, and sociology - steroids had fascinated me from a societal perspective, but also scared the shit out of me. I'm not being hyperbolic when I say anabolic androgenic steroids pervades every bit of modern male culture and masculinity. It's a lie cultivated from a culture that worships personal responsibility to the degree of mass amounts of men secretly injecting themselves with an oil they bought off the internet that was probably mixed in some dudes garage.
TLDR: I was a skinny dude, started lifting at the gym, didn't see the results promised, and fond everyone at my gym was juicing. It lead me to the point of researching anabolic androgenic steroids.

Athletes

There is nothing more respected in modern western culture than athleticism. As a society we often swoon over the hard work and hustle stories of athletes waking up at 5am to start training. Every culture respects these people to the degree that it could be said that the Olympics is just a fight to see what countries culture is representatively creates the better, smarter, worker.
Over the past couple of years we've had documentaries, like Icarus, that have given light to Russian doping scandals. The problem is that the Americans, and every other nation, is either probably just as guilty of having doping programs. The difference between the other countries is that their doping is probably on a private level with select trainers, and not state sponsored.
I know what I'm saying is controversial, because athletics are one of the things at the heart of national pride, but it's absolutely true. Here is Dr Wade Exum, who was director of anti doping at the US Olympic Committee saying 2000 American athletes failed their drug tests. He found out his job wasn't to catch American Olympians using drugs, it was to hide it. This might not be enough for some, so let's just apply basic logic here. In the 1960's the East Germans started a massive state sponsored doping scandal, we also know about Russia, and potentially China. These are countries that put every single bit of the states resources into their athletes, what brings you to the thoughts that other Western teams could routinely compete with other countries that are known to dope? I'm sure there are genetic freaks out there, but stating that they're all in America to be able to compete like that? Come on.
Your favourite athlete is probably on gear (AAS). It's not just the Olympics. UFC and Pride were notorious for steroid use before trying to make it a more palatable sport for the American masses. Jose Canseco disclosed that the top baseball players were using anabolic steroids and it lead to them having to testify in front of congress. So many people were caught doping in the Tour De France, Lance Armstrong being one, that it was nicknamed the Tour de shame. Steroids have even been said to be used in fucking golf to give people longer drives. Why would athletes use these substances? A recruiter comes to you telling you your gifted at a sport and we'll sign you for a contract for 40 million dollars on the condition you bulk up, what would you do? Then there's coming back from injuries, and being able to push the age that you can compete at professional level. The incentive to use far exceeds the incentive to not use anabolic steroids.
You're probably saying to yourself: testing. There are evasive ways to get through it. Here's a short brief lesson in testosterone. It's a hormone that has a key role in building and maintaining muscle. Your testosterone levels can massively fluctuate through the day, week, month, and year. Having too little of sleep, a vitamin deficiency, diet, and over training can wreck havoc on your natural testosterone levels. Anabolic steroids are essentially just derivatives of testosterone that in most cases are taken at supraphysiological levels. You naturally produce roughly 50 to 80mgs of testosterone a week. In a cycle of steroids you usually start by taking 400 to 500mgs of testosterone a week, and veteran bodybuilders get into grams of the stuff. In the off season an athlete might cycle and take high amounts, in season they might just be able to artificially maintain a naturally high level of testosterone all of the time using steroids with out the fear of over training or a bad night of sleep. Then there's short duration cycles, now this one might piss the conventional steroid user off, but I've heard of athletes using steroids that exit the blood stream quickly in 2 to 3 week durations. All of this can help evade detection.
There's a mass amount of cognitive dissonance on this subject. People don't want to see their favourite athlete, and in many cases the pride of their nation, as cheaters. There's too much culturally at stake. Sports allow us to feel like we can work hard and achieve in our own lives, they're motivational for us. To take all of that away by stating that most people are cheating? It's a tough sell, but I'm here to make the claim.

Celebrities

The top most attractive men in the 1970's and 80's that I can think of are Robert Redford, John Travolta, Al Pacino, Mark Hamill, Michael Jackson, and so on. The most attractive celebs now are men that have mostly gotten in stellar shape for movie roles that mostly involve superheros. The men from the 70's and 80's are notably smaller in size than the men now. One of my favourite parts of Bigger Stronger Faster (a doc about steroids), is when Harvard Psychiatrist Harrison Pope shows the differences in sizes of action figures throughout the generations.
It's clear over time that you have steroidal transformations in celebrities that are happening for movie roles. Christian Bale was said to put on 80 (Or 100?) pounds in months after The Machinist for Batman It's not uncommon anymore for a celeb, in their 40's, to get absolutely shreded for a role in a span of months; which mostly physically not possible.
To dive into Carl Jung for a second to explain this as a problem is we tend to identify our lives with archetypes that we see in popular culture, the main one being the hero. Men are now basing themselves on hero's we see in popular culture that are using substances to artificially create a unmaintainable body without serious health risks. These are the archetypes that not only men are setting out to be, but children as well.
There's now a few steroid using bodybuilders, like Derek From more Plates More Dates that are finally calling out these celebs for their generic answers for how they got big. Even celebs sorta say it themselves that this is unnatural. They can't directly say it, because they're being paid shut up about it, but one of my favourite videos is Rob from It's Always Sunny taking a big gulp when steroids are brought up and becoming very sarcastic to elude to that he's just an unnatural freak of nature..
Then there's a whole mass amount of instagram users that are using for a variety of reasons, whether it be to become an influencer who peddles shitty supplements, or who cares. But they still have a massive amount of influence on young people.
There's a really decent YouTube video about celebrity transformations for those who are interested.

Impacts

Let's talk about dating first.
Harvard University researchers gave questionnaires to 1,726 people between the ages of 18 and 65 and found that 17% of them used dating apps. The results?

• 11.7% of the women who used dating apps had used laxatives as a means of losing weight, as compared to 18.8% of the men.
• 9% of the women had used vomiting for weight control, as compared to 16% of the men.
• 30% of the women had used fasting, as compared to 36% of the men.
• 13% of the women had used diet pills, as compared to 16.7% of the men.
• 7.9% of the women had used bodybuilding supplements, as compared to 28.7% of the men.
• 4.8% of the women had used steroids, as compared to 14.6% of the men.

Citation: Tran, Alvin, et al. "Dating app use and unhealthy weight control behaviors among a sample of U.S. adults: a cross-sectional study," Journal of Eating Disorders, May 31, 2019.
As I remember a substantial of gay men use anabolic steroids as well.
To get into this a little bit more, you don't need to be ripped up to get a girlfriend. Different women are attracted to different things. However, the business of everyday life for the modern youth worker is forcing the dating world to be more and more online. Tech companies have found that they can algorithmically assign you a number that will display you to more people on their services. The higher amount of 'yeses/likes' you accumulate the more people you're exposed to.
This is where the incentives to take anabolic steroids become absurd again. Let's say you're a single guy in your late 20's in a profession that forces you to work 60 hours a week. Are you really going to have the time to prepare all of those meals, hit the gym 3 to 6 times a week, date, and maintain other obligations? Absolutely not. You're going to be forced onto apps where women don't know you and you don't know them. The first challenge becomes matching with someone that you know nothing about and are attracted too, which most men just don't. Then the second challenge after matching with someone you're physically attracted to becomes matching with someone that you're emotionally attracted too. The higher amount of accumulated likes means more people will see you and potentially match with you. The more people that match with you the higher chance you have at just finding basic love.
Now, I know what some women will say. I don't need a guy that is build like Zac Efron. I'm not saying you do. I'm saying that we need more women to like us to rank higher just to be able to be shown to you. Also, you'd be surprised that even just in shape guys use anabolics. In a lot of cases you're not going to be an ultra hunk, just someone in moderately good looking shape. Also, I'm not even stating that women we're attracted too need to be super models.
General impacts
The anabolic steroid communities, at least what I remember them as, are filled with people that think AAS should only be used for powerlifting, bodybuilding and sports, but the mass majority of steroid users are doing so to look good. There used to be an animosity for users that used it just to look good. According to the Journal of the International Society of Sports Nutrition only 6% of steroid users are athletes or bodybuilders.
A Mayo Clinic report reported that as many as 1 in 20 teenagers use steroids to increase muscle mass. According to the Monitoring the Future Study (2016), steroids are used by 1.0% of 8th graders, 1.2% of 10th graders, and 2.3% of 12th graders. In 2013, the FDA estimated that among these high school users, each year 375,000 young men and 175,000 young women are using steroids at the level of abuse.
The health impacts are going to be pretty massive. In his book, America on Steroids: A Time to Heal: Bro-Science vs Evidence Based Medicine, Dr. Thomas O’Connor argues that we are seeing a burgeoning epidemic of anabolic steroid induced hypogonadism that makes 15 to 30% of user chemically dependant, or even addicted, to anabolic steroids for the rest of their life. He also states that getting help from a medical doctor after damaging your HPTA (Hypothalamic–pituitary–gonadal axis), leaving men susceptible to depression and even suicide, among other physical health problems.

Summary

I think anabolic steroids represents a lot of the hidden problems that men are going through. It's a totally secretive behaviour that you're mostly alone with, much like mens mental health and how they feel about themselves. It shows how entirely overworked we are. It shows how desperate we are in the dating world. How personal responsibility can be taken to extremes. It shows us that our hero's are humans that choose to push unreasonable standards for men; while not following those standards themselves. It shows how society routinely fails young men, and sets them up to deal with their problems in isolation. It shows that we're being lied to in masses in a world where institutional trust is degrading by the day. It shows that we'll probably continue to fail men by not allowing them to get the help they need if they do choose such a path. It shows that tech has tried to solve problems while just exacerbating them for profits. I think it most of all it shows how much we crave feeling safety and acceptance.

Disclaimers

• It might seem like I am stigmatizing anabolic steroid use. I'm not. I don't think anyone should care what others put in their body. However; I do think if you're of significant influence you should at least admit it.
  
• There's man reasons to do AAS outside of just getting dates. I use this as a fast example
  
• I didn't really read through this. Just spent an hour or so going from the top of my head.
  
• In regards to sports, I think AAS use is so prevalent that it might as well be allowed.
  
• This is not me telling you to do AAS. However, if you do make sure you really know what you're doing. Get blood work. Know how to train and diet. Know how post cycle therapies. Be careful of what you read online. There's many things you can do to increase your test naturally though: like sleep, destress, don't overtrain, eat a proper diet, and figure out any nutrient deficiencies
  
• These are opinions. I'm not writing a thesis here. I'm getting things off my chest. I'm happy to be wrong. I'm sure I am in areas.
  

So I got my hormones tested. Not a comprehensive test but enough to get a picture of my hormone profile;
D.H.E.A. SULPHATE 4.780 umol/L 0.44 - 13.40 FOLLICLE STIM. HORMONE *0.757 IU/L 1.50 - 12.40 LUTEINISING HORMONE 2.39 IU/L 1.70 - 8.60 TESTOSTERONE 15.51 nmol/L 7.60 - 31.40 SEX HORMONE BINDING GLOB *57.35 nmol/L 16.00 - 55.00 FREE ANDROGEN INDEX 27.04 Ratio 24.00 - 104.00
So- balls seem to be working fine but pituitary isn't producing much lh and fsh. Also SHBG is raised. Got tested because I'm struggling to recover from physical work and exercises. Joints and muscles hurt and take longer to recover, along with niggling injuries. Started to occur a year ago in coincidence with starting to eat a healthier diet (I lived on junk food the first 26 years of my life). I've upped calorie intake for a while but hasn't made much difference. Other than that- I'm lean, well above average strength, have a healthy sex drive with decent loads. Fairly masculine in most areas. Mentally I feel fine, don't lack energy and I have a pretty positive outlook. I was surprised at results as I 'feel' like I have high test in comparison to a lot of other people. Thinking of giving clomid a go to kickstart HPTA. Looking for general advice. Thanks