Male 50 years old

[tek]

Hello
Since i remember myself i have had  a semi-hourglass effect on the right side of my penis 1cm from the base when i am erected.When i am flaccid this spot goes inside the body.
Though i have had this effect at least 25 years(i am sure because i recall an exact time that i have noticed it) my penis for all these tears was straight and 18+ cm.
Also a small downwards curve.


08/2023 at masturbation i noticed that the hole penis is looking to right side especially when i was not fully erected but also in full erection.

I noticed that i can fix this"bending" just by pulling the hernia area skin to the left and then the penis is again straight
08/2024 i visited  my doctor,he performed a flaccid ultrasound.
Found a very small hard nodule like at the area.

09/2024 started taking  L-arginin- vitamin E and CQ10  and these supplements gave me better noctural erections.
01/2025  i stopped suppllements and everything seemed stable.

07/2025 a new defomity suddenly appeared at the Coronal sulcus at the left side that cause  the penis head an 20 degree(as i see it) bending to left.At this point a palpates structure like hard veins.

After this incident i could not achive an erection probably because i didnt want to see the bending.Αlso lost 1.5-2cm in lenth
08/2025 while waiting appointment with doctor i made blood tests+testosterone+prolactin+TSH+blood sugar and performed a heart strees test.Everything was ok.
Startes myself daily cialis but stopped after 1 week because made my tinnitus worst

09/2025 ourologist with experience at peyronies performed ultrasound while erected with trimix with the above results
Left peak systolic velocity-PV=58.9 cm/sec
Left end diastolic velocity – EDV=0

Right peak systolic velocity-PVS=55.1 cm/sec
Right end diastolic velocity – EDV=0
ρesistance index – RI=1

Front Left(new deformity) At the level of the coronal sulcus, between the corpora cavernosa, a thickening of the tunica albuginea with calcification is observed.
Ventral curvature of the glans, approximately 40 degrees, noted at the level of the coronal sulcus

Base Right(old deformity).At the base of the penis, thickening of the tunica without calcification.Thinning of the penile shaft with a semi-hourglass deformity  effect  1cm from the base


Right and Left Corpora Cavernosa normal

Diagnosis=Peyronies


So doctor proposed
1.Daily Cialis
2.Traction with Restorex x
3.Four  sessions Shockwave+prp

He stated that while he has seen hundrends of patients, its the 3rd of 4th time that he saw 2 anti diametric deformities, one on the top left and one at the base right,and he considers  that this is positive mainly for helping it with straight traction.


Its time to take my decisions,considering all options, you are welcome to express your opinion.


1.Daily Cialis.I wll try 2.5 mg every other day to see if i can handle tinnitus
2.Traction with Restorex x.I will order immediately
3.Four  sessions Shockwave+prp.I didnt decided yet
4.I will start again L Argininine-Vitamin E + CQ10 and i will add Propolis

[Mikel7]

Welcome Tek to the forum and I'm sorry to hear about what you are going through. Thanks for the detailed info and if you could please fill out your signature line ==>Signature Line . Then you should download our survival guide==>Survival Guide . This will give you a lot of peyronies info and it's treatments.

I have tinnitus also and I can understand about Cialis possibly worsening it, but you could try using it EOD and it may only cause a mild increase. Remember that this is only temporary and should not cause any permanent damage. Cialis does help with reducing inflammation and bringing in fresh oxygenated blood. It also stretches things out so to speak.

I would say that you are wasting your money on the shockwave therapy as there isn't anyone who was helped with their peyronies. It is a big money maker for Dr's though.

Starting traction and keeping with it is your biggest helper! Also looking into VED therapy can also help with things. I would also ask when you had your Testosterone checked did the Dr do a free T test? Also was your estrogen levels checked? Some Dr's just look at lab ranges and don't subjectively look at their patients symptoms.

Also adopting a healthy lifestyle if you haven't already has helped men in reducing their overall body inflammation markers. Also worrying has killed more erections and sexual encounters than men realize and peyronies brings on a lot of anxiety itself.

Get a game plan and stick with it as you have to be your own advocate sometimes as there is not a lot of peyronies specialist out there. Hopefully you feel secure in working with your Dr at this point.  
     Mikel7

[tek]

Τhanks
Total Testosterone was 12.80nmol/L   (min 7.64-max 24.85)
PRL Prolaktin was 12.40 ng/ml(min 3-max 15)
TSH was 1.73 mIU/L(min 0.35-max 4.94)
PSA is always ok

No other hormones measured
You think i could check IGF1-DHT-Progesterone-DHEA-S-E1-E2?
something else?

[Mikel7]

Well the Testosterone test tells you nothing because it is only the free T that matters. A lot of total Testosterone is bound up in SHGB and unbound for male things.
He should have done a Free T test. I personally believe that your total T is way to low for. Also your prolactin is a little elevated. Yes you could check for DHT but because your total T is on the low side I can guarantee you that your DHT is low. It is the DHT that gives us males our sexuality along with a tiny bit of  estrogen and I say tiny.

Dhea is not of much use but you could ask for your E2 estradiol levels to be checked because when they are high it will affect your erections and libido.

[tek]

So Free T test+ DHT+ E2 estradiol
All these if i understand correct for better erections so better healing?

[Mikel7]

Yes that is correct. Now for some men as they age their DHT increases for some reason or another. It is the DHT and Free T that are the powerhouse of our libidos and erections. Although when a mans E2 (Estradiol) is high it can block the conversion of your Free T. So some DR's will focus on lowering your estrogen. Usually just loosing weight will lower your estrogen because of the aromatase enzyme that is stored in our fat cells. More aromatase enzyme = more estrogen conversion of your testosterone.
I can almost bet that if you got your free T levels up you would notice an improvement in your symptoms.

You need to take the Adam questionnaire for men's low T symptoms --> Adam Questionnaire

[tek]

Thanks i will check these levels

[tek]

Mikel7
Estradiol E2 is 18.50 pg/ml(min 11.30-max 43.20)
Free Testosterone is 6.37ng/dl(min 4.70-max 14.00)
waiting for DHT results