Peyronie's in the Bedroom: How to Rebuild Intimacy and Confidence

“Many individuals affected by Peyronie’s disease experience low self-esteem and self-confidence about the appearance and functioning of their penis,” says Ryan Rahm-Knigge, PhD, sex therapist, psychologist, and assistant professor at the University of Minnesota’s Department of Family Medicine and Community Health in Minneapolis. “[They may have] concerns about decreased attractiveness, feeling like they or their penis are broken, worry about sexual functioning and if they can please their partners, or fear of being judged by others.”

With patience, therapeutic techniques, and psychological counseling, however, you can find positive ways to adapt and achieve intimacy while living with Peyronie’s disease.

Speaking candidly with your partner can be a good way to maintain intimacy and to work out the psychological, emotional, and physical challenges of Peyronie’s.

“You don’t have to delve into all the details [of Peyronie’s disease], but it will help if you share with your partner and open the lines of communication,” says Amarnath Rambhatla, MD, a urologist with Henry Ford Health in Detroit and a member of the American Urological Association. “That will help your partner be supportive, which can have a huge positive psychological impact.”

Talking about your situation objectively can help your partner better understand what you feel, Dr. Rahm-Knigge says. Some objective statements include:

• “I have some scar tissue on my penis.”
• “My penis has a curve or pain during erections.”
• “It’s hard for me to do some sexual activities because of pain, the curve, or difficulty with erections.”
• “I really want to be sexual or intimate with you, but I’m nervous because of the pain/the curve of my penis/I don’t know if I will have an erection. Can we talk about it?”

Be clear about what you enjoy and what doesn’t feel right, says Rosara Torrisi, PhD, LCSW, assistant professor at the Widener University Center for Human Sexuality Studies in Chester, Pennsylvania, and founder of the Long Island Institute of Sex Therapy in Syosset, New York. You may consider saying things such as:

• “I really like when we do ‘this,’ but doing this other thing isn’t really working for me.”
• “Could we try doing this? I think it might be good and might reduce pressure on my penis.”
• “There are ways to be intimate besides penetration I’d like to explore.”

There are many ways to feel physical and emotional intimacy with your partner beyond penetration and ejaculation. Dr. Torrisi suggests exploring intimacy options that don’t involve penetration to reduce pressure related to erections.

“I encourage patients to explore touch and play with their senses,” she says. Some approaches may be sharing how you enjoy the smell of certain candles, getting or giving a foot rub or back massage, or taking a warm bath together.

“Everybody is different,” Torrisi says. “Over the years, I’ve had patients who really enjoy painting their partner’s body. I have found people who really love eating naked next to each other, and some who find bringing them tea is more sexy than any sex they have had.”

Rahm-Knigge recommends exploring sensation and stimulation through toys, different types of lubricants, changing up ways of experiencing touch (pressure, temperature, duration, vibration, and what you are being touched with), and experimenting with sensations from other body parts.

If anxiety, depression, low self-worth, or fear of pain or worsening symptoms cause you to avoid intimacy and connection, visiting a sex therapist or mental health professional trained in sexuality can help.

“Working with a professional can help interrupt this cycle of pain and help individuals tailor strategies to address their specific concerns,” Rahm-Knigge says. “Working with a therapist early in the progression of the disease can prevent worsening emotional or sexual distress and maximize positive outcomes.”

• Peyronie’s disease, especially in its early stage, can make sex painful and create a strain on your self-image and relationship with your partner.
• Talking about your symptoms with your partner, in addition to what could work for you, is one way to maintain intimacy.
• Trying different options that explore touch and other sensations, as well as therapeutic techniques, can help you maintain a physical connection.
• Consider visiting a mental health professional or a sex therapist to help you find ways to build back your self-image and cope with the mental effects of Peyronie’s disease.