Peyronie’s and Vitamin E: Science and Scientific Evidence
Peyronie’s disease causes curvature and deformity of the penis in males. It is characterised by localized inflammation of tunica albuginea layer of penis which heals with fibrosis. The exact cause is not known though many factors have been proposed and include repeated microtrauma, vasculitis and connective tissue disorder. A thick fibrotic plaque forms that consists of collagen and is palpable as a nodule. It results in localized changes in penile elasticity and an abnormal curvature causing a difficulty in coitus. Other symptoms include pain during an erection and erectile dysfunction.
The treatment options are multiple and depend on duration and severity of symptoms. The options include observation for spontaneous resolution, medical therapy and surgery. Observation is usually recommended in cases with mild symptoms and a curvature of penis lesser than 30°. Any curvature less than 30° may allow successful vaginal penetration during coitus. It may take 1 to 2 years for spontaneous resolution of inflammation though about 90% will require some form of therapy.
Medical management is offered to majority of men who are under observation for some time and show no significant improvement. Usually these men have penile angulation more than 30° or have associated erectile dysfunction.
Vitamin E has been used for the treatment of many conditions due to its antioxidant and anti-inflammatory properties. It is a fat soluble vitamin and is known for its therapeutic efficacy.
The trials involving vitamin E for Peyronie’s disease were based on the premise that it reduces oxidative damage caused by reactive oxygen species that induce inflammation. Due to this effect, it may suppress the inflammation involving tunica albuginea and reduce or prevent fibrosis associated disability.
A double blind study was conducted by researchers in 40 patients with Peyronie’s disease. The aim was to evaluate the role of vitamin E. The result of the study showed no significant improvement in the plaque size or penile curvature. Some of the side effects of vitamin E reported in such people were cerebrovascular events, nausea, vomiting, diarrhea, headache and dizziness.
Vitamin E was also tried in combination with propionyl-L-carnitine or colchicine, but the results showed no significant improvement.
No other clinical trial in such patient with vitamin E has shown any benefit. It is also important to mention that till date, there is no single drug therapy that is completely effective. Therefore, at present Vitamin E therapy for Peyronies disease is not recommended.
1. Sikka SC, Hellstrom WJ. Role of oxidative stress and antioxidants in Peyronie’s disease. Int J Impot Res 2002;14:353–60.
2. Pryor JP, Farell CF. Controlled clinical trial of Vitamin E in Peyronie’s disease. Prog Reprod Biol 1983; 9:41–5.
3. Safarinejad MR, Hosseini SY, Kolahi AA. Comparison of vitamin E and propionyl-L-carnitine, separately or in combination, in patients with early chronic Peyronie’s disease: a double-blind, placebo controlled, randomized study. J Urol 2007;178(4 Pt 1):1398–403.
4. Prieto Castro RM, Leva Vallejo ME, Regueiro L et al.: Combined treatment with vitamin E and colchicine in the early stages of Peyronie’s disease. BJU Int.91(6),522–524 (2003)