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The psychological aspects of Peyronie’s disease

Unpleasant pain. Sad unhappy handsome man sitting on the sofa and holding his forehead while having headache

Neither psychological impact assessment nor any psychological support for the individual and also the couple are considered in the intervention protocols. Yet depressive symptoms and anxiety and relational distress are extremely common in this area.
In fact, the disease, manifesting itself on the morphological and functional level, takes the form of a kind of “betrayal of the body” with effects that affect personal image and security as well as the quality of relationships.
To use a “technical” term, Peyronie ‘s represents a heavy
narcissistic wound
that needs time and help to heal.

Morphological alteration, seen as deformity/monstrosity, can give rise to a
dysmorphophobia
, i.e., an obsessive, exaggerated and pervasive preoccupation with the physical defect, resulting in altered body image and genital and sexual experience. Hence anxiety, depression, shame are associated with one’s sexual organ

Functional alteration can have as effect:

  • Erectile dysfunction, either as failure to have an erection or as difficulty maintaining it throughout intercourse;
  • Decreased sexual pleasure, due to pain (which may also affect the partner);
  • Sexual impediment, when the curve is such that penetration is impossible;
  • procreative difficulties.

A dangerous vicious cycle can be activated, defined as. Performanceanxiety , in which excessive preoccupation with sexual performance and partner satisfaction leads to avoidance of sexual intercourse, leading to a decrease in sex drive and a consequent lowering of self-esteem, with depressive effects.
All this naturally reverberates on the couple’s relationship, with the triggering of bad feelings, misunderstandings, etc., especially if due to shame or an unestablished relationship, there is no communication between the partners in this regard.
Therefore, it is important that on the part of the health care provider there be attention to grasping and emphasizing psychological aspects and risks, including providing the possibility of psychological counseling for both individuals and couples.
Such counseling would have the function of informing and reassuring the patient that something can be done but at the same time accompanying him or her to encounter the limitation that the disease represents and the redefinition of life and outlook that it entails.
Psychological counseling even more necessary if the patient is to undergo surgery, for reflection on expectations that may not be realistic or adequate.

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