Smoking can affect vascular health and erectile function, but its direct relationship with Peyronie’s Disease is not yet fully clarified.

The relationship between smoking and Peyronie’s Disease raises frequent questions, especially among men who want to understand whether smoking may be associated with vascular health and erectile function, or whether it may influence recovery after a therapeutic approach.

To date, it is not possible to conclude that smoking determines penile curvature or disease progression in all cases.

It is important to emphasize that Peyronie’s Disease has a multifactorial origin and smoking should not be presented as a proven cause of the condition.

However, the known effects of cigarette smoking on blood circulation and vascular health make it relevant when assessing male sexual health.

Smoking and Peyronie’s Disease: Is There a Relationship?

The association between smoking and Peyronie’s Disease is not fully clarified.

However, a multicenter study published in 2001 in the journal European Urology, found a significant association between smoking and Peyronie’s Disease. Men who smoked were more likely to develop the condition, leading the authors to consider smoking as a possible risk factor.

Even so, smoking should not be presented as a direct cause of Peyronie’s Disease, which has a multifactorial origin.

Some metabolic and vascular changes associated with the habit of smoking may be related to mechanisms involved in the formation of fibrotic plaques in the tunica albuginea, but the specific causal relationship and its impact on penile curvature are not established for all cases.

How Does Smoking Affect Erectile Function?

The relationship between smoking and erectile dysfunction is well established. The European Association of Urology includes smoking among the factors associated with erectile dysfunction.

Tobacco smoke and nicotine can contribute to endothelial dysfunction and vascular changes. They can also reduce the availability of nitric oxide, a molecule important for vessel relaxation and for increasing the blood flow necessary for erection.

This connection is particularly relevant in Peyronie’s Disease, because the condition has a higher prevalence among men with erectile dysfunction, while erectile dysfunction is common in patients with Peyronie’s Disease.

Moreover, when penile curvature and erectile dysfunction coexist, assessment of rigidity and vascular function can influence the choice of therapeutic approach.

Can Smoking Worsen the Symptoms of Peyronie’s Disease?

There is not enough basis to state that smoking directly increases curvature or that it causes progression of fibrosis. The progression of Peyronie’s varies from person to person, especially during the acute phase of Peyronie’s Disease.

Smoking, however, can contribute to vascular changes relevant to sexual function.

When there is reduced rigidity or difficulty maintaining an erection, attempts at penetration may promote bending of the penis and the occurrence of microtraumas. In predisposed men, these microtraumas are considered one of the mechanisms involved in the formation or worsening of the fibrosis characteristic of Peyronie’s Disease.

Can Smoking Affect Recovery After Surgery?

The recovery after penile surgery depends on multiple factors, and smoking may be associated with difficulties in recovery, namely because it can affect blood circulation, tissue oxygenation and wound healing. The relevance of this effect depends on the type of surgery, health conditions and other individual factors.

Smoking interferes with various essential processes in the postoperative period, such as blood circulation and tissue oxygenation, which can alter the inflammatory response and make postoperative healing more difficult.

In general surgery, there is evidence that smoking may be associated with adverse postoperative outcomes in different contexts.

A review published online in 2024 in the scientific journal Anesthesia & Analgesia concluded, with a high degree of certainty, that smoking cessation programs started at least four weeks before surgery can reduce complications, especially surgical site infections.

This does not mean that the same results can be automatically applied to surgery for Peyronie’s Disease. The specific evidence for penile surgery is more limited.

Can Quitting Smoking Improve Erectile Function?

Smoking cessation may help improve factors related to vascular health and, in some men, erectile function. However, it is not appropriate to state that quitting smoking restores erections.

The response depends on the duration and intensity of tobacco use, age, the presence of diabetes or hypertension, cardiovascular health and other factors.

Quitting smoking should be understood as a global health measure and as a way to reduce factors associated with erectile dysfunction.

When analyzing smoking and Peyronie’s, smoking cessation can benefit vascular health, but it should not be presented as a means to eliminate fibrosis or correct penile curvature.

What Else May Affect Recovery From Peyronie’s Disease?

Besides smoking, other factors can influence sexual function, the choice of therapeutic approach and recovery in men with Peyronie’s Disease.

Erectile function

The presence of erectile dysfunction and its impact on sexual activity should be evaluated before choosing between different treatment options.

Diabetes and metabolic health

Hypertension and cardiovascular disease

Hypertension and cardiovascular diseases can compromise blood circulation and are associated with erectile dysfunction. Since erection depends on adequate blood flow, cardiovascular health is an important aspect to consider in men with Peyronie’s Disease.

Weight and physical activity

Overweight and physical inactivity are associated with metabolic and cardiovascular changes that can also affect erectile function. Maintaining a healthy weight and engaging in regular physical activity contribute to vascular health and overall health.

Alcohol consumption

Excessive alcohol consumption can affect sexual function and contribute to other health problems. The amount and frequency of consumption should be considered in the overall health assessment, especially when there is regular or heavy intake.

Specialized follow-up

Peyronie’s Disease does not progress the same way in all men. Specialized evaluation allows analysis of curvature, erectile function, associated conditions and lifestyle habits to define an individualized and appropriate approach for each case.

When Should You Seek a Specialist Evaluation?

In men who smoke, the presence of any of the following signs or symptoms justifies considering a medical evaluation to clarify the possibility of Peyronie’s Disease, erectile dysfunction or another condition:

• Recent or progressive penile curvature;
• Pain during erection;
• A palpable plaque or nodule in the penis;
• Difficulty obtaining or maintaining an erection;
• Reduced rigidity;
• Difficulty in sexual activity;
• Change in penile length or girth.

Medical follow-up helps determine whether Peyronie’s, erectile dysfunction or another condition is present and allows defining the most appropriate approach.

Smoking should not be used to automatically explain any penile change.

If you have Peyronie’s, erectile dysfunction or recent changes in penile curvature, a specialized evaluation can help clarify the factors involved and define the most appropriate approach for your case.