As a spouse of a PD patient, what is the best way to approach the “inadequate” mental state my husband experiences — ignore, encourage, be candid, recommend medical treatment?

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This is a very important question and I am delighted that you are concerned enough to address it in this website. Peyronie’s disease has been known for many years, but has recently been demonstrated in a proper trial to result in significant depression in the affected male. This is clearly because the penis is an important organ for men and for some, it truly defines them. Any alteration in the penis in terms of physical appearance or function can result in states of anxiety and mild to severe depression. Certainly, ignoring this problem will not help your husband and instead, I would recommend that you encourage him to see a qualified physician with experience in Peyronie’s disease who may be able to offer treatment to stabilize or possibly resolve the problem. What is important to remember is that the goal of the physician is to prevent progression of the Peyronie’s disease and also to try to restore function, but not necessarily to restore the appearance and condition of the penis to how it was before the Peyronie’s disease occurred. Usually there will be some residual loss of length, possibly some residual curvature and maybe even some erectile dysfunction. Support from spouses, sexual partners and family will be very important to the successful recovery of the affected man. Occasionally the depression can be so severe that counseling, sex therapy or even psychiatric care may be necessary and beneficial.