My bend is about 35% down and slightly to the right. Though I have never felt a plaque of any kind, there is a small indent in the right side close to the base. I do not experience pain unless I undergo more than one erection in a short amount of time. In the past few years, I have noticed a definite decrease in size, strength, stamina and intensity of climax. My urine flow has decreased and my penis in the flaccid state is both smaller and more limp than it ever has been. I can achieve erections, but for a short period of time and with little to no build up to a less than satisfying orgasm. These problems seem to be worsening. I am 27 and do not want the condition to worsen. Does this sound like a specific condition or symptom of PD and if so, what can I do?

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Dr. Levine answers: This is a complex situation that you describe and given your youth it is likely that your curvature is a congenital one, but may be due to a progressive scarring that may be associated with Peyronie’s or just thickening due to the repetitive trauma. It is less likely that you have PD because you have no palpable plaque. A diminished intensity of orgasm is not unusual in the older man, which appears to be a natural change that occurs with aging, but in the young man this problem may be due to underlying neurological deficits but most commonly it is a psychodynamic problem. Unfortunately, once a man starts having sexual dysfunction the attention to that problem becomes intensified and this can result in further reduction or inhibition of one’s sexual response. The best treatment for this may be seeing a local sex therapist who may be able to help identify the triggers which inhibit your sexual response and may then result in an improved overall experience with time. It is also reasonable to have your testosterone checked as this can be associated with reduced libido and ejaculate volume.

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