Whether it’s the size of the penis or its girth, society’s obsession with the phallus dates back to ancient times. The penis has long been used as a measure of masculine adequacy, especially when it comes to getting an erection. However, while some men have a penis that curves to the side, upward, or downward when erect, when does this curvature become something more significant?

The 'Normal' Curve

A bend in the penis is common among men when it’s erect due to the very nature of human anatomy rarely being perfectly symmetrical. During an erection, the blood vessels of the corpora cavernosa relax and open up, while blood rushes in through the cavernosus arteries to fill them and get trapped under high pressure to form the erection, according to the Cleveland Clinic.

The direction that an erect penis takes depends on the proportion of crus — penis under the skin — to exposed penis. This means men with a shorter crus and a longer penis will tend to have an erection that points downward, while those with a longer crus will have an erection that points outward or straight up. In some cases, the penis can bend to the left or to the right.

However, on occasion, a man could have a more extreme curve than most. The severity of the curve is determined by its level of pain, a possible symptom of Peyronie’s disease.

The Extreme Curve: Peyronie's Disease

Peyronie’s disease is characterized by the curvature of the penis and painful erections and most common among men ages 40 to 60, or older. Plaque builds up in the penis, which then progresses to hardened fibrous scar tissue under the skin, according to Medline Plus. Risk factors for this condition include penis injury during sex and surgery or radiation treatment for prostate cancer. The condition is also associated with Dupuytren’s contracture, which is a cord-like thickening across the palm of one or both hands. Doctors do speculate the condition may be inherited, since patients tend to have a certain type of immune cell marker.

Most men do not become fully aware of the severity of their condition until they have sex. According to Dr. Duana C. Welch, an expert in developmental psychology and author of Love Factually: 10 Proven Steps from I Wish to I Do, a curve that hits a woman’s G-spot can enhance sex. However, she told Medical Daily in an email, “but with Peyronie’s, the curve is often so pronounced, it can keep the penis from becoming fully erect, and such a curve can even prevent penetration altogether.”

While the condition may affect a man’s erection and penile curvature, it won’t affect sperm production. Dr. Eric Scott Sills, medical director at the Center for Advanced Genetics and a physician sub-specializing in reproductive endocrinology, IVF, surrogacy and fertility surgery in Carlsbad, Calif., reassures men it rarely hurts their chances of fertility. “I see these cases every so often, but the good news is that it rarely impacts reproductive outcome and fertility treatments are generally successful for couples,” he told Medical Daily in an email.

In general, there are men with the condition that get pain and there are others that don’t. Symptoms can get better over time for those in pain. It is possible for Peyronie’s disease to not take a toll on a man’s sex life, with the condition improving over time without treatment. This is known as the “watchful waiting” approach. In severe cases, Peyronie’s disease may be treated with surgery, but doctors recommend waiting at least 12 months to see if it improves on its own.

Remember, as long as erection, intercourse, and ejaculation are normal, Peyronie’s disease does not affect fertility. If you’re unsure of where your bend falls within the spectrum, it’s best to consult a urologist, and then get a second opinion.