Oral Vitamin E Is Not Recommended for Peyronie's Disease

Guideline‑Based Recommendations

The 2025 European Association of Urology (EAU) guidelines state that oral vitamin E should not be used for Peyronie's disease because there is no proven efficacy and its use may postpone more effective interventions. Strong recommendation based on current evidence. 1
The 2015 American Urological Association (AUA) guidelines advise clinicians not to offer oral vitamin E (Moderate Recommendation; Evidence Strength Grade B), noting that such therapy can delay definitive treatment, fail to relieve patient distress, waste time, and increase costs. 3

Non‑steroidal anti‑inflammatory drugs (NSAIDs) are recommended for pain control in patients with active Peyronie's disease. 1
Daily low‑dose tadalafil (5 mg) has been shown to lower the rate of curvature progression during the active phase. 2

Intralesional collagenase clostridium histolyticum (FDA‑approved) produces a mean curvature reduction of ≈ 17° versus ≈ 9.3° with placebo. Level A evidence. 5
Penile traction therapy is considered safe and effective, requiring 2–8 hours of daily use to achieve benefit. Level B evidence. 1
Surgical correction is recommended for patients with stable disease persisting > 3–6 months when non‑invasive measures are insufficient. Level A evidence. 2

Prescribing oral vitamin E simply because patients request it or because it appears “harmless” is discouraged; it can delay definitive treatment during the critical therapeutic window. 4
Use of vitamin E creates false hope, prolongs patient distress, and wastes healthcare resources without demonstrable benefit. 4