Penile curvature and TRT: separating fact from TikTok speculation

What did @drsusieg actually say?

In a brief TikTok, Dr. Susie made two core claims: first, that penises come in "all shapes and sizes" and mild curvature is "totally normal and healthy." Second, that curvature becomes a concern when it is "too noticeable, persistent, painful, and consistently shows up with an erection." She did not name a specific condition, offer a diagnosis, or explain the mechanism. The video ends with a Patreon pitch.

To her credit, she packed a clinically defensible message into a short format without overclaiming. But the brevity also means she left out information that actually matters to the men watching, specifically what the underlying condition is, how common it is, and what can actually be done about it.

Does the science back this up?

Yes, mostly. The science is solidly on her side for both points, though the nuance she skipped is not trivial.

Anatomical variation in penile curvature is well-documented. A 2010 study by Schneider et al. published in the Journal of Urology found that curvature up to approximately 30 degrees in any direction can exist without any underlying pathology and without affecting sexual function. Most urologists put the "normal" threshold somewhere in that range, though the cutoff is not perfectly standardized.

The four descriptors she used, noticeable, persistent, painful, and erection-specific, do align with clinical screening criteria for Peyronie's disease (PD). The 2015 AUA Guidelines on Peyronie's disease list penile pain, curvature, and deformity during erection as the hallmark presenting symptoms. Prevalence estimates for PD range from 0.5% to 13% depending on the study population, with a landmark study by Stuntz et al. (2016, PLOS ONE) suggesting true prevalence is substantially underdiagnosed.

What did they get wrong (or right)?

She got the basics right. Mild curvature is genuinely normal, and the warning signs she listed do reflect legitimate red flags clinicians look for. Credit where it is due.

What she got wrong is more about omission than commission. She never mentioned Peyronie's disease by name, which is almost certainly what she is describing when she references painful, persistent, erection-associated curvature. That omission matters because PD has actual treatment pathways. Collagenase clostridium histolyticum (Xiaflex) is FDA-approved specifically for Peyronie's disease and has clinical trial data behind it. Traction therapy also has supporting evidence (Moncada et al., 2019, Sexual Medicine Reviews).

Leaving men with a vague "see someone if it hurts" without naming the condition or the fact that it is treatable is a missed opportunity at best. At 4.4 million views, the public health math on that gap is not small.

What should you actually know?

If you are watching this video because something feels off, here is what is actually useful to understand.

• Congenital curvature (curvature you have had since puberty, painless, stable) is generally benign and rarely requires treatment unless it causes functional problems.
• Peyronie's disease is a connective tissue disorder. It involves scar tissue (a plaque) forming inside the tunica albuginea, the fibrous layer surrounding erectile tissue. This is not the same as congenital curvature.
• Pain during erection, especially in the acute phase of PD, can actually resolve on its own within 12 to 18 months. The curvature itself may or may not stabilize.
• Waiting and watching is a legitimate clinical strategy during the acute phase. Intervening too early with surgery is generally not recommended by the AUA.
• Testosterone replacement therapy does not cause Peyronie's disease, but low testosterone is associated with increased fibrous tissue changes in some studies (Moreno et al., 2021, Sexual Medicine). If you are on TRT and notice new curvature, that is worth discussing with your prescriber.
• A urologist, not a pelvic floor PT, is the appropriate first stop if you suspect PD. Pelvic floor therapy can be a useful adjunct but is not a primary treatment for Peyronie's.

Bottom line

Dr. Susie gave medically reasonable general guidance in a very compressed format. The warning signs she described are real. But a video that gets 4.4 million views has an outsized responsibility to name the condition it is describing and point people toward actual treatment options. Calling it out is not nitpicking. It is the difference between a useful public health message and a teaser for a Patreon page.