Finasteride and Erectile Dysfunction: Can Hair Loss Pills Cause ED?
Health ConditionsMen's Health

Can Hair Loss Pills Cause Erectile Dysfunction?

Can Hair Loss Pills Cause Erectile Dysfunction?
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Published on February 19, 2026
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Many men face a difficult choice: treat hair loss or avoid the potential risk of erectile dysfunction (ED, or the inability to get or maintain an erection).

The relationship between hair loss pills and erectile dysfunction is complex, and it’s difficult to say with certainty whether these medications cause sexual problems. “Many affected men have comorbid conditions, like stress, anxiety, or metabolic syndrome, that can independently contribute to erectile dysfunction,” says Justin Houman, MD, a urologist with Tower Urology at Cedars-Sinai in Los Angeles.

Although the research is still ongoing and conflicting, some evidence suggests a potential connection between hair loss pills and sexual issues.

Which Hair Loss Pills Have Been Linked to Erectile Dysfunction?

Not every hair loss pill is linked to ED — and much of the research is still evolving. It’s important to speak to your doctor about what types of hair loss pills may be best for you based on your health history, existing conditions, and concerns.

“As with any long-term therapy, shared decision-making and regular monitoring ensure patients maintain both confidence and safety throughout treatment,” says Dr. Houman.

Finasteride and Erectile Dysfunction

Finasteride (brand names Propecia and Proscar) is an oral prescription medication used to treat hair loss in men.

Finasteride may lead to erectile dysfunction through its impact on male sex hormones. It blocks the 5α-reductase enzyme (a protein that speeds up chemical reactions in the body) that converts testosterone into dihydrotestosterone (DHT).

By lowering DHT levels, finasteride may reduce hormone activity in the prostate, penis, and nervous system. “The reduction of these hormone levels can interfere with the body’s ability to make nitric oxide which is important for libido, mood, and erections, explains Houman. “The result can be diminished sexual desire, weaker erections, or delayed orgasm in some men,” he adds.

The connection between hair loss pills and ED was discovered in research, including a 2018 meta-analysis that found men taking finasteride had a higher risk of sexual side effects compared with a placebo.

Other Hair Loss Drugs That Have Not Been Linked to Erectile Dysfunction

For men concerned about sexual side effects, there are other hair loss treatments that may carry lower risk.

Topical Finasteride Finasteride is also available in a topical spray, though no topical finasteride product has been approved by the U.S. Food and Drug Administration (FDA) for treating hair loss.

Topical finasteride significantly improves hair count compared to a placebo — similar to oral finasteride — but with less impact on DHT levels. In one randomized controlled trial, topical finasteride lowered DHT levels by nearly 35 percent, whereas oral finasteride lowered them by more than 50 percent.

“Topical finasteride seems to have less sexual side effects than oral finasteride, however patients can still develop sexual side effects from the topical form,” says Aron Nusbaum, MD, a board-certified dermatologist and hair loss specialist with the Miami Hair Institute in Florida, and hair loss specialist with the American Hair Loss Association. Topical finasteride still enters your bloodstream, but at more than 100 times lower levels than oral finasteride — meaning it’s less likely to cause whole-body side effects, including sexual side effects related to lowered DHT.

Minoxidil Minoxidil (Rogaine) is a topical over-the-counter treatment commonly used to stimulate hair growth.

 There is also an oral form of minoxidil, but it doesn’t have FDA approval for treating hair loss like the topical form.

 The oral form is used to treat high blood pressure, though some providers do prescribe it for hair loss with few reported side effects.

Research on minoxidil has largely focused on fertility rather than erectile dysfunction. Currently, there is no scientific consensus that it adversely affects male fertility, with research either mixed or inconclusive.

“For men concerned about sexual health, alternatives like minoxidil may offer a better risk-benefit profile,” says Houman. “It is generally well tolerated, though it carries cardiovascular rather than sexual risks.” It’s particularly important to speak to your doctor about the risks and benefits of minoxidil if you have heart disease, since it can cause fluid buildup or make problems resulting from heart attack or stroke worse.

The Latest Science on Finasteride and Sexual Health Side Effects

Early studies linked finasteride to sexual side effects in only about 1 to 2 percent of users — rates comparable to a placebo. But more recent research suggests these issues may be more common, says Houman. In one study comparing 25 men taking oral finasteride with 28 men who weren’t, 68 percent of finasteride users had reduced blood flow to the penis (a primary cause of ED).

The varying results in studies is likely because researchers looked at different groups of men and different doses, and asked about side effects in different ways, says Houman.

More recent studies and meta-analyses suggest that finasteride may slightly increase the risk of erectile dysfunction, particularly with higher doses and longer durations of use, he adds. For instance, one review found that erectile dysfunction is reported in up to 15.8 percent of patients treated with 5 milligrams (mg) of finasteride daily (compared with up to 6.3 percent with a placebo).

Researchers have also studied post-finasteride syndrome, a rare condition in which ED symptoms persist even after stopping finasteride.

 They found that symptoms, including loss of libido and erectile dysfunction, can last for years.

But the research is still limited: Most studies involve a small number of participants, including volunteers who may seek studies because they are having issues, which can skew results, says Houman. Plus, there aren’t objective lab tests to confirm what’s happening biologically yet, he adds.

Is Finasteride Erectile Dysfunction Reversible?

Some men report persistent sexual side effects after stopping finasteride. But research hasn’t confirmed whether finasteride causes these ongoing issues, as other medical conditions and medications can create similar ED symptoms.

Typically, side effects from medications resolve once you stop taking them.

 “Most men who experience sexual side effects see improvement after discontinuing finasteride, often within weeks to a few months,” says Houman.
If symptoms continue, your doctor may recommend several approaches to help. These can include lifestyle changes and exercise to improve hormone health, treatment for anxiety or depression, and medications for erectile dysfunction, Houman says. Research shows strong links between sexual wellness and psychological health, with worse mental health associated with more sexual dysfunction.

Other Risks and Side Effects for Finasteride and Other Hair Loss Drugs

Beyond sexual side effects, hair loss medications can cause other health concerns, like blood pressure changes and breast enlargement.

 Don’t hesitate to speak to your doctor if you’re concerned by new or unpleasant symptoms after starting a hair loss medication.

Oral Finasteride

Oral finasteride commonly causes:

More concerning, oral finasteride has also been linked to higher rates of depression and anxiety.

 Younger men may be particularly susceptible.

 Talk to your doctor right away if you experience any changes in mood while taking the medication.

Also, seek immediate medical attention if you experience confusion, cold sweats, sudden dizziness when standing, rapid weight gain, severe bloating, skin rash, or tingling in your hands or feet.

Topical Finasteride

The FDA has warned that compounded topical finasteride products — made on-site at a pharmacy or clinic to order — have been linked with the following side effects:

Topical Minoxidil

Topical minoxidil products typically cause milder side effects, including:

  • Changes in hair color or texture
  • Dizziness
  • Unexpected hair growth
But more serious allergic reactions — including burning, itching, or peeling skin — are also possible and require immediate medical attention.

The Takeaway

  • The hair loss medication finasteride may cause erectile dysfunction and other sexual side effects, such as low libido and delayed ejaculation.
  • Topical finasteride and minoxidil are alternatives that may carry lower sexual health risks than oral finasteride.
  • Most sexual side effects resolve within weeks to months are stopping finasteride, though some men report persistent symptoms.
  • Talk to your doctor right away if you are taking hair loss pills and notice new or concerning symptoms, including erectile dysfunction, depression, anxiety, or dizziness.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Finasteride (Oral Route). Mayo Clinic.
  2. Salisbury BH et al. 5α-Reductase Inhibitors. StatPearls Publishing. June 8, 2024.
  3. Lee S et al. Adverse Sexual Effects of Treatment with Finasteride or Dutasteride for Male Androgenetic Alopecia: A Systematic Review and Meta-Analysis. Advances in Dermatology and Venereology. September 11, 2018.
  4. FDA Alerts Health Care Providers, Compounders and Consumers of Potential Risks Associated With Compounded Topical Finasteride Products. U.S. Food and Drug Administration. April 22, 2025.
  5. Piraccini BM et al. Efficacy and Safety of Topical Finasteride Spray Solution for Male Androgenetic Alopecia: A Phase III, Randomized, Controlled Clinical Trial. Journal of the European Academy of Dermatology and Venereology. October 25, 2021.
  6. Minoxidil (Topical Route). Mayo Clinic.
  7. de Fátima Viana Santana Fe et al. Comparative Effects of Finasteride and Minoxidil on the Male Reproductive Organs: A Systematic Review of in Vitro and in Vivo Evidence. Toxicology and Applied Pharmacology. November 1, 2023.
  8. Oral Minoxidil Offers Strong Results Against Alopecia. Cleveland Clinic. October 13, 2022.
  9. Minoxidil (Oral Route). Mayo Clinic. January 1, 2026.
  10. Khera M et al. Penile Vascular Abnormalities in Young Men With Persistent Side Effects After Finasteride Use for the Treatment of Androgenic Alopecia. Translational Andrology and Urology. June 2020.
  11. Estill MC et al. Finasteride and Dutasteride for the Treatment of Male Androgenetic Alopecia: A Review of Efficacy and Reproductive Adverse Effects. Georgetown Medical Review. October 27, 2023.
  12. Lonergan EM et al. 8679 Case: The Sexual, Physical and Psychological Effects of Post-Finasteride Syndrome. Journal of the Endocrine Society. October 5, 2024.
  13. Frequently Asked Questions. Post-Finasteride Syndrome Foundation.
  14. Should I Worry About Finasteride Side Effects Even After Stopping the Drug? Harvard Medical School. September 11, 2021.
  15. Vasconcelos P et al. Associations Between Sexual Health and Well-Being: A Systematic Review. Bulletin of the World Health Association. November 4, 2024.
  16. Zito PM et al. Finasteride. StatPearls Publishing. February 28, 2024.
  17. Lyakhovitsky A et al. The Risk of Psychiatric Disorders in Finasteride Users With Benign Prostatic Hyperplasia and Androgenetic Alopecia: A Population-Based Case-Control Study. Australasian Journal of Dermatology. December 2024.
  18. Nguyen DD et al. Investigation of Suicidality and Psychological Adverse Events in Patients Treated With Finasteride. JAMA Dermatology. November 11, 2020.
  19. Side Effects of Finasteride. NHS. August 2, 2023.
  20. Minoxidil Topical Solution or Foam. Cleveland Clinic.
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Christopher Wolter, MD

Medical Reviewer

Christopher Wolter, MD, is an assistant professor in urology at Mayo Clinic in Phoenix, Arizona. He has been in practice since 2008, specializing in the areas of urinary incontinence, pelvic organ prolapse, urologic reconstruction, urologic prosthetics, post prostate cancer survivorship, erectile dysfunction, neurourology and neuromodulation, and overall functional considerations of urogenital health.

Dr. Wolter has been heavily involved in urologic education. He spent the last 12 years heavily involved in resident education and leadership for his department, including the last eight years as urology residency program director. He currently serves as the director of urologic education for the preclinical and clinical rotations for the Mayo Clinic Alix School of Medicine Phoenix, Arizona, campus.

Wolter completed his undergraduate and medical education at the University of Illinois. He then completed his urology residency at Tulane University in New Orleans, followed by a fellowship in female pelvic medicine and reconstructive urology at Vanderbilt University in Nashville, Tennessee.

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Kelsey Kloss

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Kelsey Kloss is a health and wellness journalist with over a decade of experience. She started her career as an in-house editor for brands including Reader’s Digest, Elle Decor, Good Housekeeping, Prevention, Woman's Day, and Redbook, and her work has been featured in over 50 publications.

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