Can Minoxidil Cause Sexual Side Effects?

Maybe your curiosity about minoxidil started when you noticed more of your forehead when you looked in the mirror. Or perhaps your kid asked for a ride on your shoulders only to drop a truth bomb while up there: You’re starting to get a bald spot. (Cue frantically taking 100 blurry selfies of the top of your head as soon as you’re alone.)

Minoxidil (along with finasteride) is one of the stars of hair loss treatment. It’s normal to worry about side effects when starting a new medication. Luckily, minoxidil hasn’t been linked to sexual side effects in clinical trials, and serious side effects are rare. 

Read on to learn about the potential side effects of minoxidil and why it’s unlikely to cause changes to your sexual health. 

• Sexual side effects of minoxidil haven’t been reported in clinical trials.

• Sexual side effects are among the most common side effects in people taking the oral medication finasteride to treat hair loss. This medication is often combined with minoxidil. 

• Some of the common side effects of minoxidil include scalp irritation and itchiness.

A receding hairline or bald patch could be a sign you’re experiencing male pattern baldness (also known as androgenetic alopecia) — which affects up to half of men by age 50. Although minoxidil may help slow or even somewhat reverse hair loss, it’s important to note all medications have some potential for side effects.

The good news is that while some drugs — like antidepressants, blood pressure medications, and medications for prostate cancer — may cause sexual problems like erectile dysfunction, minoxidil isn’t typically considered one of them.

Most of the common side effects of minoxidil are related to scalp irritation (more on those later). 

Does Minoxidil Cause Erectile Dysfunction (ED)?

Minoxidil is FDA-approved as a hair loss and regrowth treatment for people with male pattern hair loss. While the exact mechanism of how minoxidil works isn’t totally understood, we know a few critical things about the medication.

Minoxidil doesn’t alter your hormones in any way. It’s a vasodilator, meaning it widens blood vessels so more blood flow, oxygen, and nutrients reach your scalp.

Think of minoxidil as a pre-work cup of coffee for your hair follicles — it wakes them up and increases blood flow. These effects help move your hair follicles into active growth (known as the anagen phase of the hair growth cycle).

In a 2016 study, researchers reviewed reports submitted to the FDA Adverse Event Reporting System (FAERS). There were eight reports of sexual side effects out of 92 cases of men exposed to minoxidil. These effects included:

• Diminished libido

• Loss of libido

• Erectile dysfunction

• Ejaculation disorders

• Decreased seminal volume

That may sound like a lot. It would be easy to conclude that eight out of 92 minoxidil users experience ED as a side effect, which seems at odds with the fact that seconds ago, we told you minoxidil doesn’t cause ED.

Let’s break down the data.

First, the complaints aren’t from a random sample of minoxidil users — the study looked at only those who had filed anonymous reports. So, missing from the data set is everyone who had no minoxidil side effects, sexually or otherwise. Presumably, this is the majority of people. 

It’s also unclear whether these side effects were linked to the medication or occurred for unrelated reasons and if the reports were made by people who had taken oral minoxidil or used minoxidil foam or liquid minoxidil solution topically.

The sample is also incredibly small. We know 92 people may sound like a lot, but that’s nowhere near the typical standard for establishing clinical significance.

Although sexual side effects aren’t among the most common side effects of minoxidil, they are for the other major hair loss treatment called finasteride (sold as a generic and under the brand name Propecia^®).

Finasteride is an inhibitor of the conversion of testosterone into dihydrotestosterone (DHT), a hormone associated with hair loss.

In clinical trials, about 1.3 percent of men who took finasteride tablets experienced erectile dysfunction during the first year of treatment, compared to 0.7 percent of those who used a placebo. Only 1.2 percent of people discontinued the drug because of sexual side effects during that year, compared to 0.9 percent of people taking a placebo.

Other sexual problems reported in these trials included:

• Lower volume of semen when ejaculating

• Loss of libido (low sex drive)

Why Might Finasteride Be More Likely to Cause Sexual Side Effects?

The reason why finasteride might be more likely to cause sexual side effects than minoxidil may partially be explained by the way the two medications are generally administered.

Finasteride is only FDA-approved as an oral medication, and this is usually how it’s administered. It’s also available as a topical solution from compounding pharmacies, but researchers are still examining how effective this treatment is (some early studies look promising and suggest that this form may have fewer side effects).

Minoxidil is only FDA-approved as a topical solution applied directly to your scalp, although it may be prescribed as an oral drug for some people with high blood pressure who don’t respond to other treatments.

Oral drugs are generally carried through your bloodstream at higher concentrations than drugs applied to your skin. For example, only about 1.4 percent of minoxidil is absorbed through your skin, while about 95 percent would be absorbed by your gastrointestinal tract if you took it orally.

Because the concentration is higher for oral medications, these drugs are typically more likely to cause side effects affecting parts of your body other than the target area.

What About Minoxidil With Finasteride?

Minoxidil is often combined with finasteride. Research suggests combining these two medications is more effective than either medication alone. Our topical finasteride & minoxidil spray makes it easy to use the two together.

The side effects of finasteride also seem to typically be pretty manageable — only 1.2 percent of men who participated in finasteride clinical trials stopped using their medication because of the side effects in the first year.

Like many medications, minoxidil comes with some potential downsides, but it’s generally considered a safe drug and side effects of minoxidil aren’t usually sexual. 

We’ll go over some of the more common side effects below.

Dermatitis

One of the most common adverse effects of topical minoxidil is dermatitis at the site of application, which causes itchy, scaly skin. Dermatitis is a catch-all term for swelling or irritation of your skin.

Although the 5 percent concentration version of the drug seems to be more effective than the 2 percent, it’s also been linked to higher rates of side effects such as dermatitis. 

In cases where the reaction is allergic, minoxidil itself is rarely the culprit. In fact, allergic reactions to propylene glycol (a medication additive) are so common that there are now versions of minoxidil that don’t contain this ingredient — like our minoxidil foam. If you’ve experienced a reaction to other types of minoxidil, the foam might be a better option.

About 6.7 percent of side effects in clinical trials examining Rogaine containing 5 percent minoxidil were related to irritation causing mild to moderate pain. This side effect made up about 7 percent of side effects in the placebo group.

Hypertrichosis

Hypertrichosis (a fancy word for excessive hair growth) is another potential adverse reaction of minoxidil. This is good for your scalp but not so great for your other body parts.

In fact, this is how minoxidil was originally discovered to have hair growth benefits. It was first used to treat high blood pressure (hypertension), and it’s still used for this purpose in an oral pill called Loniten^®. In early studies examining the medication, minoxidil had an unexpected good side effect for hypertension patients — it caused hair growth.

But when hypertrichosis occurs, it’s typically seen with body hair — on the face, arms and legs. The issue usually resolves within months after stopping minoxidil. (It’s also been reported in infants from accidental skin-to-skin contact with treated areas.) 

This side effect is most common with the 5 percent application of topical minoxidil, and it’s more common in women than men. When applying minoxidil solution, make sure it only touches your scalp and doesn’t drip onto your face, neck or shoulders.

In a year-long clinical trial, hypertrichosis was seen in 3 out of 161 men (or 1.9 percent) using 5 percent minoxidil foam twice a week. 

Make sure you’re using this treatment appropriately with our detailed guide to how to apply minoxidil.

Hair Shedding

It seems counterintuitive, but minoxidil can sometimes cause a surprising side effect: increased hair shedding.

This is due to the drug’s shortening of the resting phase of the hair growth cycle. Known as the telogen phase, this iswhen a strand of hair completes its growth and falls out.

If minoxidil has this effect on a large portion of your individual hairs, you may notice a lot of shedding at once. The good news is it should resolve on its own in a few months. And remember, it’s actually normal to shed 50 to 100 hairs per day.

Other Potential Side Effects of Minoxidil

The oral version of this medication may have different side effects than the topical. 

Side effects of low-dose oral minoxidil include:

• Lightheadedness

• Fluid retention

• Tachycardia

• Headache

• Periorbital edema (Eye swelling)

• Insomnia

• Scalp and skin irritation or dryness

But hypertrichosis is the most commonly reported side effect of oral minoxidil. 

Learn more about the potential side effects of minoxidil and minoxidil interactions with other medications.

Wondering if minoxidil causes side effects, sexually speaking? Here’s the TL;DR on minoxidil and sexual side effects.

• If you’re experiencing sexual dysfunction and trying to figure out its root cause, you’re definitely not alone. Though it’s very unlikely minoxidil is the reason you’re experiencing the condition, erectile dysfunction treatments are available to help.

• On the other hand, if you’re on the fence about using the topical treatment because you’re wondering if minoxidil really does cause ED, don’t fret. Minoxidil is very unlikely to cause side effects sexually.

• Like most medications, minoxidil does have possible down sides, but most often they’re rare, mild, and resolve on their own.

• Minoxidil has been studied for many years and is considered a safe hair loss medication. But it comes with a risk of potential side effects, like hair shedding, irritation, redness and headaches.

Have questions about how treatment options for hair regrowth or hair thinning affect sexual function? Reach out to a dermatologist or other healthcare provider for medical advice and to discuss your options for hair loss prescriptions, supplements, and other over-the-counter solutions.

Learn more about using finasteride and minoxidil together (and their side effects).