Maybe you’re seeing more of your forehead when you look in the mirror these days. 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).
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 fifty. If you currently use minoxidil for hair loss or are thinking of starting, you may have questions about its effects — and not just on your hairline.
Finasteride and minoxidil (or high-strength minoxidil) are the stars of the show when it comes to hair loss treatments. They’re also the only two drugs for hair loss approved by the FDA (U.S. Food and Drug Administration).
Finasteride is known to cause some sexual side effects in rare cases, but does minoxidil have side effects sexually as well? More to the point, does minoxidil cause ED (erectile dysfunction)?
Read on to learn about the common side effects of minoxidil and whether minoxidil causes erectile dysfunction and other sexual reactions.
Minoxidil (generic for brand-name Rogaine®) is FDA-approved as a hair loss and regrowth treatment. While the exact mechanism of how minoxidil works isn’t totally understood, we know a few critical things about the medication.
Think of minoxidil as a pre-work cup of coffee for your hair follicles — it wakes them up and gets them to work by moving the hair into active growth (known as the anagen phase of the hair growth cycle).
So, minoxidil works to help treat hair loss, but at what cost? We know you’re still wondering if minoxidil causes erectile dysfunction — because who wants to choose between great hair and a great sex life?
Good news: While some drugs — like antidepressants, blood pressure medications and medications for prostate cancer therapy — may cause erectile dysfunction, minoxidil isn’t typically considered one of them.
However, a 2016 study reviewed reports submitted to the FDA Adverse Event Reporting System (FAERS). It found eight reports of sexual side effects out of 92 cases of male minoxidil-exposed patients. These effects included diminished libido, loss of libido, erectile dysfunction, ejaculation disorder and 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.
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.
If you’ve heard through the grapevine that minoxidil causes sexual dysfunction or other sexual side effects, it’s possible your game of telephone got jumbled and minoxidil was mistaken for another hair loss medication.
Finasteride (also called Propecia®) is more likely to cause sexual side effects, but it’s still pretty rare. In clinical trials, about 1.3 percent of men who took finasteride experienced erectile dysfunction, compared to 0.7 percent of those who used a placebo.
A 2012 study on finasteride and sexual side effects showed that adverse sexual effects occurred in 2.1 to 3.8 percent of those studied. Erectile dysfunction was the most commonly reported issue, followed by ejaculatory dysfunction and loss of libido.
While it sounds intense, the side effects of finasteride seem to be pretty manageable — only 1.2 percent of men who participated in finasteride clinical trials stopped using their medication because of the side effects.
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 come to the scalp.
For hair loss, minoxidil is a topical treatment applied directly to the scalp. Oral minoxidil for hair loss, while promising, is still considered an off-label use — it’s typically prescribed to lower blood pressure.
You can use finasteride topically as well. And — humble brag — our topical finasteride & minoxidil spray makes it easy to use the two together. This potent combo is known to increase the effectiveness of each while being just as safe as using either on its own.
As mentioned, minoxidil is a vasodilator. The medication was originally used to treat high blood pressure (hypertension), and it’s still used for this purpose in a pill called Loniten®. But minoxidil also had an unexpected good side effect for hypertension patients — it caused hair growth.
Like many medications, minoxidil comes with not-so-great side effects, but it’s generally considered a safe drug, even for use in children. We’ll go over some of the more common side effects below.
The most common adverse effect of topical minoxidil is dermatitis at the site of application, which causes itchy, scaly skin.
In some people, dermatitis is the result of simple irritation, but for others, it could signal an allergic reaction. This particular side effect is more common with the 5% concentration of the drug.
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.
Generic for Rogaine®, this FDA-approved over-the-counter version of topical minoxidil is used for regrowth on the crown of the head.
This is the FDA-approved dynamic duo. When used together, men saw better results in clinical trials compared to using either alone.
If you’re looking for something effective but don’t want too many steps in your routine, this once-a-day pill could be right for you.
Clinically proven to regrow hair in 3-6 months, no pills required.
Hypertrichosis (a fancy word for excessive hair growth) is another common adverse reaction of minoxidil. This is good for your scalp but not so great for your other body parts.
When hypertrichosis occurs, it’s typically seen with body hair — on the face, arms and legs. The issue usually resolves within one to five months after stopping minoxidil.
This side effect is most common with the 5% 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.
See our detailed guide to learn exactly how to apply minoxidil.
It seems weird, 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 is when 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.
The oral version of this medication may have different side effects.
Side effects of low-dose oral minoxidil include:
Hypertrichosis is the most commonly reported side effect of oral minoxidil. A few rare effects may occur in men treated with oral minoxidil. This includes headaches and generalized scalp and skin irritation, such as itchy skin or dryness.
“I tried several different options before but Hims combined approach of all four methods by far created the best results.”
“Hims has been the greatest confidence boost, no more bald jokes! I look and feel so much younger!”
“When I show my barber my progress, he is always in disbelief. I have to recommend Hims to any guy who’s experiencing thinning.”
“Cost effective and affordable. My hair keeps growing thicker, fuller, and at a fast rate.”
“I noticed a huge change in the overall health and fullness of my hairline.”
“Now after 5 months I’m able to style waves first time in 10 years!”
“I decided to jump right in and I'm so glad I did. I definitely feel ten years younger!”
“In just as little over two and half months, I can really see the difference in thickness and in color.”
“4-months strong and my confidence boosted back up to 100% using Hims, future me really does thank me.”
“I’m a 34-year-old father of two and have been using Hims for over a year now. My hair is back to what it was in my mid-twenties.”
Wondering if minoxidil causes side effects, sexually speaking? Read on for the TLDR on minoxidil and sexual side effects.
If you’re experiencing ED 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 solution 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 side effects, but they’re uncommon, not typically severe and most often resolve on their own.
Minoxidil has been studied for many years and is considered safe. 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 healthcare provider to discuss your options for hair loss prescriptions, supplements and other over-the-counter solutions.
To learn more about using finasteride and minoxidil together (and their side effects), check out our guide.
Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!
Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA.
Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world.
Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time.
Bachelor of Science, Life Sciences. United States Military Academy.
Doctor of Medicine. Tulane University School of Medicine
Dermatology Residency. San Antonio Uniformed Services Health Education Consortium
Board Certified. American Board of Dermatology
Wilson, L. M., Beasley, K. J., Sorrells, T. C., & Johnson, V. V. (2017). Congenital neurocristic cutaneous hamartoma with poliosis: A case report. Journal of cutaneous pathology, 44(11), 974–977. https://onlinelibrary.wiley.com/doi/10.1111/cup.13027
Banta, J., Beasley, K., Kobayashi, T., & Rohena, L. (2016). Encephalocraniocutaneous lipomatosis (Haberland syndrome): A mild case with bilateral cutaneous and ocular involvement. JAAD case reports, 2(2), 150–152. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867906/
Patterson, A. T., Beasley, K. J., & Kobayashi, T. T. (2016). Fibroelastolytic papulosis: histopathologic confirmation of disease spectrum variants in a single case. Journal of cutaneous pathology, 43(2), 142–147. https://onlinelibrary.wiley.com/doi/10.1111/cup.12569
Beasley, K., Panach, K., & Dominguez, A. R. (2016). Disseminated Candida tropicalis presenting with Ecthyma-Gangrenosum-like Lesions. Dermatology online journal, 22(1), 13030/qt7vg4n68j. https://pubmed.ncbi.nlm.nih.gov/26990472/
Kimes, K., Beasley, K., & Dalton, S. R. (2015). Eruptive milia and comedones during treatment with dovitinib. Dermatology online journal, 21(9), 13030/qt8kw141mb. https://pubmed.ncbi.nlm.nih.gov/26437285/
Miladi, A., Thomas, B. C., Beasley, K., & Meyerle, J. (2015). Angioimmunoblastic t-cell lymphoma presenting as purpura fulminans. Cutis, 95(2), 113–115. https://pubmed.ncbi.nlm.nih.gov/25750965/
Beasley K, Dai JM, Brown P, Lenz B, Hivnor CM. (2013). Ablative Fractional Versus Nonablative Fractional Lasers – Where Are We and How Do We Compare Differing Products?. Curr Dermatol Rep, 2, 135–143. https://link.springer.com/article/10.1007/s13671-013-0043-0
Siami P, Beasley K, Woolen S, Zahn J. (2012). A retrospective study evaluating the efficacy and tolerability of intra-abdominal once-yearly histrelin acetate subcutaneous implant in patients with advanced prostate cancer. UroToday Int J, June 5(3), art 26. https://www.urotoday.com/volume-5-2012/vol-5-issue-3/51132-a-retrospective-study-evaluating-the-efficacy-and-tolerability-of-intra-abdominal-once-yearly-histrelin-acetate-subcutaneous-implants-in-patients-with-advanced-prostate-cancer.html
Siami P, Beasley K. (2012). Dutasteride with As-Needed Tamsulosin in Men at Risk of Benign Prostate Hypertrophy Progression. UroToday Int J, Feb 5(1), art 93. https://www.urotoday.com/volume-5-2012/vol-5-issue-1/48691-dutasteride-with-as-needed-tamsulosin-in-men-at-risk-of-benign-prostatic-hypertrophy-progression.html