Does Minoxidil (Rogaine) Cause Sexual Side Effects

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Noticing your hair thinning can be a distressing experience, whether it's a few extra strands in the shower drain or more substantial hair loss. Minoxidil (Men's Rogaine, Women's Rogaine) is a popular over-the-counter topical medication for hair loss. It's available as a topical foam, liquid solution, and spray. But low doses of oral minoxidil are also sometimes used off-label for this purpose.

If you've been exploring hair-loss treatment options, you may have heard that some medications, such as finasteride (Propecia), can impact your sex life. But does minoxidil also cause sexual side effects?

Does minoxidil cause sexual side effects?

It's not clear if minoxidil causes sexual side effects, since there haven't been clinical studies on the subject. But some people have reported experiencing side effects such as erectile dysfunction (ED) and decreased libido (sex drive) while taking it. Though, the number of reports is relatively low. And it's not known if these side effects were actually caused by minoxidil or something else.

Sexual side effects of minoxidil for men

As mentioned above, there have been some reports of sexual side effects with minoxidil. These reports, which included instances of ED, decreased libido, and ejaculation problems, have been from men specifically. Though, again, it's not clear if minoxidil was the cause. Plus, researchers think that topical minoxidil may even play a role in treating ED.

Sexual side effects of minoxidil for women

Sexual side effects such as libido changes haven't been reported by women taking minoxidil. Instead, most side effects from topical minoxidil, such as irritation, are limited to the scalp. Lightheadedness, swelling, and a fast heartbeat are possible with low doses of oral minoxidil for hair loss.

How common are sexual side effects with minoxidil?

Sexual side effects from minoxidil appear to be rare, if they happen at all. They weren't commonly reported during clinical trials involving topical minoxidil. And from 2004 to 2014, the FDA only received eight reports of sexual side effects from men using minoxidil for hair loss.

How can you manage sexual side effects from minoxidil?

If you notice changes in your libido or sexual performance after starting treatment with minoxidil, talk to your healthcare team. It's possible that other factors - such as hormonal changes, your age, or other medications - may be contributing to your symptoms. Your healthcare team can help figure out the cause of your symptoms and next steps. If there's no other obvious cause, they may have you stop taking minoxidil to see if that helps your symptoms.

Is minoxidil less likely to cause sexual side effects than other hair loss medications?

Generally, yes, minoxidil is less likely to cause sexual side effects than other hair-loss medications.

Other medications used for hair loss, such as finasteride (Propecia) and dutasteride (Avodart), work by lowering the amount of a hormone called dihydrotestosterone (DHT) in the body. Reductions in DHT can result in sexual side effects in some men. So side effects such as lower libido and ED are possible with finasteride and dutasteride.

Experts don't fully understand how minoxidil works for hair loss. But the medication is thought to stimulate and increase blood flow to hair follicles. It's not known to directly block DHT like finasteride and dutasteride.

If you're experiencing sexual side effects from finasteride or dutasteride, your prescriber may consider having you give minoxidil a try. And since topical minoxidil is applied to the scalp, it's less likely to cause body-wide side effects than finasteride and dutasteride. But if the topical side effects are bothersome, low-dose oral minoxidil may be an option.

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