Today, we have the pleasure of speaking with Dr. Marah Hehemann, an assistant professor of urology and the Associate Program Director of Andrology at the University of Washington in Seattle. Dr. Hehemann specializes in male sexual function and fertility and also practices clinically at the university.
Hair loss can be a distressing experience for many men, leading them to seek out treatments like minoxidil (Rogaine) and finasteride (Propecia). However, these popular medications may come with potential side effects that impact sexual function.
Minoxidil is unlikely to significantly affect erectile function when applied topically, as only about 1% of the medication is absorbed into the bloodstream. On the other hand, finasteride, which blocks the conversion of testosterone into dihydrotestosterone (DHT), has been associated with a 5-10% chance of negatively impacting sexual function, including reduced libido, erectile dysfunction, ejaculatory problems, and decreased sexual pleasure. These effects have been reported with both the higher 5mg dose used for benign prostatic hyperplasia (BPH) and the lower 1mg dose for male pattern baldness.
Concerningly, some men have experienced a condition called "post-finasteride syndrome," where sexual dysfunction persists even after discontinuing the medication.
While finasteride can be an effective treatment for hair loss and BPH, patients should carefully weigh the potential risks and benefits with their healthcare provider before starting this medication. Open communication and prompt reporting of any adverse effects are crucial for managing potential sexual side effects.
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