Rogaine (minoxidil) and Propecia: (finasteride) Impact on Erections and Sexual Function


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 5 mg 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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Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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