Can minoxidil cause erectile dysfunction and other sexual side effects?

Minoxidil (Rogaine) is one of the most popular medications for treating hair loss, available in topical or pill form. If you’re thinking about trying hair loss medication, you might be wondering whether minoxidil could cause erectile dysfunction (ED) since some other hair loss medications can cause ED.

Short answer: ED isn’t a common side effect of minoxidil. Keep reading to learn more.

It is very rare for minoxidil to cause erectile dysfunction. ED doesn’t show up on the usual list of minoxidil side effects, and no studies have found a direct link between the two. Still, there are some men who have reported ED while using minoxidil. 

From 2004 to 2014, the FDA received 92 safety reports from men using topical minoxidil. Only four of those reports mentioned erection problems. 

Because filing these reports is voluntary and we don’t know how many people actually use each drug, the numbers don’t tell us exactly how common this side effect really is; they do show that very few people who filed reports linked minoxidil to ED.

Some research shows that minoxidil may actually help with ED. But more studies are needed to confirm this.

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It isn’t likely for minoxidil to cause other sexual side effects, but they may be possible in rare cases. 

Potential (though, again, rare) sexual side effects of minoxidil may include:

• Erectile dysfunction

• Problems with ejaculation, such as premature ejaculation or delayed ejaculation

• Reduced sex drive

• Loss of libido

• Decreased semen volume

These are so rare that they are not included in the list of common side effects for minoxidil, but a small number of reports have been submitted to the FDA. 

From 2004 to 2014, the FDA received a total of eight reports regarding these sexual side effects. Four men reported ED, as mentioned, while the other sexual side effects were each reported only once. In other words, out of the many thousands of men taking minoxidil each year, we have fewer than 10 reported cases of sexual side effects.

Typical (non-sexual) side effects of minoxidil include:

• Hair shedding at the start of treatment

• Skin irritation, including redness, itching, or burning on the scalp

• Scaling or seborrheic dermatitis on the scalp

• Allergic contact dermatitis or eczema

• Increased hair growth on the scalp or other areas of the body

Yes, minoxidil is less likely to cause sexual side effects than other hair loss medications like finasteride and dutasteride. ED, decreased libido, and reduced ejaculate volume are known potential side effects of finasteride, affecting less than 5% of men in clinical trials. These sexual side effects are also common with dutasteride. ED and minoxidil, on the other hand, are such a rare mix that ED isn’t even listed as a potential side effect.

Finasteride and dutasteride are more likely to cause sexual side effects because they lower levels of dihydrotestosterone (DHT, a male sex hormone linked to hair loss) in the body. Lower DHT levels can lead to a range of sexual side effects in men. On the other hand, minoxidil doesn’t appear to block DHT, which may be why it’s less likely to cause sexual side effects. 

Whether minoxidil causes ED or not, ED itself is not uncommon, affecting at least 30–50 million American men. The good news is ED is usually treatable. If you start noticing signs of ED, consider these proven treatment options:

Try prescription medications

Viagra (sildenafil) and Cialis (tadalafil) are the first-line treatment for ED. Both Viagra and Cialis are phosphodiesterase type-5 inhibitors (aka PDE5 inhibitors) that can be taken on demand, about 30–60 minutes before sex. 

Cialis is also available as a daily medication for more spontaneity. 

When taken on demand, Viagra kicks in faster but lasts for less time (about 3–5 hours), while Cialis takes a bit longer to kick in but can remain active in the system for up to 36 hours. 

The active ingredients in both ED pills are also available through Ro in newer formulations, such as Daily Rise Gummies and dissolvable Ro Sparks. Both of these options are considered off-label prescriptions, since they are different formulations than the FDA’s approved pill formulation. 

Eat a healthy diet

ED is highly correlated with obesity and eating an unhealthy diet. On the other hand, following a healthy diet (and weight loss if you have excess weight to lose) have been shown to improve erectile function. 

Exercise regularly

Increasing physical activity is also recommended for men with ED, since obesity and having a sedentary lifestyle are associated with ED. According to research, regular physical activity may prevent and improve ED symptoms.

Take care of your mental health

Stress, depression, and anxiety (including performance anxiety) can all contribute to ED. Finding healthy ways to manage your stress, including through therapy, can help you feel better about yourself and sex, which can relieve ED.

Treat underlying health conditions

If you have other health conditions that can lead to ED, treating those underlying conditions may help relieve your symptoms. ED can be caused by conditions like heart disease, high blood pressure, and more. So, if you haven’t been to your healthcare provider in a while, it may be worth getting a check up just to make sure there isn’t anything you don’t know about contributing to your ED. 

Minoxidil erectile dysfunction is extremely rare. It was not common enough to report in clinical trials or in subsequent randomized controlled trials of the drug. ED is not considered a common side effect of this hair loss medication. 

However, that doesn’t mean it’s not possible to experience ED while taking minoxidil. The question is whether it’s due to minoxidil or (more likely) to something else. After all, ED is a multifactorial condition that often has more than one cause. 

You can get topical minoxidil in pharmacies or reputable online retailers. If you want the oral minoxidil pill, a healthcare provider has to prescribe it. You can visit your provider or use a telehealth platform like Ro to get a prescription. 

No matter which form you use, it’s important to buy your medications from well-established, verified companies to ensure you’re getting authentic minoxidil with the correct concentration and safe ingredients.

And watch out for retailers making misleading claims in their advertising of minoxidil. Always speak with your healthcare provider if you have any questions or concerns.

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Minoxidil is considered a safe and effective hair loss treatment with minimal risk of sexual side effects. While there have been rare reports of erectile dysfunction and other sexual issues, these cases are not typical and may be unrelated to the medication itself.

• ED is not a known side effect of minoxidil. Only four reports of ED were submitted to the FDA over 10 years, and clinical trials did not identify it as a risk. 

• Minoxidil is not known to cause sexual side effects, with fewer than 10 cases of sexual side effects reported over a decade.

• Minoxidil is less likely to cause ED and other sexual side effects than other hair loss medications. Oral drugs like finasteride and dutasteride are more likely to cause sexual side effects like ED, decreased sex drive, and ejaculation problems.

• If you do experience ED or other sexual side effects while using minoxidil, talk to your healthcare provider. Safe and effective treatments for ED are widely available, including oral medications, lifestyle changes, and therapy.