What Are the Sexual Side Effects of Minoxidil?

Minoxidil was first introduced as a treatment for high blood pressure in the 1970s. It was found to have an interesting side effect—hair growth. Since then, research has focused on developing a topical minoxidil solution for treating androgenetic alopecia in men and women. The 2% solution first appeared on the market in 1986, and the 5% solution followed in 1993. ^1,2

Minoxidil is FDA-approved and is considered a safe and effective treatment for hair loss, but like all medications, it has side effects.¹ Since finasteride, another high-use hair-loss medication, has known impacts on sexual health, many people are concerned about whether minoxidil will affect their sexual health.

How Does Minoxidil Work?

Minoxidil takes about four months to have its full effect. Its exact mechanism of action is not known, but science supports the idea that minoxidil works through several pathways.^2,3

• Vasodilation: Minoxidil dilates blood vessels and increases blood flow to the hair follicle. This may promote hair growth by increasing the delivery of nutrients and oxygen to hair follicles.
• Extend the anagen phase: Minoxidil may extend the anagen growth phase in the hair growth cycle, which allows for longer, thicker hair.
• Opens ion gates in the hair follicle: Minoxidil may open potassium gates, causing increased hair growth early in the hair cycle.
• Increase vascular endothelial growth factors: Minoxidil may increase vascular endothelial growth factors, which extends the growth phase of the hair growth cycle.

More research is needed to understand how minoxidil increases hair growth, but there is no evidence that its effects are on the testosterone-DHT conversion pathway.

What Side Effects Are Typically Associated With Minoxidil?

The common side effects associated with minoxidil include scalp itching, scalp scaling, excessive hair growth, and changes in hair color and texture.

The following minoxidil side effects are rare but more serious:

• Severe scalp irritation
• Unwanted excessive facial hair growth
• Chest pain
• Fast heartbeat
• Swelling in the hands and feet
• Rapid weight gain from fluid retention
• Lightheadedness
• Headache
• Dizziness
• Confusion
• Flushing
• Vision changes

Does Minoxidil Affect Your Hormones? 

Unlike with finasteride, no definitive research suggests that minoxidil significantly affects testosterone levels. Minoxidil may have some anti-androgenic effects, slightly inhibiting the effect of testosterone on the hair follicle. However, the extent and clinical significance of this potential effect are unknown.^5,6

Can Minoxidil Cause Erectile Dysfunction? 

To date, there is no scientific support for a connection between minoxidil use and erectile dysfunction. The FDA Adverse Event Reporting System (FAERS) is a computerized information database established by the U.S. government to allow people and their healthcare providers to submit information on the side effects of medications. There are isolated reports attributing sexual side effects to minoxidil use. Sexual side effects in men are much more common with finasteride than with minoxidil use.⁴  

Sexual side effects were less commonly reported in women, with four finasteride users and one minoxidil user reporting menstrual changes.⁴

Can Minoxidil Affect Fertility?  

Topical minoxidil use is not associated with any effects on fertility. Currently, no scientific evidence demonstrates that minoxidil significantly affects hormone levels.⁴

There are two reports to FAERs that minoxidil was associated with abortion, and another case report in the literature suggests that minoxidil may cause fetal toxicity. More research is needed to understand how minoxidil works in the body and any potential side effects of its use in pregnant women.⁷

How Common Are Sexual Side Effects From Minoxidil? 

According to a report from the FAERs database, there are isolated cases of sexual side effects from minoxidil. More research is needed to determine whether there is a causative relationship between the sexual effect and minoxidil. Minoxidil is far less likely to cause sexual side effects than finasteride. However, finasteride has been shown to be more effective for treating androgenetic alopecia. It is important to discuss finasteride and minoxidil with your healthcare provider to decide which one is best for you.

How To Decide If Minoxidil Is Right For You 

Overall, the research suggests that there are no known sexual side effects from taking minoxidil. After clinical testing, minoxidil is considered to be a safe and effective treatment for hair loss. Reach out to a treatment specialist at Invigor Medical to discuss your hair loss treatment options and learn how they fit into a complete age management plan.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice. 

References

1. Suchonwanit P, Thammarucha S, Leerunyakul K. Minoxidil and its use in hair disorders: a review. Drug Des Devel Ther. 2019 Aug 9;13:2777-2786. doi: 10.2147/DDDT.S214907. Erratum in: Drug Des Devel Ther. 2020 Feb 10;14:575. PMID: 31496654; PMCID: PMC6691938.
2. Rossi A, Cantisani C, Melis L, Iorio A, Scali E, Calvieri S. Minoxidil use in dermatology, side effects and recent patents. Recent Pat Inflamm Allergy Drug Discov. 2012;6(2):130–136.
3. Barbareschi M. The use of minoxidil in the treatment of male and female androgenetic alopecia: a story of more than 30 years. G Ital Dermatol Venereol. 2018 Feb;153(1):102-106. doi: 10.23736/S0392-0488.17.05781-9. PMID: 29319278.
4. Wu M, Yu Q, Li Q. Differences in reproductive toxicology between alopecia drugs: an analysis on adverse events among female and male cases. Oncotarget. 2016 Dec 13;7(50):82074-82084. doi: 10.18632/oncotarget.12617. PMID: 27738338; PMCID: PMC5347675.
5. Hsu CL, Liu JS, Lin AC, Yang CH, Chung WH, Wu WG. Minoxidil may suppress androgen receptor-related functions. Oncotarget. 2014 Apr 30;5(8):2187-97. doi: 10.18632/oncotarget.1886. PMID: 24742982; PMCID: PMC4039155.
6. Sato T, Tadokoro T, Sonoda T, Asada Y, Itami S, Takayasu S. Minoxidil increases 17 beta-hydroxysteroid dehydrogenase and 5 alpha-reductase activity of cultured human dermal papilla cells from balding scalp. J Dermatol Sci. 1999 Feb;19(2):123-5. doi: 10.1016/s0923-1811(98)00048-6. PMID: 10098703.

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