Finasteride sexual side effects: what to know
Finasteride sexual side effects can include lower libido, ED, or ejaculation changes. Most resolve after stopping, but not for everyone.
Key facts
- Finasteride + Minoxidil Scalp Solution is $53.50/month (billed $107 every 50 days), charged only after a clinician approves it.
- Answer a few health questions online. A licensed clinician reviews them. If approved, it ships to your door.
- Adults 18 or older. A licensed clinician reviews your health history and decides whether treatment is appropriate for you. Availability depends on the state you live in.
Finasteride is a medication that lowers dihydrotestosterone (DHT) and is used for male pattern hair loss and benign prostatic hyperplasia. Because DHT is involved in sexual function, some people worry about sexual side effects such as lower libido, erectile dysfunction, or changes in ejaculation. This page explains what finasteride sexual side effects are, how common they were in studies, what to watch for, and when to get help. Vitals Vault also offers lab options you can share with a clinician if symptoms show up.
- Finasteride sexual side effects can include lower libido, erectile dysfunction, and ejaculation changes.
- These effects were reported in clinical trials and are listed in FDA labeling for finasteride tablets.
- Many people improve after stopping finasteride, but persistent symptoms have been reported.
- New sexual symptoms can have other causes, including stress, low testosterone, and vascular disease.
Do finasteride sexual side effects happen?
- Sexual side effects listed on-label
- Decreased libido, erectile dysfunction, and ejaculation disorders are listed adverse reactions for finasteride tablets.
- Why it can affect sex
- Finasteride inhibits 5-alpha reductase, lowering DHT, an androgen involved in sexual function.
- What “persistent” means
- FDA labeling notes reports of continued sexual adverse reactions after discontinuation in some patients.
Which sexual side effects are most common and what to do about them
Lower sex drive (libido)
Some people report decreased interest in sex while taking finasteride. If this happens, it is worth reviewing other contributors like stress, sleep, alcohol, depression, and other medications. If symptoms are new or bothersome, a clinician can help you weigh hair goals against side effect risk.
Erectile dysfunction (ED)
Difficulty getting or keeping an erection has been reported with finasteride and is listed in FDA labeling. ED can also be caused by anxiety, relationship factors, low testosterone, diabetes, high blood pressure, and cardiovascular disease. A clinician can help sort out likely causes and discuss options.
Ejaculation changes
Finasteride labeling includes ejaculation disorders, which can include reduced ejaculate volume or changes in orgasm. These symptoms can also occur with age, pelvic floor issues, prostatitis, and some antidepressants. If you notice pain, blood in semen, or urinary symptoms, contact a clinician promptly.
Fertility and semen parameters
Finasteride can affect semen parameters in some men, and labeling notes male infertility and or poor semen quality have been reported, with improvement after stopping in some cases. If you are trying to conceive, discuss this risk before starting or continuing treatment. Do not stop a prescription medication without clinician guidance.
Persistent sexual symptoms
Some patients have reported sexual adverse reactions that continued after discontinuing finasteride, and this is described in FDA labeling. It is not possible to predict who will experience persistence. If symptoms last after stopping or are affecting mental health or relationships, ask for a structured evaluation rather than waiting it out.
Mood changes with sexual symptoms
Finasteride labeling includes depression and suicidal ideation. If sexual symptoms occur alongside low mood, hopelessness, or thoughts of self-harm, seek urgent help right away. A clinician can help assess whether finasteride or another factor may be contributing and discuss safer next steps.
| What you notice | Common non-finasteride contributors | What a clinician may consider |
|---|---|---|
| Lower libido | Stress, sleep loss, depression, alcohol, relationship strain | Medication review; screening for depression; hormone evaluation when appropriate |
| Erectile dysfunction | Anxiety, vascular disease, diabetes, smoking, low testosterone, some meds | Cardiometabolic risk review; targeted labs; ED treatment options if appropriate |
| Ejaculation changes | Age, pelvic floor dysfunction, prostatitis, antidepressants | Medication review; urologic evaluation if pain, blood, or urinary symptoms |
How long do finasteride sexual side effects last?
While taking finasteride
Sexual side effects can occur during treatment. If they appear, note when they started and whether anything else changed at the same time, such as stress, sleep, alcohol use, or new medications. Bring that timeline to a clinician visit.
After stopping
In clinical trials and postmarketing reports, many patients improved after discontinuation, but FDA labeling also notes reports of sexual adverse reactions that persisted after stopping. If symptoms continue, ask for evaluation for other causes rather than assuming it is only finasteride.
If symptoms are severe
If you have chest pain with sexual activity, fainting, severe depression, or thoughts of self-harm, seek urgent care. Those symptoms need immediate evaluation and are not something to monitor at home.
When to talk to a clinician (and when to get urgent help)
New or worsening sexual symptoms
Contact a clinician if you develop new decreased libido, erectile dysfunction, or ejaculation changes that are persistent or distressing. They can review your full medication list, medical history, and goals for hair treatment to decide what is safest.
Trying to conceive
If you are trying for pregnancy, ask a clinician about finasteride and fertility concerns before starting, and if symptoms arise while taking it. Your clinician may consider semen analysis or other evaluation depending on your situation.
Depression or suicidal thoughts
Seek urgent help if you have thoughts of self-harm or suicide, or if depression is severe. Finasteride labeling includes depression and suicidal ideation, and mental health symptoms should be treated as urgent regardless of the cause.
Signs of an allergic reaction
Get emergency care for trouble breathing, swelling of the face, lips, tongue, or throat, or widespread hives. Hypersensitivity reactions are described in postmarketing reports for finasteride.
Frequently Asked Questions
What are finasteride sexual side effects?
Finasteride sexual side effects can include decreased libido, erectile dysfunction, and ejaculation disorders, which are listed in FDA labeling. Some patients have also reported sexual symptoms that persisted after discontinuation. If symptoms are new or distressing, talk with a clinician.
Do finasteride sexual side effects go away after stopping?
Many people improve after discontinuing finasteride, but FDA labeling notes reports of sexual adverse reactions that continued after stopping in some patients. If symptoms persist, ask a clinician to evaluate other common causes of sexual dysfunction as well.
Can finasteride cause erectile dysfunction even if I am young?
Erectile dysfunction is listed as a possible adverse reaction with finasteride, regardless of age. Younger people can also develop ED from anxiety, depression, sleep loss, substance use, or hormonal issues. A clinician can help determine the most likely contributors in your case.
Can finasteride affect fertility or semen?
Finasteride labeling notes reports of male infertility and or poor semen quality, with improvement after discontinuation in some cases. If you are trying to conceive, discuss risks and alternatives with a clinician. Do not change a prescription plan without medical guidance.
How can Vitals Vault help if I notice sexual side effects?
Vitals Vault can help you start with labs to check for common contributors and share results with a clinician. You can also use PocketMD, which is free to download, to ask questions using your own health history and labs. It is not a doctor and is not for emergencies.