The Bottom Line
Clinical trials show 2-4% of men experience sexual side effects on finasteride. For most, these resolve after stopping. The vast majority of men have no issues.
If you're concerned, topical finasteride may reduce systemic exposure while still treating hair loss.
What the Studies Show
From Clinical Trials (1mg Propecia)
- Decreased libido: 1.8% (vs 1.3% placebo)
- Erectile dysfunction: 1.3% (vs 0.7% placebo)
- Ejaculatory disorder: 1.2% (vs 0.7% placebo)
Source: Original FDA approval trials. Note placebo rates — some "side effects" occur even without medication.
The difference between finasteride and placebo is small. Most men taking finasteride experience no sexual side effects.
Do Side Effects Go Away?
For most men who experience side effects, they resolve after stopping finasteride. Some report resolution even while continuing medication as the body adjusts.
Post-Finasteride Syndrome (PFS): A small number of men report persistent symptoms after stopping. This is controversial — some researchers question whether it's related to finasteride. If you experience persistent issues, consult a healthcare provider.
Options If You're Concerned
1. Topical Finasteride
Applied to scalp instead of taken orally. Lower systemic absorption may reduce side effect risk while still treating hair loss. Hims offers this option.
2. Lower Dose
Some providers prescribe 0.5mg or 0.25mg instead of 1mg. Research suggests lower doses still provide significant DHT reduction.
3. Minoxidil Only
Oral or topical minoxidil doesn't affect hormones. Less effective than finasteride for stopping loss, but stimulates growth without DHT concerns.
Making Your Decision
Most men tolerate finasteride well. If you're concerned, start with a trial period and monitor how you feel. Topical options exist if you want to minimize systemic exposure.
Explore Options at Hims →