TLDR Most men stopped using the hair loss treatment not because of sexual side effects, but because they didn't see positive results.
The study from 2015 evaluated long-term adverse effects and reasons for therapy withdrawal in 130 patients with androgenic alopecia (AGA) treated with either a combination of 5% minoxidil (M5) and oral finasteride (FT) or M5 alone. Erectile dysfunction (3%), diminished libido (4%), and reduced ejaculation (7%) were reported in patients taking M5+FT, but not in those taking M5 alone. However, only 1 out of 100 patients discontinued the M5+FT therapy due to sexual adverse effects. The primary reasons for therapy withdrawal in the FT group were lack of positive results (11%), while in the M5 group, it was side effects (4%). Increased body hair was reported by 6.6% in the M5 group and 4% in the M5+FT group. The study concluded that the main cause of therapy withdrawal in long-term treated AGA patients was unrelated to sexual side effects.
September 2021 in “Fertility and Sterility” 10 citations
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April 2019 in “Sexual medicine reviews” Men using hair loss drugs like finasteride may experience sexual side effects like erectile dysfunction, but it's unclear who will be affected and when. Treating depression and sexual symptoms is suggested, as these men often have higher rates of both. More research is needed to understand why these side effects occur.
13 citations
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June 2018 in “Current Urology Reports” Hair loss drugs may cause sexual issues and infertility in men.
January 2017 in “Scripta Scientifica Vox Studentium” Finasterid 1mg, used for male hair loss, can cause sexual problems in some men, which can last for several months even after stopping the medication.
3 citations
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May 2015 in “PubMed” Most men stopped using the hair loss treatment not because of sexual side effects, but because they didn't see positive results.
185 citations
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June 2011 in “The Journal of Sexual Medicine” Finasteride for hair loss can cause long-lasting sexual side effects like low libido and erectile dysfunction.
223 citations
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March 2011 in “The Journal of Sexual Medicine” Some patients taking finasteride or dutasteride may have ongoing sexual problems and depression even after stopping the medication.
225 citations
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November 2007 in “The Journal of Sexual Medicine” Knowing about finasteride's sexual side effects increases reported dysfunction.