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When it comes to physical appearance, many men take pride in having a good head of hair on their shoulders as it can help make them feel more attractive.
Unfortunately, either from underlying conditions, genetics, nutritional deficiencies, or older age, male pattern baldness can occur, causing many to look for solutions to reverse or disguise the issue.
Of the few available solutions, minoxidil or rogaine is the number one treatment for hair loss despite some user testimonies stating that there may be a connection between rogaine and impotence (1), as some men have experienced problems with performance, erections, and libido.
If you are looking to take rogaine as a hair loss treatment, read on to find out whether it is safe, what its side effects are, and how likely you are to run into sexual performance issues while on it.
What Is Rogaine & How Does It Work?
Rogaine, which is just a more common name for the chemical minoxidil, is one of the oldest and most highly recommended anti-hair loss medications currently available. Its exact workings are still a bit of a mystery to researchers, but what we do know is that it acts as a vasodilator, partially enlarging the hair follicles and extending the hair growth cycle (2).
Researchers believe that the stimulatory effect comes from rogaine opening up the potassium channels in the hair follicles, but there has been no clear demonstration of this as of yet. What has been seen is that rogaine shortens telogens and accelerates the telogen-exogen phase, causing early entry of resting hair follicles to proceed into the anagen phase (3).
In most cases, this results in at least partial hair restoration with continued use. The downside, other than relatively minor side effects such as sensitivity, irritation, dryness, and flaking around the area of application, is when taken orally, rogaine has an impact on testosterone functions, possibly suppressing certain androgenic activities.
This may be the reason why men have experienced a connection between rogaine and impotence.
What Is the Relationship Between Male Hair Loss & Testosterone?
The relationship between male pattern baldness and testosterone is found between genetics, hormones, and metabolism.
When a man has a balding scalp, it is characterized by high levels of androgen dihydrotestosterone (4), which is a byproduct of testosterone metabolism. When this is combined with an increased expression of the androgen receptor gene (via genetics) and shortened CAG and GGC triplet repeat haplotypes, it appears that these are markers necessary for male pattern baldness (5).
This means that men who are more sensitive to or have higher quantities of DHT may be more likely to experience hair loss. This also means that blocking some of the DHT receptors or reducing the conversion of testosterone to DHT can be a remedy for male pattern baldness.
However, because testosterone can act differently from male to male, the side effects will also vary. There may be a connection between rogaine and impotence in some men who experience impotence as a side effect of rogaine impacting male testosterone (6).
What Is the Connection Between Rogaine and Impotence?
Currently, two available medications are FDA approved for male pattern baldness, the first being minoxidil, which is a potassium channel opener, and finasteride, which is a dihydrotestosterone synthesis inhibitor (7).
Finasteride is taken in tablet form and can cause impotence in a small number of cases, which is reversed when the medication is stopped (8).
Rogaine, on the other hand, is a bit murkier in whether it causes impotence or not as there are conflicting reports. There are some reports that it has a mild influence on suppressing male erectile function due to its impact on the androgenic receptors. Still, this effect is weak and also only happens in a small number of cases (8).
What Is The Risk Level of Sexual Impotence and Rogaine?
While there is some risk of impotence when taking rogaine, the risk level is extremely low, as it is really only going to impact a small number of individuals who have a sensitivity to its mechanisms (anti-androgenic effects).
If you are planning on taking minoxidil for male pattern baldness, the chances of adverse effects like impotence are rare. If it does occur, it can be reversed by discontinuing the medication.