A Reddit commenter recently asked a reasonable question.
He’d been taking finasteride for almost a year without any obvious problems. Then his erections started getting weaker. Sometimes he couldn’t maintain one during sex or masturbation.
So naturally, the question became:
Is it the finasteride?
For those of you who aren’t familiar, finasteride is a prescription medication commonly used to treat male pattern hair loss and an enlarged prostate. It works by blocking the conversion of testosterone into dihydrotestosterone, or DHT.
Lowering DHT can help slow hair loss and reduce prostate growth.
But it can also come with side effects.
Quick Detour: What Finasteride Is Actually Doing In There
Testosterone doesn’t do all of its own work.
Some of it gets converted into a stronger version of itself called DHT, by an enzyme with a name only a pharmacist could love: 5-alpha-reductase.
If testosterone is the guy who signs off on the plan, DHT is the contractor who shows up and swings the hammer. Same blueprint, a lot more force. DHT grabs the androgen receptor harder than testosterone does, and it doesn’t let go as fast.
Great news for your beard, your body hair, and whatever happened to your voice at fourteen.
Less great news for your hairline and your prostate, because DHT is also the thing quietly shrinking your follicles and growing your prostate.
So finasteride’s entire job is to interrupt that conversion. Less enzyme activity, less DHT, less follicle miniaturization, less prostate growth. That’s the trade you signed up for.
Here’s the part nobody mentions at the pharmacy counter:
There is no DHT valve that only feeds your scalp.
You can’t turn it down in one location. Lower DHT is lower DHT everywhere, including tissue that has absolutely nothing to do with your hair.
So Where Does the Bedroom Come In
Erectile tissue has androgen receptors too, and they’re not picky about your hair goals. Androgen signaling helps support the nitric oxide machinery that makes an erection physically possible in the first place.
And 5-alpha-reductase doesn’t only produce DHT. It’s also a step in making neurosteroids that influence mood, anxiety, and desire.
Turn that enzyme down and you may be adjusting more than one system at once.
None of that means this is going to happen to you. Most men take finasteride without any of it. But it’s the reason these reports are biologically plausible instead of imaginary.
Yes, Finasteride Can Affect Sexual Function
Decreased libido, erectile dysfunction, and changes in ejaculation have all been reported with finasteride.
They don’t happen to everyone, or even most people, but pretending they don’t exist isn’t helpful either.
The FDA’s clinical trial data for 1 mg finasteride found sexual adverse effects in a small percentage of men, and research looking across multiple trials has also found an increased risk of sexual dysfunction.
So if something changes after starting finasteride, the medication deserves a place on the list of possibilities.
It just shouldn’t automatically be the only thing on the list.
Your Erection Doesn’t Exist in a Vacuum
(Unless you put it there.)
Let’s say you’ve taken finasteride for months without a problem and suddenly your sexual function changes.
What else changed?
Are you sleeping less?
Training differently?
Eating in a calorie deficit?
Drinking more?
Under more stress?
Did you start another medication?
Did you change jobs, have a kid, lose someone close to you, or spend the last three months running yourself into the ground?
Sexual function can be influenced by physical health, hormones, cardiovascular health, medications, sleep, psychological stress, relationship factors, and lifestyle.
And once you’re worried about whether you’ll be able to maintain an erection, that worry itself becomes part of the problem.
That’s why reducing the entire conversation to “finasteride killed my erections” or “it’s all in your head” misses the point.
Both answers are trying to solve a complicated problem with one variable.
Real Experiences Matter, But So Does Context
There’s value in reading other people’s experiences.
It’s actually why we’re talking about this.
Reddit and other online communities can give you access to thousands of real people discussing what worked for them, what didn’t, and what they experienced along the way.
That’s useful information.
But someone else’s experience is still someone else’s experience.
Read enough horror stories about any medication and suddenly you’re monitoring every sensation in your body. Expectations, anxiety, and attention all influence how symptoms get perceived and experienced.
On the other hand, dismissing a legitimate change because somebody online took the same medication for ten years without a problem makes just as little sense.
Their body isn’t yours.
Medications aren’t one-size-fits-all either. A medication that works incredibly well for one person may cause unwanted side effects in someone else. Sometimes the answer is adjusting the treatment with your clinician. Sometimes another medication or approach makes more sense.
The goal is finding what works for you.
My Take
If your hair looks better but your sex life suddenly doesn’t, that’s worth figuring out.
Not panicking about.
Not ignoring.
Figuring out.
Look at when the problem started. Look at what changed around the same time. Look at your medications, training, nutrition, sleep, stress, and overall health.
And get bloodwork done.
Symptoms tell you something has changed. Bloodwork tells you and your physician what’s actually happening under the hood, and whether there are other factors worth investigating.
Do your due diligence. Pay attention to your body. Give yourself enough information to have a productive conversation with a qualified specialist.
Maybe finasteride is contributing.
Maybe it isn’t.
Maybe your treatment needs to change.
The point isn’t to defend the medication or blame it. The point is to figure out what’s happening before you start changing things blindly.
Hair, Hormones, and Everything In Between
This is exactly why HollyFit doesn’t treat health like a collection of unrelated problems.
Hair loss is one conversation.
Sexual health is another.
Prostate health is another.
Hormones, training, nutrition, sleep, stress, and bloodwork are somewhere else entirely.
Except your body doesn’t work that way.
The whole reason this article exists is that a medication for your scalp reached into a system nobody was watching. That’s not a weird edge case. That’s how the body works. Everything is downstream of something.
So at HollyFit we do the opposite of siloing it. We look at the whole picture, control the variables we can control, and figure out what’s actually working for your body.
When you sign up, comprehensive bloodwork is part of your programming, along with a dedicated physician who reads it in the context of your health, your medications, your symptoms, and your goals. Your coach and your physician are on the same team, in the same app, talking to each other.
We offer treatment options for hair loss, prostate health, and erectile dysfunction when medically appropriate.
But the goal isn’t to throw another product at every symptom.
If something we give you causes a side effect somewhere else, we’re going to catch it, tell you why it’s happening, and fix it. You’ll never be the guy on Reddit trying to reverse-engineer his own body at midnight. You’ll have someone who can actually answer the question.
Because the right medication, training program, nutrition plan, or health protocol isn’t necessarily the one that worked for somebody else.
It’s the one that helps you thrive.