Finasteride dosis baja y disfunción eréctil... nueva data.

May 19, 2026

Low-dose finasteride linked to higher erectile dysfunction risk over time

WASHINGTON, DC -- May 19, 2026 -- A large retrospective study of more than 10,000 men with androgenetic alopecia found that low-dose finasteride (1 mg) was associated with a significantly increased risk of new-onset erectile dysfunction at both 1 year and 3 years compared with matched controls not taking the drug.

The findings, presented at the 2026 Annual Meeting of the American Urological Association (AUA), highlight the need for clinicians to discuss potential long-term sexual side effects with younger patients considering finasteride therapy and reinforce the importance of shared decision-making in hair loss treatment.

“Finasteride remains an effective, FDA-approved treatment, and for many men, the benefit to their hair and to their confidence will outweigh the risk that we observed,” reported Hriday Bhambhvani, Weill Cornell Medicine, New York, New York.

For the study, the researchers evaluated data from the TriNetX Research Network, identifying men aged 18 and 45 years with androgenetic alopecia and no prior history of erectile dysfunction. Using propensity score matching, 5,091 men who were prescribed 1 mg finasteride were compared with 5,091 controls, balancing groups for age, body mass index, race and ethnicity, depression, anxiety, tobacco use, alcohol use, hypertension, hyperlipidaemia, type 2 diabetes, and sleep apnoea.

For the primary outcome, no significant differences were observed between the 2 groups in terms of new-onset erectile dysfunction at 6 months (risk ratio [RR], 1.32; P = .21).

However, a significantly higher incidence of erectile dysfunction was observed with the finasteride group at 1 year (1.61% vs 0.96%; RR, 1.67; P = .004) and at 3 years (3.73% vs 2.36%; RR, 1.58; P = .0001).

“As we looked further out, a significant gap emerged at 3 years and those on finasteride had a meaningfully higher rate of erectile dysfunction, at about 4% compared to roughly 2.8% in the control group,” Bhambhvani said. “That corresponds to about a 46% higher risk. We also found significantly higher rates of low libido and ejaculatory dysfunction at the 3-year mark in the finasteride group.”

A further sensitivity analysis of the finasteride cohort compared with a separate propensity-matched cohort of men prescribed oral minoxidil 2.5 mg also similarly showed an increased 3-year risk for PDE5i prescription (4.03% vs 1.84%; RR, 2.19; P = .007). However, no difference in erectile dysfunction rates were observed at the 6-month and 1-year timepoints in the sensitivity analysis.

“The absolute difference in erectile dysfunction at three years was about 1.3%,” said Bhambhvani. “That means approximately 1 in 79 men on finasteride will develop erectile dysfunction as a result of the medication. Ultimately, the core message here is that shared decision-making providers should be having this conversation up front, laying out the real but modest risks discussing alternatives and letting the patient weigh in.”

“It's also worth noting that our study was not designed to assess whether these side effects persist after stopping finasteride,” he added. “That remains an important question for future research.”

[Presentation title: Risk of Erectile Dysfunction Among Reproductive-Aged Men Following Low-Dose Finasteride Use for Androgenetic Alopecia: A Propensity-Matched Cohort Study]

Prithviraj Bose, MD

EBAC® CE