Nope, I'm very busy at work, when I get home and my social life. I only comment in short bursts if I have time.
Regardless, I don't see why you're trying to move the goal posts, when we already know that quite evidently just from those studies a majority or very large % of people who do get sides, still keep them long term or permanently which is even more scarier.
It's also pretty obvious that the incidence rate is enormously greater than 0.8%
I think it's concerning that there are some people who experience prolonged side effects after discontinuation of finasteride, and there isn't a clear explanation for why that happens.
You're confusing three things here:
1. The incidence of side effects
2. Of those that experience side effects, what is the incidence of persistent side effects
3. Of those that experience persistent side effects, what is the incidence of side effects that continue to remain persistent?
I'm not moving goal posts. You're making the claim that 40 percent or more of finasteride users experience side effects, which is outlandish and not supported by any medical literature.
The studies you're referring to relate to point number 3 above, and they indicate that people who experience persistent side effects will tend to continue experiencing them. The incidence of people continuing to experience persistent side effects after developing them is not the same thing as the incidence of persistent side effects.
You're making the claim that it's "obvious" that the incidence of persistent side effects is greater than 0.8%, but there isn't a single study in existence that supports that claim.
If you don't want to listen to me, that's fine, but know that even the researchers associated with the PFS foundation who conducted the same studies you're citing don't come to the conclusions that you do.
The researcher responsible for the studies you posted, Dr. Michael S. Irwig:
https://pubmed.ncbi.nlm.nih.gov/21418145/
"While this study serves an important purpose to document a risk of persistent sexual adverse events with finasteride for MPHL,
the true incidence of these events is unknown as this is a post hoc approach. According to the randomized controlled trials by GlaxoSmithKline and Merck, the actual number of subjects experiencing adverse sexual events, in either the treatment or placebo groups, was <8% and <3%, respectively [1,3].
Assuming that the vast majority of these events resolved, the incidence of persistent sexual events in finasteride users would probably be less than 1%. Nonetheless, it is the persistence of these sexual side effects that is the most concerning finding. The looming question for all the subjects is whether their sexual function will ever recover."
"Our study has several limitations.
Most importantly, the retrospective nature of this study does not allow us to estimate what percentage of prospective finasteride users would develop persistent sexual side effects. A second limitation is selection bias in which those subjects experiencing more severe side effects, or those for whom sexuality is a more significant aspect of their life, would be more likely to participate in a study looking at sexual parameters. Another limitation is recall bias, in which subjects may not have remembered certain details such as the exact month when they started finasteride. Furthermore, no serum hormone levels were measured."
The most recent information that the PFS foundation put forward on their website:
https://www.pfsfoundation.org/frequently-asked-questions/
"What’s certain is that a subset of men who take finasteride develop PFS. According to a 2017 study published in PeerJ and titled
Persistent erectile dysfunction in men exposed to the 5α-reductase inhibitors finasteride or dutasteride,
1.2% of young men (defined as those 16 to 42 years old) who took finasteride for 206 days or longer, and had no prior history of sexual dysfunction, developed persistent erectile dysfunction (PED) that lasted an average of 4.2 years after quitting the drug. The study also showed that the longer men are on finasteride, the more likely they are to develop PED. Overall, men who take finasteride for at least 205 days are nearly five times more likely to develop PED than men who take it for less than 205 days.
For symptoms other than PED, no similar statistical analyses involving critical masses of patient records have yet been published."
From the same study they cite in their FAQ:
Among men with 5α-RI exposure, 167 of 11,909 (1.4%) developed PED (persistence median 1,348 days after stopping 5α-RI, interquartile range (IQR) 631.5–2320.5 days); the multivariable model predicting PED had four variables: prostate disease, duration of 5α-RI exposure, age, and nonsteroidal anti-inflammatory drug (NSAID) use. Of 530 men with new ED, 167 (31.5%) had new PED. Men without prostate disease who combined NSAID use with >208.5 days of 5α-RI exposure had 4.8-fold higher risk of PED than men with shorter exposure (NNH 59.8, all
p < 0.002).
Among men 16–42 years old and exposed to finasteride ≤1.25 mg/day, 34 of 4,284 (0.8%) developed PED (persistence median 1,534 days, IQR 651–2,351 days); the multivariable model predicting PED had one variable: duration of 5α-RI exposure. Of 103 young men with new ED, 34 (33%) had new PED. Young men with >205 days of finasteride exposure had 4.9-fold higher risk of PED (NNH 108.2,
p < 0.004) than men with shorter exposure.
So given the above information, what are you talking about? You're making sweeping statements that aren't supported by medical literature.