Here's the thing though. Many Men will naturally experience sexual dysfunction and the likes at some point in their life, and the odds of such occurrences happening only increase as you get older. When a guy says he's only just now having ED after taking finasteride for more than a few years it seems more than likely they were inevitably going to have that issue come up regardless of the finasteride use.
Yeah, I've heard that one on the forums before. Like 20 years ago. And 15 years ago. And 10 years ago. And 5 years ago.
Guys have been trying to rationalize around the problems with the drug since the 1990s. The names of the forum members periodically change. The old arguments get dusted off & repeated again by the next generation.
The drug continues to have the same common sexual side effect problem. Each new generation of balding guys discovers it. It keeps on stubbornly existing no matter how much research gets thrown at denying it.
That's why they have placebo groups in trials to see how the occurrences of ED compare with test subjects.
Sexual side effect problems are massively underreported on drug trials in general. Especially on trials done decades ago.
The Finasteride FDA trials relied on self-reports in generic questionnaires. FFS, they didn't even follow up on the fact that they had a high number of men drop out of the trials for "undisclosed reasons."
Those trials didn't find a significant side effect problem because they didn't want to find one. And because it's a difficult subject to study. That is generally how drug research works. A sexual problem has to be pretty severe/widespread before it makes a dent in the data. Most of Finasteride's users don't get their dicks totally shut down, they just get their sexual function inhibited. And the way the Finasteride's effects can gradually worsen over time just makes it even less likely to be documented.
All this . . . and once the drug hits the streets, the users have no realistic alternatives but to keep their mouths shut and stay on it or else they go bald. (Many people say losing their hair to chemotherapy was the most traumatic part of having CANCER.)
Imagine if we had a nice perfect topical (non-systemic & effective) version of Finasteride on the market. If that existed then there would be no forum debates about whether oral Finasteride has a dick-limping problem. It would be an accepted fact, because there wouldn't be a big emotional incentive to deny it.
My point is, Finasteride is perfectly situated to get away with having a widespread sexual side effect problem. You could hardly design a better situation for a drug to get away with it and stay underreported.
Honestly though, ED is still a very real side effect of finasteride and whether it's 2% or 5% or whatever, that's simply too high for most men to be comfortable with using for their entire life. Most people don't like the idea of playing Russian roulette with their sex life at all
Trying to debate the specific percentage on the baldness forums will just turn into a food fight.
But I will say this: Guys on the forums are always framing that debate in terms of what percentage of men "can use Finasteride" or something to that effect. In other words, what percentage of guys find the side effects tolerable enough to stay on the drug.
Stop and think about how far that is moving the goalposts.
The official research didn't find that 98% of guys had "tolerable" side effects. It indicated that 98% of guys had NO SIDE EFFECTS WHATSOEVER. Zero. None. As if they couldn't tell the drug from fake sugar pills. That's the story in the research data and it's completely implausible.
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