I agree with OP generally, but the main problem is, as far as I'm concerned there has never been a conclusive independent research study on finasteride. If anyone thinks they have one, please send it this way.
I'm very happy with my results on finasteride, after 4 or 5 years on minoxidil, and realising it's effectively doing nothing, finasteride has grown my fringe and even temple points (which I thought was rare, but I've been a good responder with the temples) in less than a year.
It's still thin though all over, there's no real density under harsh lighting, it's really hard to tell if this is improving or not. Nonetheless, the central part of the fringe was only 1-2cm wide a year ago, now it's probably 4cm wide (I've never thought about this before so it feels weird guessing) and it's moved forward as well, there's even sparks of a few hairs a centimetre further down my forehead, where my hairline was when I was probably 15 or something.
"Sides" (if you can call it that) were increased libido, initially insanely increased, to the point if I was laying in bed with a girl and she so much as breathed in my direction, it would be on it's way, and any kind of touching or kissing being full boner within half a minute, and since then it still stays 100% hard at all times, during foreplay, eating her out, switching positions etc there's never any need to yank on it to keep it going.
Keep in mind I am a 29 year old male who smokes, drinks, used to do a lot of drugs and still do sometimes, I've never had any major issues with ED to the point of a woman noticing, but like most guys I felt like for some days my erection was less strong for different reasons, for example if I've eaten too much or felt bloated, had indigestion etc. or understandably if on drugs or alcohol there's more effort to perform, but actually some days for no reason at all. I haven't had this sort of feeling in quite a while now.
Obviously I have little to complain about, and keeping others in mind, I feel for anyone who's had sides, I'd react emotionally very badly to that, especially if it's been working on the hairline. I've lucked out basically, more hair, increased libido, and other people haven't been so fortunate, but how many other people? Is the risk for most of us worth the reward?
I really think it needs to be looked at extensively. For example, DHT levels are hard to measure but there may be some correlations, I've heard people suffering from finasteride sides as having "beta genes" which sounds facetious but it's pretty much true, and it's not slandering, we can't control our genes, it's just factual. For me personally I have a lot of chest and body hair (or I would if I didn't completely trim it away every fortnight) and have had since only age 14 or 15, I probably had pubes when I was only 9 or maybe 10, that when I got to high school and they explained in biology what puberty will be when it hits us, I was really confused because I was already used to this.
Anyway, would there possibly be a correlation between this and how we respond to hormone treatments? That I'm lucky enough to have "alpha" genes and get stronger erections and hair, but some people's biological make-up can't deal with it and become effeminate, gynecomastia, ED, etc.
It would be helpful in determining who would be viable candidates to get on finasteride, but for the time being, it's just a lottery. I don't mean this post to discourage anyone who was late in hitting puberty or has no body hair, I'm simply saying we don't know because there's no real studies being carried out. My point on my "alpha genes" is simply theorizing and if anyone has anything to contradict it, even just anecdotal experience, that would be interesting.
And then again maybe in a year I'll be crying about man tits and my dick shrinking to a prawn, who knows.