Thank you for posting my comment on your blog this week. I re-read my comment and thought it may have been unclear so I wanted to clarify a point.
Haber’s original data set showed some peculiar results for the finasteride (F) group versus the control (C). It is very widely accepted that finasteride impairs sexual functioning compared to the control but that was not what Haber found in his study due to the research design. I don’t really know how to put it any more nicely unfortunately. According to the ASEX score, (F) had only 24.3% with some sexual dysfunction versus 38.4% for (C). Libido was similar between groups with (F) showing 22.8% with libido loss and (C) at 22.2%. Reduced sexual functioning was much lower for (F) at 17.8% versus 24.2% for (C).
Keep in mind there is a small amount of missing data in the fin group but it shouldn’t matter that much. Because of the way they excluded patients who stopped taking the drug, likely due to side effects, the data appears to show that on average finasteride improves sexual functioning but that isn’t true because the data isn’t properly randomized. Everybody basically knows that finasteride causes sexual side effects and the data is growing ever stronger that a small group gets persistent side effects. When their data showed the opposite effect and they didn’t stop to question why, they decided to completely ignore the data and conclude “there was no difference in loss of libido, reduced sexual performance, or the number of men with an ASEX score indicating sexual dysfunction.” I’m really not sure how this article got published but the authors appeared to have willfully distorted the data and study design to meet their presumed conclusion.
My experience parallels Dr. Haber’s experience as well as another few dozen doctors with lots of experience. From a first hand perspective, I take it and don’t have ED or libido issue and my son took it and got an increased sexual drive. My patient’s parallel the official reports with about 2-4% ED and libido issues, possibly slightly higher. I have written thousands of prescriptions for finasteride and that makes me more of an authority than those who look in from the sidelines.