No need to be a douche. Anyhow, I should've been more specific with that.
Even though the studies claim the sides are unable to distinguish between 1 mg and 5 mg, there is still a high possibility 5 mg may increase the chances of getting sides.
Publimed has a publishing where the 5 mg finasteride higher sides might be nocebo bias phenomenon.
Here's the conclusion, remember the study was based on the 5 mg dose, one hundred and seven patients finished the studies (of one hundred twenty patients) after 1 year of therapy.
In the current study, blinded administration of finasteride was associated with a significantly higher proportion of sexual dysfunction in patients informed on sexual side effects (group 2) as compared to those in which the same information was omitted (group 1) (P = 0.03). A scenario similar to group 2 of the current study is likely to occur in clinical practice, where the patient is counseled by the physician and has access to the drug information sheet. The burden of this nocebo effect (an adverse side effect that is not a direct result of the specific pharmacological action of the drug) has to be taken into account when managing finasteride sexual side effects.
Of course, we still need a study where they compare sides dose to dose to come to any formal conclusions (outside from the brochures and companies).
However, the 5mg finasteride dose is proven to increase the risks of having prostate cancer. Here's the excerpt:
"Men aged 55 and over with a normal digital rectal examination and PSA ≤3.0 ng/mL at baseline taking Finasteride 5 mg/day (5 times the dose of Finasteride tablet) in the 7-year Prostate Cancer Prevention Trial (PCPT) had an increased risk of Gleason score 8-10 prostate cancer (Finasteride 1.8% vs placebo 1.1%). [See Adverse Reactions (6.1).] Similar results were observed in a 4-year placebo-controlled clinical trial with another 5α-reductase inhibitor (dutasteride, AVODART) (1% dutasteride vs 0.5% placebo). 5α-reductase inhibitors may increase the risk of development of high-grade prostate cancer. Whether the effect of 5α-reductase inhibitors to reduce prostate volume, or study-related factors, impacted the results of these studies has not been established."
That alone proves relevance on the dose. And we are ignoring how in practice many users can support reducing the dose and coincidentally lower the sides (trusty users at least).
Anyway, I still stand to what I said initially and would advice that such dose is overkill.
