How Does Accutane Affect Female Reproductive Health?

You’ve more than likely experienced at least one pimple in your life, probably a lot more than that. Acne is one of the most common skin conditions out there, affecting around 85% of people between the ages of 12 and 24. This is in large part thanks to the fluctuation of hormones you experience around puberty. 

Although acne is more common in teens, it can happen at any age and is often influenced by hormones, including around your period or during pregnancy. For most people, it resolves itself over the course of time, with lifestyle changes, and topical medications – but that’s not the case for everyone.

Oral Medications for Acne

Many people choose to take oral medications to help with more severe cases of acne like hormonal birth control, antibiotics, or Accutane. While Accutane is the most well-known name for this drug, it’s also known by Absorica, Claravis, Amnesteem, Myorisan, Zenatane, and its generic name, Isotretinoin. 

Although Accutane can offer incredible results for people with severe acne, it also comes with quite a few potential side effects. One possible area where people can experience Accutane side effects is in their reproductive health. If you’re considering going on Accutane or have been on it in the past, it’s important to understand how this medication may affect your reproductive health. 

How Does Accutane Work?

You’ve probably heard of using retinoids or retinol topically, which are all forms of Vitamin A. Accutane is also a type of retinoid, but unlike its counterparts, it’s an oral medication intended to treat severe cases of acne. Accutane is typically used in people with cystic acne, which are deep, painful pimples that may cause nodules or lumps that are not treatable through conventional methods.

Much like using topical retinoids, isotretinoin, which is the main ingredient of Accutane, increases the shedding of dead skin cells and cell turnover, reducing build up and clogged pores. Isotretinoin also reduces the size of oil glands and how much oil they produce by up to 90% – that’s why so many people experience dry skin when on Accutane. 

Side Effects of Acutane

• Irritation around the eyes and eyelids
• Sensitivity to the sun
• Chapped lips
• Itchy or sensitive skin
• Temporary hair thinning
• Gastrointestinal symptoms
• Urinary tract symptoms
• Joint pain

There are also more severe or lesser known potential side effects when it comes to reproductive health. 

Accutane and Pregnancy

A well known potential side effect of Accutane is pregnancy complications. Taking the medication while pregnant poses a high risk of birth defects. Up to 35% of infants exposed to Accutane during pregnancy will have birth defects, often affecting their ears and hearing or eyesight. There is also a miscarriage rate of up to 40% for people who become pregnant while on Isotretinoin. 

Because of this, some providers may strongly advise using at least one form of birth control while on Accutane and for several months after, often two forms like an IUD and an oral hormonal pill. You’ll also likely need to take a pregnancy test before going on the medication if you are sexually active. 

Outside of pregnancy while on the medication, Accutane can affect your reproductive system in other ways. Let’s explore how. 

Accutane and Reproductive Health

Accutane has been linked to a wide range of reproductive problems for both males and females. In males it can decrease sperm count and motility. Studies have shown that females taking Isotretinoin may experience menstrual irregularities.

This includes issues like amenorrhea (the absence of periods) and irregular cycles. These issues may or may not go away after the end of Isotretinoin treatment. There is a potential that this medication can cause permanent damage to the reproductive system, but there is limited research on the issue. 

It’s difficult to get an accurate number on how many people’s menstrual cycles are impacted by Accutane. This is because so many female Accutane users are also on birth control, which can affect or even suppress the menstrual cycle. They may or may not go off of birth control when they’re done with Isotretinoin treatment. 

It’s not quite understood why Accutane affects the reproductive system. Some researchers believe that Isotretinoin alters the way the body processes hormones. This can affect egg and sperm development, and ultimately – fertility.

Although the studies are not conclusive, researchers have found that people who took Accutane in the past had decreased ovarian reserves as well as an increased risk of miscarriage. Ovarian reserve refers to the quantity and quality of the ovarian primordial follicular pool, and poor ovarian reserve may be an indicator of infertility.

These changes to hormones can also affect another area of reproductive health – your libido. People on Accutane may experience a decrease in sexual function and libido. It can also lead to side effects like vaginal dryness and erectile dysfunction. 

Is Accutane Right for You?

This article is intended to offer insight on the potential downsides of taking Accutane. But it’s not meant to scare you away from taking a medication that for many, can be life changing. Most people never experience reproductive health issues or infertility after taking Accutane.

Accutane does come with quite a few potential side effects, including ones that are reproductive health related. That being said, severe acne can be painful, uncomfortable, and greatly impact someone’s confidence and self-image.

Other Acne Management Methods

• Getting tested for any food sensitivities or allergies
• Seeing a holistic provider like an acupuncturist or naturopathic doctor
• Using topical treatments like retinol and salicylic acid
• Going to a dermatologist
• Getting dermatological treatments

It’s important to weigh the pros and cons of going on Accutane or a different Isotretinoin medication – especially if you’d like to get pregnant in the semi-near future. Only you know what the right decision is for your body, but it’s important to talk to your healthcare provider to get more information and see what your potential options are.