Investigating Sexual Dysfunction in Patients on Isotretinoin, and Evaluating Patient Education Practices among Dermatologists: Survey Study (Preprint)
Elizabeth Tchernogorova; Eve Golden; Natalia Correa; Olnita Martini; Taylor M. Runion; Alyssa P Quinn; Alexandra Ortiz-Jimenez; Gabriella Vasile; Amanda Brooks
JMIR Preprints2024
In plain terms
Researchers ran an anonymous online survey, shared by email and on social media, of 144 adults who had taken isotretinoin for acne. About 1 in 3 of the 118 women said they had vaginal dryness while on the drug, and 8 of the 23 men said they had erection problems. Very few said their dermatologist had mentioned these possible effects beforehand: about 1 in 15 women for vaginal dryness, and 1 of the 23 men for each male sexual symptom.
What it doesn’t show: It can't tell how common these problems are among everyone who takes isotretinoin, whether the drug caused them, or whether they lasted after stopping: the people who answered chose to take part, there was no comparison group, and many were also taking other medicines linked to sexual side effects, such as the contraceptive pill.
Summary (paraphrased)
A patient survey study set out to measure how common sexual-dysfunction symptoms are among people taking isotretinoin and how often dermatologists counsel patients about them beforehand. Among 144 respondents, 33% of women (n=118) reported vaginal dryness and 34.7% of men (n=23) reported erectile dysfunction while on isotretinoin. Very few had discussed these risks with their prescriber first: 6.8% of women had discussed vaginal dryness and 4.3% of men had discussed erectile dysfunction, ejaculatory failure, or delayed ejaculation. The authors conclude there is a clear opportunity to improve awareness and counseling about isotretinoin's sexual-health effects.
Evidence
Extracted from the full text; page numbers refer to the paper. The library’s own notes are labelled as such.
- Design
- Cross-sectional studyPreprint (submitted version, not peer reviewed). Cross-sectional anonymous online survey of 14 questions, with no comparison group
- Setting
- Online (Qualtrics) survey run by students at Rocky Vista University College of Osteopathic Medicine, USA, 29 November to 20 December 2023, shared by email, Facebook, Reddit and Instagram
- Population
- Adults over 18 with past or present use of isotretinoin for acne who completed the survey. Sex was not asked directly; it was inferred from iPLEDGE answers, and 3 respondents could not be assigned.
- Size
- 144 · 144 completed surveys, of whom 118 classified female, 23 male and 3 unassigned (excluded from sex-specific analyses); 110 reported being sexually active
- Exposure
- Isotretinoin for acne, past or present; dose, duration and time since stopping are not reported
- Compared with
- None
- Outcome
- Self-reported symptoms experienced while using isotretinoin, sexual and non-sexual, and whether each was discussed with the prescribing dermatologist before starting
- Follow-up
- None; one survey. Only symptoms "while using" isotretinoin are reported, and the questionnaire (Appendix 1) is not included in the PDF
Key results
- Women (n = 118): vaginal dryness 33.0%, painful intercourse 22.0%, vaginal discomfort 17.8%, more vaginal yeast infections 16.9%, more bacterial vaginosis 9.3% (39, 26, 21, 20 and 11 women) · p. 6
- Men (n = 23): erectile dysfunction 34.7%, ejaculatory failure 17.3%, delayed ejaculation 8.7%. These correspond to 8, 4 and 2 men (34.8%, 17.4%, 8.7%; the paper truncates rather than rounds). Fig. 1, which adds the 3 unassigned respondents (as its female bars do, e.g. 39 + 3 = 42 for vaginal dryness), shows 9 with erectile dysfunction and 6 with ejaculatory failure (read from the chart), whereas the text implies 8 + 3 = 11 and 4 + 1 = 5 · p. 6, Fig. 1 (p. 13)
- Discussed with the dermatologist before starting, women: vaginal dryness 6.8% (8 of 118), vaginal discomfort 4.2%, painful intercourse 3.4%, bacterial vaginosis 2.5%, yeast infections 1.7%; men: 1 of 23 (4.3%) each for erectile dysfunction, ejaculatory failure and delayed ejaculation. For comparison, of all 144, dry lips was discussed with 90.9%, depression 65.9% and birth defects 52% · p. 7, Figs 1–2 (pp. 13–14)
- Non-sexual effects among all 144: dry lips 93.7%, headaches 49.3%, joint pain 47.9%, mood swings 40.2%, depression 35.4%, vision changes 27.7% · p. 6
- Write-in answers under "other symptoms" included decreased libido (7 respondents) and genital paresthesia, i.e. altered genital sensation (4); neither was a listed option · p. 6
Limitations the authors note
- 69% of female respondents were taking oral contraceptives for iPLEDGE, which can themselves cause sexual dysfunction (83 selections among the 121 respondents asked, 68.6%)
- 12 respondents were taking an SSRI antidepressant, known to cause sexual dysfunction
- Only 16% of respondents were male
- People aged 12–17 were excluded, although isotretinoin is approved from age 12
- Sex was not asked but inferred from iPLEDGE answers, and 3 respondents could not be assigned
Also worth weighing (library’s note)
- Preprint (submitted version), not peer reviewed
- Self-selected respondents recruited through social media, with no response rate, so the percentages are not population frequencies
- No comparison group of people not taking isotretinoin
- Dose, duration, timing of symptoms and whether they resolved after stopping are not reported
- Counselling was reported by patients, not checked against records
- All 3 unassigned respondents reported vaginal dryness, painful intercourse and vaginal discomfort, and all 3 also reported erectile dysfunction (p. 6)
- No statistical tests are described, though discussion of non-sexual effects is called "significantly" more frequent (p. 7)
- The introduction says that in a survey of 300 patients with sexual dysfunction "54% of the patients were taking isotretinoin" (p. 6); in that series (Healy et al. 2018, LIT-019 in this corpus) isotretinoin accounted for 54 of 300 cases, 18.0% (LIT-019 p. 127, Table 1). Reference numbers in the introduction also appear shifted against the reference list (pp. 5–6, 10)
Funding: Not stated; the acknowledgements say there are no financial disclosures Interests: None declared
What it can support (library’s note): That, in a small self-selected online sample, many isotretinoin users reported sexual symptoms during treatment and few recalled being told about them beforehand. It cannot estimate how common these symptoms are, show that isotretinoin caused them, or say whether they persisted after stopping.
Why it’s in the corpus
Documents sexual symptoms reported during treatment by respondents to a self-selected online survey (vaginal dryness in 33% of 118 women, erectile dysfunction in 8 of 23 men) and a near-total counseling gap. These are proportions of respondents, not prevalence, and complement the regulatory warnings and pharmacovigilance signals elsewhere in this sweep.
Related records
- Peer-reviewed paper
Exploring the association between isotretinoin and sexual dysfunction: a comprehensive scoping review
Eugene Tan; Harriet Kennedy; Marius Rademaker · Clinical and Experimental Dermatology
This scoping review searched for peer-reviewed studies on isotretinoin and sexual dysfunction using a broad set of terms covering erectile, ejaculatory, libido, arousal, orgasmic, fertility, and menstrual outcomes. It included 55 manuscripts (8 animal, 46…
LIT-0382024PRSDLiterature sweep · Oct 2026 - Peer-reviewed paper
Isotretinoin-related adverse sexual and reproductive outcomes: a real-world pharmacovigilance study of the FDA Adverse Event Reporting System (FAERS)
Cansu Altınöz Güney; Huriye Aybüke Koç · Cutaneous and Ocular Toxicology
Using FAERS data from 2004-2024 via the public dashboard and OpenVigil 2.1, the authors pulled isotretinoin-related adverse events and ran disproportionality analyses (PRR, ROR with 95% CIs, Evans' criteria) across four MedDRA system organ classes. From…
LIT-0392025PFSPSSDPRSDLiterature sweep · Oct 2026