Accutane erectile dysfunction: can it last?

Accutane (isotretinoin, sold in the UK as Roaccutane) can cause problems getting or keeping an erection. The UK leaflet and new US labels say sexual problems like this may continue after stopping, and lasting cases are part of post-Accutane syndrome, or PAS.

The NHS page on isotretinoin lists erectile dysfunction but doesn’t say it can continue after stopping. If yours started on the course and hasn’t gone away, the leaflet that came with your capsules already says this can happen.

Stefan was 15 when he took a short course of Accutane. The YouTube channel Moral Medicine filmed his story. By then, it says, he had lived with PAS for almost 19 years.

In the interview he talks about what PAS has done to his life, and the many symptoms he manages every day.

Can Accutane cause erectile dysfunction?

Yes, it’s a listed side effect. The UK leaflet names “problems getting or maintaining an erection”, and says how often this happens “cannot be estimated from the available data”. Our article on Accutane sexual side effects covers the others, such as lower sex drive and numbness.

It’s also the one reported most. A 2023 UK expert review went through reports of sexual side effects sent to the MHRA, the UK medicines regulator, and erection problems topped the list. Most of the men seem to have noticed them within a month of starting.

“This never happened before starting my treatment,” one man told the review.

Not everyone is sure the drug is to blame. In a 2024 study of US health records, men on isotretinoin seemed no more likely than men on acne antibiotics to be diagnosed with erection problems within a year. Its authors note that not every man sees a doctor about it.

Is erectile dysfunction from Accutane permanent?

For some men it has lasted years after stopping. Nobody knows yet who will be affected, or whether it will ease.

The UK leaflet mentions reports of “long-lasting sexual problems where the symptoms have continued despite stopping treatment”. In the UK review, half the men whose reports covered the time after stopping said their erection problems carried on. Two had lasted more than 20 years when they were reported.

In June 2026 the US regulator, the FDA, told isotretinoin makers to add “sexual dysfunction that may continue after discontinuation of treatment” to their labels. Erectile dysfunction is the first example it gives.

The FDA didn’t find “reasonable evidence” that the drug causes these problems, but it noted reports of “notable impacts” on patients. Nobody has measured how often it happens.

Play video: Newcastle dermatology - Isotretinoin

Is it all in my head?

Not necessarily, though your mind can play a part. Severe acne makes depression and anxiety more likely, the FDA notes, and both can affect sex.

The FDA also noticed who was reporting. Most of the reports it read came from young, healthy men and women who mentioned nothing else that might explain the problem.

Two Italian specialists in men’s sexual health warned in 2017 that erection problems in young men are “likely to be overlooked and dismissed” without even a basic check. People assume they’ll clear up on their own, they wrote, and the UK review cites their warning.

Doctors who drew up criteria in 2022 for lasting sexual problems after isotretinoin say a mental health diagnosis doesn’t rule those problems out.

Dr Kenneth Peters, chair of urology at a hospital in Michigan, organised the first summit on PAS and two similar conditions. “It infuriates me when I hear the patient blame side of this,” he told us there.

Play video: Interview with Dr. Kenneth Peters, PFS / PAS / PSSD Summit 2026

What can I do?

These medicines help many people. If you have side effects, that’s a decision for you and your prescriber. The UK leaflet says to talk to your doctor about any sexual problems during treatment.

If your erections haven’t come back since the course, see your GP or a sexual health clinic. Erection problems that keep happening might be a sign of a health condition that can be treated, the NHS says, so a check is worth having.

1

Your medicine

“Isotretinoin 20 mg from March 2024, last capsule September 2024.”

2

What changed

“Erections don’t last”, “no morning erections”, “less feeling in the penis”.

3

When it started

Before the course, while taking it, or after stopping.

4

How it was before

“No problems before 2024.”

Many people say it took time to be taken seriously. Bring the leaflet line. You can report it without a doctor agreeing.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. PAS has no official term of its own yet, so name the symptom, such as erectile dysfunction, and say it continued after you stopped isotretinoin.

Our reporting guide walks you through it

What else do people ask?

Does it get better? Some men improve and some don’t. How many recover fully “has never been properly investigated”, say the doctors behind the 2022 criteria. Problems that last after stopping are part of post-Accutane syndrome, which our condition page explains.

Does the dose matter? Nobody knows yet. Many UK reports didn’t give the dose, so the review couldn’t say how it affects erection problems. It called a link with dose “plausible and logical”, but said this hadn’t been formally shown.

Does Accutane lower testosterone? It may, during the course. The UK review pointed to studies in which testosterone and other hormones fell after three months of treatment, and called this a possible cause of erection problems. The 2022 criteria add that borderline hormone levels in lasting cases may be a result of the condition rather than its cause.

If your erections still aren’t what they were before the course, report it. The MHRA takes reports from any time, even years later.

Sources

1. Roaccutane 10 mg and 20 mg soft capsules, patient leaflet, Electronic Medicines Compendium (EMC 100633), revised April 2026. Section 2 lists “problems getting or maintaining an erection” among the sexual problems. It adds: “There have been reports of long-lasting sexual problems where the symptoms have continued despite stopping treatment with isotretinoin”. It also says: “Talk to your doctor if you experience any sexual problems during treatment”. In section 4 these are listed under “Unknown frequency”.
2. NHS, Isotretinoin (Roaccutane), page last reviewed 26 June 2026. Lists “problems with sex, such as erectile dysfunction (impotence) and low sex drive”; does not mention that they can continue after stopping.
3. NHS, Erectile dysfunction (impotence), page last reviewed 28 July 2023. “See a GP or go to a sexual health clinic if: erection problems keep happening. It might be a sign of a health condition that can be treated”. The doctor or nurse may ask about lifestyle and relationships. They may also do basic checks, such as blood pressure.
4. Commission on Human Medicines, Report of the Isotretinoin Expert Working Group, 26 April 2023. Section 5.3.4.1: 93 Yellow Card reports of erectile dysfunction, half of the 184 reports of sexual side effects up to 20 May 2021. Reduced libido, with 74, was “the second most common type” (section 5.3.4.2). “The majority of men reporting erectile dysfunction appeared to have experienced it within the first month of starting isotretinoin”. “Where information was provided, half of men reported their erectile dysfunction did not stop when they stopped their isotretinoin”. Table 4 gives the duration for 27 men, two of them at 21 and 24 years. The true number “is likely to be higher” because of under-reporting. The patient quote is a comment received through the call for information, in the same section. Section 5.4.1.8: “There is evidence that isotretinoin reduces testosterone levels”, a “possible mechanism for erectile dysfunction and reduced libido”. These are studies by Karadag and colleagues, published from 2010 to 2015, measuring hormones after three months. Section 5.4.2: erectile dysfunction in younger men “is likely to be overlooked and dismissed without performing any assessment”, citing Rastrelli and Maggi (source 5). On dose, sections 5.3.4.1 and 5.4.3: often missing from reports. A dose link “has not been formally established” but is “plausible and logical”. These are voluntary reports, often missing dates and doses. The review could not say isotretinoin definitively caused these effects.
5. Rastrelli G, Maggi M. Erectile dysfunction in fit and healthy young men: psychological or pathological? Transl Androl Urol 2017;6(1):79-90. Sexual Medicine and Andrology Unit, University of Florence. The abstract: erectile dysfunction in younger men “is likely to be overlooked and dismissed without performing any medical assessment, even the most basic ones”, because of “the widespread assumption” that it is “a self-limiting condition”.
6. US Food and Drug Administration, response to citizen petition FDA-2018-P-4088, letter to David Healy, 16 June 2026. Granted in part and denied in part. The FDA found no “reasonable evidence of a causal association”, so there is no Warnings and Precautions entry. The required Adverse Reactions wording: “Abnormal menses, sexual dysfunction that may continue after discontinuation of treatment (including erectile dysfunction, decreased libido, decreased vaginal lubrication, and vaginal dryness)”. Most relevant FAERS reports “featured young, overall healthy men and women without specifically stated additional risk factors for sexual dysfunction”. The continuing problems are “reported to have had notable impacts on patients, especially given the young patient population”. Severe acne carries higher risks of sexual dysfunction, depression and anxiety. FAERS data “cannot be used to calculate the incidence”.
7. Thang CJ, Garate D, Golovko G, Barbieri JS. Isotretinoin exposure does not appear to be associated with risk of adverse male sexual health outcomes in acne patients. Int J Dermatol 2024;63(2):e54-7. TriNetX US health records, male acne patients aged 14 to 40, 13,600 on isotretinoin matched with 13,600 on tetracycline-class antibiotics; erectile dysfunction diagnosed within one year of the first prescription, adjusted risk ratio 1.0 (95% CI 0.55 to 1.8). Limitations named by the authors include “ascertainment bias as not all patients will seek care for sexual dysfunction” and imprecise estimates. The FDA (source 6) judged it too imprecise to bear on causality.
8. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Section 6, post-retinoid sexual dysfunction (PRSD), including “Enduring erectile dysfunction (males)” for three months or more after stopping. “The number of patients who regain 100% of their original sexual function … has never been properly investigated”. “A current diagnosis of a mental health disorder does not prevent a diagnosis of these enduring conditions”. Borderline testosterone or other hormone levels “may be a consequence of the conditions rather than a cause”. An expert consensus built on reports to RxISK.org, a website linked to three of the authors.
9. Newcastle Hospitals, Newcastle dermatology - Isotretinoin, 29 November 2024. Sexual dysfunction “during and following treatment” at 5:13; suicide mentioned at about 4:29.
10. SIDEfxHUB, Interview with Dr. Kenneth Peters, PFS / PAS / PSSD Summit 2026, April 2026. Dr Peters is chair of urology at Corewell Health William Beaumont University Hospital, Michigan. Two post-Accutane patients at about 3:45; “it infuriates me when I hear the patient blame side of this” at about 14:11; suicide mentioned at about 7:40. Our write-up: Dr. Kenneth Peters on the First PFS/PSSD/PAS Summit.
11. Moral Medicine, interview with Stefan, 11 December 2024. The video’s description says he has been living with PAS for almost 19 years after a short exposure to Accutane at 15. Not linked or embedded here, because its opening describes a suicide. If you’re struggling, the Samaritans are on 116 123 in the UK. Our page: Stefan’s story: Accutane at 15.
12. MHRA, Drug Safety Update, 31 October 2023. Yellow Card reports “can be made of suspected reactions experienced at any time, including historic adverse experiences with medicines”, “particularly if a side effect continued or started after treatment was stopped”.