Effects of isotretinoin treatment on menstrual cycle in acne patients

Isotretinoin is a vitamin A derivative frequently employed in the treatment of acne. Although it is highly effective in acne treatment, menstrual irregularities are a frequently reported as a side effect. This study retrospectively analyzed the data of 122 female patients undergoing systemic isotretinoin therapy for the treatment of acne. Demographic and clinical information of the patients were recorded. The mean age was 20.2 years and the mean age of onset for menstruation was 13.3 years. Menstrual irregularities were observed during treatment in 65 patients (68.4%), whose menstruation was regular before treatment. Among them, 45.3% (43 patients) started to have less frequent menses, 18.9% (18 patients) started to have more frequent menses, 2.1% (2 patients) started to have prolonged menstrual bleeding, and 2.1% (2 patients) started to have shorter menstrual bleeding during treatment. Hirsutism during treatment was statistically more prevalent in those with menstrual irregularities during treatment (p=0.02). In conclusion, our study indicates that patients with regular menstrual cycles prior to isotretinoin treatment developed irregular menstrual cycles after initiation of the medication with a higher prevalence of hirsutism. Further clinical research is necessary to elucidate the mechanism by which isotretinoin affects hormonal imbalances, thereby leading to menstrual irregularities. [Med-Science 2024; 13(3.000): 629-32]