P046 Investigating sexual side-effects in female patients on isotretinoin via routine screening questionnaires

Abstract The relationship between isotretinoin and sexual side-effects is subject to ongoing debate following the October 2023 UK Commission on Human Medicines advisory report recommending stricter monitoring of these side-effects during treatment. We aimed to review sexual side-effects in female patients on isotretinoin as disclosed via routine questionnaires in a single tertiary centre. An observational retrospective review was conducted on all female patients prescribed isotretinoin from 1 November 2023 to 31 October 2024. All patients are routinely sent online questionnaires monitoring for drug side-effects. From November 2023 two screening questions were added. Since your last visit have you had any of the following: (i) Changes to your sexual desire? (ii) Problems with vaginal dryness (female patients), change in periods (female), decreased sex drive (male/female) or other changes in sexual function (male/female)? For all patients completing an updated questionnaire, demographic characteristics and daily and cumulative dosing data were collected. Positive responders to either or both questions were sent a validated questionnaire: the Female Sexual Function Index (FSFI). Data analysis was performed using SPSS Statistics v29.0. Statistical significance was interpreted at the 95% level. In total, 181 female patients were prescribed isotretinoin during the study period, of whom 122 completed at least one side-effect questionnaire. No patients reported sexual side-effects before initiating isotretinoin. There were 27 positive responders reporting sexual dysfunction (n = 18), change in sexual desire (n = 13) or both. This occurred at the first visit (n = 24) or the second (n = 3) (Table). Adjusting for age, atopy and contraceptive use, pre-existing atopy (P = 0.03) was the only statistically significant variable between positive and negative responders on multivariate analysis. Nine (33%) positive responders completed FSFI questionnaires, with a mean score of 8.4. A significant proportion of our female cohort disclosed sexual side-effects on isotretinoin. Given previous studies illustrating conflicting evidence on the subject, further investigation into a relationship would be beneficial (Tan E, Kennedy H, Rademaker M. Exploring the association between isotretinoin and sexual dysfunction: a comprehensive scoping review. Clin Exp Dermatol 2024; 49: 1396–404). This study highlights the need for monitoring platforms to prompt dermatologists to explore genital symptoms and for clear guidance for managing sexual side-effects should these occur.TableOutcomes for positive responders (n = 27)OutcomeNumber of patients (%)Resolution of sexual side-effects7 (26)Sexual side-effects not acknowledged by clinicians9 (33)Sexual side-effects acknowledged by clinicians2 (7)Sexual side-effects acknowledged & managed7 (26)Stopped isotretinoin due to multiple side-effects2 (7)