I used to be on Accutane. It only worked while I was on it and my acne has been getting worse and worse each month I've been off of it (but not as bad as it was before Accutane). Since finishing Accutane, I've tried a few more prescription topical medications with little results (but better results than when I took numerous topical medications before I was on Accutane -- the drug dramatically changes your skin, I think forever, in a good way). Accutane was the only system that truly worked and have thought about asking my doctor to put me back on it at my dermatology appointment tomorrow. But going back on it isn't an option for me. Why?

Because I no longer have health insurance. I would have to pay $90 for each monthly visit to the dermatologist. I would have to pay a $200 or $300 more in blood work a month. I would have to pay over $100 for the generic Accutane. If I did become sexually active, I'd have to pay the gynecologist to tell me which pills I should be on and then pay for the pills each month. I'm a grad student that works part time and simply can't pay for all of that out-of-pocket. I would have to pay all of this money just to follow the laws protecting the pregnancy I'll never have (since I've never been sexually active, probably because of my horrific acne! Plus, I'm responsible.) So the best treatment for my condition is out of my reach because the government doesn't trust me with my own sex life.

And the kicker: the program does nothing to reduce pregnancy among women taking Accutane. As much as conservatives think so, you simply can't regulate people's sex lives.

I am going to venture that this has less to do with protecting the fetus than it does with protecting the doctor. The risk of a malpractice lawsuit is HUGE when birth defects occur, even ones not related to medication. Add a medication that is known to cause problems, and doctors have to do everything they can to protect themselves. I am not saying this is good or bad or how it relates to feminism. But I think this is the real cause of this situation.

Mama Mia, lots of medications cause birth defects. Probably most of them do, or at least the risk of birth defects are unknown, and so women are advised not to take or handle the medication if pregnant or planning to become pregnant. But those medications aren't regulated like Accutane. With those medications, women are just told not to get pregnant. They don't have to take monthly pregnancy tests, use two types of birth control (one of which is almost always prescription), and make the anti-pregnancy pact.

UnfunnyFeminist: That's something that, I think, I had in mind when I was writing the post, but somehow didn't articulate, and you're so, so right. I'm going to go back and add it.

I don't understand why they can't trust patients here. I, for example, am not sexually active, and would abort a pregnancy if I somehow got pregnant, so there is no need to drag me in every month for testing before I can get my medication.

Mama Mia: That's the point one commenter made over at my blog. But the same end would be achieved by having patients sign a waiver.

(Unfunny: In Mama Mia's defense, isotretinoin is a much, much stronger teratogen than other medications. But I still maintain that this over-regulation is unnecessary.)

Apparently (according to an internet search), Accutane is considered a very risky drug because of the severe birth defects it can cause. In 2002, Congress took up the issue and the FDA changed the rules regarding how it is regulated. Lots of drugs have the potential to cause birth defects, but Accutane seems to be guaranteed to cause birth defects, and many lawsuits have resulted and many women have felt they were not given enough information about the risks to make the decision. I think the seriousness of the precautions is meant to make it very clear that a pregnancy could be a disaster, since most people (including me) tend to take those waivers you have to sign with a grain of salt.

Like I said, I am not making a statement on whether this is good or bad for women, but I think it is meant to provide women enough information and protect doctors.

i was on accutane about a year and a half ago, and while i was told to use two forms of birth control if i had sex (i wasn't and am still not sexually active) i never had to sign any sort of waiver, maybe because i'm in canada? anyways, the drug was not for me, it did very little to improve my acne/medical condition and caused me to become very depressed and suicidal. i'm on diane 35 right now, which is a hormonal acne treatment (aka birth control!) and it is working fantastically.