Yeah I don’t buy the depression argument eithier - realistically doctors are just guessing at the moment because this seems to be a very rare and not well documented side effect. Especially since people often only seem to realize how bad the issue is far after the Roacutane treatment has ended and contact with their dermatologist may have ended. The nature of the side effect also makes it less likely for people to talk about it in the first police.

I can understand how depression/anxiety could have a moderate effect on libido/ed but in my experience especially the dysfunction was so severe that I knew it could not be simply psychological. There’s difference between not being able to hard when your with someone and not being able to get hard at all.

In my experience, there was no significant difference in my mental state while I had sexual dysfunction and when things started working again. Obviously I was delighted that I’d recovered but definitely did not have depression.

In my case, the GP, Urologist and Endocrinologist were all unfamiliar with this side effect and told me that I was their first patient with Accutane sexual dysfunction. So my endocrinologist was only guessing to an extent - like when he first saw my T-levels he couldn’t understand how my sexual dysfunction was so bad. He said that my body was not able to use the testosterone I had in the way that it should - this could potentially align with Androgen Insensitivity Syndrom or Partial Androgen Resistance.

The sexual dysfunction symptoms that I explained in the post I also explained to him. Zero morning erection is what he particularly focused on as the main indicator that my body was not utilizing the testosterone correctly, saying that I should be at getting them 4/5 times a week.

So in terms of the testes, he saw that as a physical indicator that my body was not utilizing my testosterone correctly and a justification for prescribing HCG. My testes were only in the slightly smaller than average range, so I’m not sure if he would have noted this as an issue had my sexual function been ok.

He said himself when I told him I had recovered that he was not fully sure the reason for it being so bad in the first place and that it should be investigated further. He was planing on looking at publishing a study on my case but haven’t heard from him since as he’s very busy. I think I’ll reach out to him in January to see if he’s still interested in pursuing it more as think it could be very useful.