Here is some information from a book called Science Of Sex, written by a doctor named Kevin Pezzi. I recommend everyone here buying this book online as it contains tons of beneficial information.
The mechanism by which Accutane causes sexual dysfunction is not known, but I suspect that it has multiple modes of action.
►I think it interferes with the proper functioning of some sensory peripheral nerves, or their receptors, or the brain’s response to the nerve data, thus greatly distorting tactile fidelity (a subject I will discuss in detail later in this chapter). This disturbance of fidelity is not necessarily confined to the genitals; Accutane has been associated with a dysesthetic230 tingling on nongenital skin, the course and intensity of which seems to parallel the unpleasant sexual “hit your funny bone”
tingling. These dysesthesias may persist for a few seconds after the inciting stimulus is removed. If you lightly touch your skin, for example, the sensation usually ends when the contact ceases. In contrast, Accutane-induced dysesthesias may take seconds to fade away.
►I think that Accutane decreases responsiveness to testosterone, at least in those areas of the brain that control libido.
What is the treatment?
►Discontinue Accutane now. I understand that it can be a difficult decision to choose between clear skin or a satisfying sex life. I cannot make this decision for you, but I can tell you what I would do: stop the Accutane. Physicians have many other ways to treat acne besides Accutane. I would rather use a less powerful therapy and spare my sex life. Every year, I hear from many patients who wish they’d done the same thing.
►Try relatively high-dose supplemental vitamin B6 (but avoid excessive doses that may induce a peripheral neuropathy; see the vitamin B6 section for more information).
►Try other supplements, herbs, and drugs, as discussed elsewhere in this book.
►Stringently avoid other things that may decrease the testosterone level or effect (such as phytoestrogens and antiandrogens).
►Consider using supplemental testosterone. It is useless to use your blood testosterone level to gauge whether or not this is necessary. Judging from tests conducted on people with Accutane-induced sexual dysfunction, Accutane does not seem to appreciably lower the blood testosterone level. What it apparently does is partially block some of the effects of testosterone. This decreased responsiveness is analogous to someone who is hard of hearing. To some extent, you can compensate for their disability by speaking louder. A partially deaf ear needs more sound, and someone who is less responsive to testosterone needs more testosterone. Of course, there are drawbacks to the use of supplemental testosterone. Because the testosterone susceptibility of most areas of the body is not affected, increasing the testosterone level enough to restore libido and sexual sensation may trigger unwanted changes elsewhere, such as alopecia and acne.
►If you are a man, avoid things that increase your estrogen level.
►Avoid things that increase sex hormone binding globulin.
►Experiment with other ways to achieve orgasm. You probably will not want to forgo coitus even if your sensation is affected, because intercourse can be emotionally very satisfying. However, if you aren’t in a relationship and having intercourse, by trying various ways of masturbation, you will likely find that some ways provide less noxious sensations and more pleasant ones. Everyone who has masturbated knows that different techniques produce different sensations. As you will realize once you read the section on sensory fidelity, different techniques of masturbation produce different neural data streams. Accutane effectively distorts this data, which reduces sexual pleasure. However, since neural data streams differ depending on the method of masturbation, some of these will be closer to the ideal that gives optimum pleasure. Your goal is to find one that, once layered on the Accutane-induced distortion, gives a reasonably satisfying experience.
►Be patient. The dysesthesias tend to diminish in time, although it may take years. Your perception of sexual pleasure will likely increase, too, although it may not return to your pre-Accutane zenith. The elimination half-life (that is, the time it takes for half of an administered drug to be excreted) suggests that Accutane does not persist in the body for a long time. The drug may not stick around for long, but its effects do. It is as if Accutane flips some switches in the body. This is true for its intended effect (the long-term suppression of acne), and its sexual side effects. Once flipped, those effects are permanent, or at least very long lasting. Hence, you should think twice before using Accutane. There is no way to
know in advance if your use of Accutane will trigger dysesthesias and reduced sensation. You may take it for a while without any problems, and then wake up with enough sensory abnormalities to make you wonder if your spinal cord was mashed in a vice while you slept. Being cheated out of life’s greatest pleasure is a terrible fate. Are you willing to take that risk?