A RECENT population-based study highlights a concerning trend: the use of oral retinoids among reproductive-aged women is on the rise, yet many are not using necessary contraceptive measures to mitigate the associated teratogenic risks. This gap underscores the urgent need for standardised pregnancy prevention programs for women prescribed these medications.
Oral retinoids, widely used for treating severe acne and other skin conditions, are known teratogens—substances that can cause congenital disabilities. Ensuring that women of childbearing age avoid pregnancy while on these medications is crucial. However, standardised prevention programs are lacking for women prescribed oral retinoids. This study aimed to analyse trends in prescription retinoid use among Australian women aged 15-44 and to assess whether these women concurrently used contraception.
The study utilised dispensing claims from the Australian Pharmaceutical Benefits Scheme (PBS) for a random 10% sample of women aged 15-44, spanning from 2013-2021. Researchers examined annual rates and trends in dispensing claims for PBS-listed retinoids and contraceptives. They also estimated the concomitant use of contraceptives on the day of each retinoid dispensing and checked for overlapping contraceptive treatment periods. These findings were then extrapolated to provide national estimates.
From 2013-2021, over 1.5 million retinoid dispensings were recorded for reproductive-aged women, with oral retinoids accounting for 57.1% of these. The dispensing rate for all retinoids increased from 28 per 1,000 population in 2013 to 41 per 1,000 in 2021. However, while the dispensing rate for oral retinoids doubled during this period, the rate for topical retinoids remained unchanged. Despite the known risks, only a quarter of women prescribed oral retinoids in 2021 had evidence of concomitant contraceptive use.
These findings highlight a critical gap in modern clinical practice regarding the prescription of oral retinoids to reproductive-aged women. The lack of a standardised pregnancy prevention program means that many women might be unknowingly exposed to the risk of serious birth defects if they become pregnant while taking these medications. Highlighting the danger of this trend, lead author and Maternal Fetal Medicine specialist Dr. Laura Gerhardy commented “This is certainly a problem. I have seen multiple women who have conceived unintended pregnancies while using oral retinoids, and then women are left needing to manage the consequences”.
Ultimately, this study underscores the need for better education and stricter protocols to ensure that women prescribed oral retinoids are adequately protected against unintended pregnancies, safeguarding both maternal and foetal health.
Reference
Gerhardy L et al. Prescription retinoid and contraception use in women in Australia: A population-based study. Australas J Dermatol. 2024; DOI: 10.1111/ajd.14294
