On Accutane, I had no side effects except for chapped lips. But, yeah, I'll agree it changes some hormone levels. In fact, that's it's mechanism of action. For me Accutane worked amazingly well...before it I spent years trying all the OTC products, antibiotics, Retin-A, etc. Nothing else completely got rid of my acne, even when I was 25. Then I tried low dose of Accutane and within 2 months my face was completely clear. So while Accutane may not be for everyone, it's amazing for some people.
Also, I'd point out the it's been heavily used for over 20 years now, and for males it still hasn't been conclusively linked to any serious side effects. That doesn't mean its completely safe, or that no one suffers its side effects, of course. But, to me at least, it seems to be well worth the risk.