Acne Tarda and Accutane - pls help

I‘m F 50 years old and have been struggeling with acne my whole life, but now with perimenopause it is worse than ever. As a woman (in Germany at least) it is almost impossible to get a prescription for accutane, but now that I am old, doctors might do it. I am realky considering it, but I am afraid of the side effects as I am physically quite active and fit and I don‘t want to risk that. I read that people died from accutane when doing sports. can I have your opinion on my situation please?