Just like people who do not have the condition, not everyone with schizophrenia wants to date or have sex. Creating intimate relationships and having sex can be complicated, especially when living with a long-term health issue. Schizophrenia symptoms, drug side effects, stigma, and more can impact a person’s desire and ability to have sex.1
Negative symptoms and sex
Negative symptoms are a main feature of schizophrenia. They are called negative because they involve the loss of something that once existed. Among other things, a person may lose their:1-3
- Sense of motivation
- Ability to express emotions
- Desire to socialize
- Ability to feel pleasure
Many of these symptoms can affect a person’s drive to create new relationships. They can also impact a person’s desire to have or enjoy sex. This can be especially frustrating for people who want to have sex but cannot get their mind and body on the same page.1-3
Drug side effects and sex
Some drugs used to treat schizophrenia may have side effects that affect sexual function or sex drive. Certain antipsychotic drugs may directly impact a person’s ability to have sex. For example, some drugs increase levels of prolactin in the body. Prolactin can decrease sex drive and make it difficult to have an erection.1-4
Other drug side effects include visible motor symptoms or metabolic syndrome, which causes weight gain. These changes can lower a person’s self-esteem. When you do not feel comfortable and confident in your body, you may want to have sex less.1
Relationship-building and stigma
Creating an intimate relationship requires trust and open communication. As a relationship becomes more serious, you may need to tell your partner about your diagnosis. This can be a scary task.5,6
Unfortunately, there is stigma around schizophrenia. Many people do not understand what schizophrenia is. They also might not know that symptoms can be manageable.5,6
The way schizophrenia is portrayed in the news, in movies, or on TV can make matters worse. People with schizophrenia are often shown as violent, unpredictable, or needing to be hospitalized. Fear of reactions because of stigma can make telling people about your diagnosis and building strong relationships challenging.7
The choice of whether to share your diagnosis, and when, is up to you. You may need to give your partner space and time to process what you have told them. This does not mean they do not care about you. Even in the best relationships, people may need time alone to think through things. Try to have the conversation when you are both focused and in good spirits. Allow yourselves plenty of time to talk further if needed.5
The importance of safe sex
People living with schizophrenia may be more likely to practice risky sexual behaviors, like not using a condom during sex. This may be due to episodes of psychosis, when their connection to reality is shaky.8,9
Also, people with schizophrenia are more likely to experience a lack of housing, intimate partner violence, and substance use disorder. These challenges make them more likely to participate in risky sexual behaviors, too.8,9
Unwise sexual behavior leads to an increased risk of developing sexually transmitted infections (STIs). STIs can be lifelong or dangerous to your overall health. This makes practicing safe sex especially important.8,9
You can contact your doctor for STI screening tests any time. Many doctor’s offices can supply condoms, too. If they do not, they can likely connect you with places to get these supplies. Many supports offer them free of charge.
If you do not want to see your doctor for STI testing, you can use the GetTested online tool from the Centers for Disease Control and Prevention (CDC). By searching your zip code, you can find fast, free, and confidential testing in your area.10
Talk with your doctor if you are having issues with your sex drive, problems with sexual performance, or drug side effects that affect your sex life. They may be able to adjust your treatment plan or recommend options to help.