Can schizophrenia affect fertility in a 26-year-old woman?

Question

Hello, doctor,

I am a 26-year-old woman living with schizophrenia since my early 20s. I am stable now with medication, but I often feel anxious about the future, especially about relationships, pregnancy, and parenting. I have read that schizophrenia symptoms can get worse with hormonal changes like menstruation, childbirth, or menopause. I am worried if I should stop or adjust my medications if I plan to get pregnant. Can pregnancy make my condition worse? Will the medications harm the baby? How does schizophrenia affect women differently from men? Will pregnancy or periods worsen my symptoms?

Kindly suggest.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concerns.

Here is what matters most:

Pregnancy and symptoms: Hormonal changes can affect schizophrenia. Pregnancy itself is variable—some women stabilize, others may see symptom changes, especially postpartum (high vigilance needed then). Periods may cause cyclic symptom fluctuations for some.
Medications and pregnancy: Do not stop your medications suddenly. Many antipsychotics are used safely in pregnancy (for example, Quetiapine, Aripiprazole, Risperidone), though risks vary. Untreated psychosis poses greater risks to you and the baby than most medications. Discuss specific medicines with your psychiatrist before pregnancy.
Gender differences: Women often have a later onset (20s or 30s), mood symptoms (like depression), and may respond better to some medicines. Hormones (estrogen) may offer some protective effect until menopause.
Planning is key: Work with a perinatal psychiatrist and your gynecologist before conceiving. They will help you in the following ways:

Adjust medications to the safest options.
Monitor closely during or after pregnancy.
Create a strong support plan (including postpartum).

You can pursue motherhood with careful planning, based on a specialist's advice, which makes a significant difference.

I hope this helps.

Thank you.