Critical aspects of the treatment of women with schizophrenia in their reproductive years

Critical aspectsFindingsPotential strategies
Early phases of disorderProdromal signs of psychosis differ between men and womenTraining to recognize sex-specific prodromal signs [26, 27]
High prevalence of childhood adversities in schizophrenia womenCareful history taking and early intervention [26]
Negative influence of hyperprolactinemia on cognitionScreening, prevention, and monitoring of hyperprolactinemia [27, 28]
Sexual and reproductive healthSexual dysfunctionSexual health interventions [29]
Abortion and sexual violencePsychoeducation, family planning [3035]
Sexually transmissible infections relatively high in schizophrenia womenCounselling re safe and effective protection and contraception [28, 32, 33, 36, 37]
Drug-induced hyperprolactinemiaDrug-induced hyperprolactinemia more prevalent in women than men (e.g., galactorrhea, amenorrhea)Appropriate choice and dose of antipsychotics and regular check of prolactin levels [38]
Low fertilityHyperprolactinemia reduces fertilityPersonalized drug choice and dose [39, 40]
Repeat pregnanciesRepeated inadvertent pregnancies

Psychoeducation [39]

Long-term contraception