Sexual Function and Gonadal Hormones in Patients Taking Antipsychotic Treatment for Schizophrenia or Schizoaffective Disorder

Objective: To determine rates of sexual dysfunction and hypogonadism and establish the relationship between gonadal hormone levels and sexual function in patients taking antipsychotic treatment for schizophrenia or schizoaffective disorder.

Method: We studied 103 patients with schizophrenia or schizoaffective disorder (mean age = 46.2 (SD = 12.9) years; 51.5% male) from October 2003 through March 2005. Sexual function was assessed using the Sexual Functioning Questionnaire (SFQ) and compared with (1) normal controls (N = 62; mean age = 36.1 (SD = 9.6) years; 55% male) recruited from primary care attendees and (2) sexually dysfunctional controls recruited from a local sexual dysfunction clinic (N = 57; mean age = 39.1 (SD = 10.7) years; 79% male). Prolactin, sex hormone-binding globulin, testosterone, estradiol, progesterone, follicle-stimulating hormone, and luteinizing hormone levels; psychopathology; and side effects were measured.

Results: Mean (SD) total SFQ scores were significantly greater in patients (women = 9.9 [5.3]; men = 7.8 [4.9]) compared with normal controls (women = 4.1 [2.9]; men = 4.09 [2.95]), and similar to the scores of sexual dysfunction clinic attendees (women = 7.2 [2.9]; men = 9.9 [4.5]). The odds ratios of patients having sexual dysfunction compared with normal controls were 15.2 for women and 3.7 for men. Hypogonadism was common (in premenopausal women, 79% showed hypoestrogenism and 92% showed low progesterone levels, and 28% of men showed hypotestosteronism). There was no association between total SFQ scores and prolactin or gonadal hormone levels.

Conclusion: Patients receiving treatment for schizophrenia or schizoaffective disorder show high rates of sexual dysfunction and hypogonadism. Sexual functioning was not related to prolactin or gonadal hormone levels.