Research shows that females experience schizophrenia in various key ways. This includes age of onset, symptoms, and response to treatment.

Schizophrenia is a mental health condition that affects how a person behaves, thinks, and feels. The condition can make it difficult for a person to participate in typical daily activities.

The symptoms of schizophrenia tend to vary from person to person. However, they are generally split into categories that include psychotic, negative, and cognitive. People with schizophrenia may experience hallucinations or delusions. They may also find it difficult to make and stick with plans, or to process information for making decisions.

Treatment options for schizophrenia are available and can improve the quality of life for those with the condition.

This article discusses schizophrenia in females. It explains the prevalence of the condition, how it affects females, and treatment options.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Learn more.

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It is difficult to determine a precise prevalence of schizophrenia. This is due to various factors, such as the overlap with other conditions and the complexity of diagnosis.

However, the National Institute of Mental Health (NIMH)Trusted Source estimates the prevalence of schizophrenia and related conditions in the United States to be around 0.25–0.64%.

Schizophrenia appears to occur more often in males than in females. According to a 2022 reviewTrusted Source, the incidence of schizophrenia in females is 1 to every 1.4 males.

The age of onset for schizophrenia is one of the core differences between males and females.

The National Alliance on Mental Illness (NAMI) states that the average age of onset for schizophrenia is the late 20s to early 30s in females, and teens to early 20s in males. NAMI also notes that it is possible for the onset to occur in people younger than 12 or older than 40, but this is rare.

A 2022 review, however, notes that the prevalence of schizophrenia in females appears to increase in those over the age of 40. The authors of the review state that this could be due to the decrease in estrogen levels following menopause.

This same review also explains that there may be two incident peaks in females. The first peak is between the ages of 20 and 39, and the second occurs during the postmenopausal period.

Symptoms of schizophrenia vary from person to person in general. However, there may also be differences between males and females.

Females may be more likely to experience affective symptoms, includingTrusted Source:

  • depression
  • sexual misconduct
  • sexual delusions
  • impulsivity
  • emotional instability

A 2021 review of research notes that females with schizophrenia may be more likely to attempt suicide, but less likely to complete the action. The reasoning for this is unclear. However, it may relate to the seemingly higher levels of depressive symptoms in females.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

  • Call or text the 988 Lifeline at 988 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
  • Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
  • Not in the United States? Find a helpline in your country with Befrienders Worldwide.
  • Call 911 or your local emergency services number if you feel safe to do so.

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you’re not in the same household, stay on the phone with them until help arrives.

While females may be more likely than males to experience certain symptoms, anyone with schizophrenia can experience any of the core symptoms, such asTrusted Source:

For any gender, the diagnosis of schizophrenia can be difficult. The diagnostic criteria are the same for anybody displaying signs of the condition, however.

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, Text Revision (DSM-5-TR), a person must experience two or more of the following symptoms for a significant portion over a 1-month periodTrusted Source:

  • delusions
  • hallucinations
  • disorganized speech
  • negative symptoms, such as loss of motivation, social withdrawal, and difficulty showing emotions
  • disorganized or catatonic behavior (being awake but not responsive)

These symptoms must be disruptive to a person’s daily life, with signs of disturbance lasting at least 6 months, including 1 month of symptoms.

Schizophrenia risk factors

The NIMH statesTrusted Source that the following factors can increase a person’s risk of developing schizophrenia:

  • Genetics: People with family members with schizophrenia may be more likely to develop the condition themselves.
  • Environment: Along with genetics, a person’s environment and life experiences can influence the development of schizophrenia. These include low socioeconomic status, living in stressful or dangerous surroundings, and exposure to viruses or nutritional issues before birth.
  • Brain structure: People with schizophrenia may have different sizes of certain areas of the brain, as well as connections between areas. It is possible that some of these differences develop before birth.

Just because a person has one or more of these risk factors does not mean they will develop schizophrenia.

Female reproductive transitions and estrogen levels may play a roleTrusted Source in the peak onset of schizophrenia. Changes in estrogen levels may be part of why there is a higher prevalence over the age of 40 in females.

According to research reviews from 2020 and 2021Trusted Source, the decrease in estrogen during and after menopause may make females more susceptible to schizophrenia.

The researchers note that estrogen is considered to be protective against symptoms of psychosis. Estrogen also helps to maintain certain physiological responses that have links to schizophrenia. These include:

These are a few of the factors that may influence the development of schizophrenia as females age and their estrogen levels naturally drop.

According to a 2022 reviewTrusted Source, there are no gender-specific dosing recommendations for the antipsychotic medications that typically help manage schizophrenia. This can lead to, at times, unavoidable risks of overmedication in females. The authors state these differentiations are important because females may process these medications differently than males.

The authors of the review note that current therapeutic strategies also focus on the symptoms that are more common in males than in females. They recommend that future recommendations take this into account.

Schizophrenia is more common in males. However, females may experience the condition differently.

They may be more likely to experience affective symptoms, such as depression, sexual delusions, and impulsivity. They may also be more likely to have a later onset of the condition than males. Females are more likely to experience an onset of symptoms over the age of 40. This may be due to the changes in estrogen levels during and after menopause.

Current schizophrenia treatment recommendations do not take gender into account. Some researchers believe that this is an important distinction to make and future recommendations should include gender differences.

With effective treatment, a person with schizophrenia can improve their day-to-day functioning and achieve personal life goals, such as education, career, and relationships.

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