BACKGROUND: Female patients with schizophrenia may experience sexual dysfunction during the recovery period. Therefore, this study conducted a multifactorial analysis to identify factors impacting sexual dysfunction, aiming to aid in developing effective personalized intervention strategies and improving sexual function recovery in these patients. METHODS: This retrospective study included the clinical data from 261 female schizophrenia patients treated at the First Affiliated Hospital of Jinzhou Medical University, diagnosed between February 2022 and March 2024. Based on the total Female Sexual Function Index (FSFI) scores, the patients were divided into the female sexual dysfunction (FSD) group (n = 69) and the non-female sexual dysfunction (non-FSD) group (n = 192). The clinical data of these patients were evaluated using the FSFI, Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), and Olson Marital Quality Questionnaire. Furthermore, univariate and multivariate logistic regression analyses were used to investigate the factors influencing sexual dysfunction in these patients. RESULTS: The FSD group exhibited significantly lower scores in sexual desire, orgasm, and sexual satisfaction than those in the non-FSD group (p <
0.001). Analysis revealed that menstrual status, reproductive history, and mental health status (anxiety and depression) were significantly associated with sexual dysfunction (p <
0.05). Furthermore, marital satisfaction, personality compatibility, spousal communication, conflict resolution methods, and sexual life were significantly linked to sexual dysfunction (p <
0.05). Additionally, childbirth (Odds Ratio (OR) = 2.531, 95% Confidence Interval (CI) = 1.025-6.25, p = 0.044), marital satisfaction (OR = 0.886, 95% CI = 0.824-0.952, p = 0.001), conflict resolution methods (OR = 0.816, 95% CI = 0.743-0.897, p <
0.001), sexual life (OR = 0.929, 95% CI = 0.876-0.986, p = 0.016), anxiety (OR = 1.459, 95% CI = 1.231-1.729, p <
0.001), and depression (OR = 1.116, 95% CI = 1.008-1.236, p = 0.035) were found as independent influencing factors for sexual dysfunction in these patients during the recovery phase. CONCLUSION: Childbirth, anxiety, depression, marital satisfaction, conflict resolution methods, and sexual life serve as independent influencing factors for sexual dysfunction in female schizophrenia patients during the recovery phase. Management approaches targeting these factors can significantly improve sexual dysfunction in this patient population.