Dry Eye

Do Hormonal Changes in Women Cause Dry Eye?

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In this prospective observational study, 30 young healthy women with regular (24 to 32-day) menstrual cycles attended 3 visits on day 7, 14, and 21 (± 1) of their menstrual cycle. A general health questionnaire was conducted at baseline, and symptoms at each subsequent visit were tracked using Ocular Surface Disease Index (OSDI) and overall ocular comfort (OOC, visual analogue scale). Efron scales, tear break-up time (TBUT) and phenol red thread (PRT), were used to assess ocular signs. Pearson’s correlation was used to determine associations between variables at each visit.

Twenty-six women (mean age = 22.3 ± 3.7 years) completed the 3 visits. According to the researchers, “the interaction between signs/symptoms and lifestyle factors changed over the cycle.”

On day 7 (follicular phase), lifestyle factors (diet and levels of stress) were correlated with PRT (r = – 0.4, p = 0.022) and OSDI (r = 0.4, P = 0.045). On day 14 (ovulation phase), the general health score was correlated with OOC scores (r = 0.4, P = 0.047). Additionally, exercise frequency correlated with PRT (r = – 0.4, P = 0.028). On day 21 (luteal phase), there was no correlation found between lifestyle factors and dry eye signs or symptoms.

The authors concluded that during the ovulation phase, the associations between lifestyle factors and objective and subjective ocular surface assessment appeared to be more pronounced.

“Natural hormonal changes during menstrual cycle should be considered for diagnosis and treatment of dry eye in young healthy women,” the authors concluded.



Colorado LH, Edwards K, Dinh L, et al. Associations between the menstrual cycle, lifestyle factors and clinical assessment of the ocular surface: a prospective observational study. BMC Womens Health. 2020;20(1):23.

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