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Review
. 2023 Aug 16;23(1):358.
doi: 10.1186/s12886-023-03085-y.

The effects of female sex hormones on the human cornea across a woman's life cycle

Donel S Kelly  1 , Sabhyta Sabharwal  2 , David J Ramsey  3   4 , Melina I Morkin  5
Affiliations
Review

The effects of female sex hormones on the human cornea across a woman's life cycle

Donel S Kelly et al. BMC Ophthalmol. .

Abstract

The cornea is a hormone-responsive tissue that responds to changing levels of female sex hormones. This review focuses on the structural and functional changes in the human cornea associated with the hormonal milestones of menarche, pregnancy, and menopause, as well as consequences stemming from the use of exogenous sex hormones for fertility control and replacement. Articles were identified by searching PubMed without language or region restrictions. The primary outcomes evaluated were changes in central corneal thickness (CCT), intraocular pressure (IOP), and quality of the ocular tear film. The potential impact of hormone-associated changes on the diagnosis and surgical management of common eye diseases, as well as the potential use of sex hormones as therapeutic agents is also considered. Understanding the physiological effects of female sex hormones on the cornea is important because that knowledge can shape the management decisions physicians and women face about ocular health across their life stages.

Keywords: Cornea; Female hormones; Menopause; Menstruation; Pregnancy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Diagram illustrating the layers of the human cornea and location of hormonal receptors. Notations: AR (androgen receptor); ER (estrogen receptor); PR (progesterone receptor); LHR (luteinizing hormone receptor); FSHR (follicle-stimulating hormone receptor). A plus-sign ( +) indicates evidence of receptor or enzyme mRNA expression in that respective layer. Figure was made in ©BioRender-biorender.com
Fig. 2
Fig. 2
Schematic diagram of hormonal changes across the different stages of a woman’s life, illustrating their impact on IOP, CCT, TBUT, and DES, as well as the proposed etiologies for each of these changes. Notations: CCT (central corneal thickness); IOP (intraocular pressure); TBUT – Tear Break-Up Time; DES – Dry Eye Symptoms; LH – Luteinizing Hormone; FSH – Follicle-Stimulating Hormone; ↑—increase; ↓—decrease; →—subsequently
See this image and copyright information in PMC

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