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Luisa Colorado, Katie Edwards, Lynne Dinh, Sarah Ha, Danica Liu, Annie Luu, Shona Trang, Tina H Yu-Ting, Katrina L Schmid; Lifestyle factors and menstrual cycle phases: impact on dry eye signs and symptoms. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4903. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
The aim was to explore the interactions between lifestyle factors and menstrual cycle phases on the ocular surface of young healthy women using clinical assessments
This was a prospective 1-month observational study. Thirty young healthy women with regular, 24 to 32-day menstrual cycles were recruited. Participants attended three visits at day 7, 14, and 21 (±1) of their menstrual cycle. At baseline, general health was conducted and inclusion/exclusion criteria were applied. At each visit, symptomology was quantified using Ocular Surface Disease Index (OSDI) and overall ocular comfort (OOC, visual analogue scale). Ocular surface assessment, tear break-up time (TBUT) and phenol red thread (PRT), were also assessed at each visit
A total of 26 participants (mean age=22.3±3.7 years) with an average menstrual cycle of 28.3±1.3 days completed the 3 visits. Some signs and symptoms changed over the menstrual cycle; blepharitis was lower at day 7 (0.2±0.2) than day 21 (0.4±0.3) (p=0.003); MGD was lower (0.4±0.4) and PRT scores higher (19±5) at day 14 compared to day 21 (0.8±0.5, p=0.005; 16±7, p=0.013 respectively); and, OOC scores were higher at day 21 (32±23) than day 7 (21±20) (p=0.030). The interaction between signs/symptoms and lifestyle factors also changed over the cycle. At the follicular phase (day 7), lifestyle factors such diet and levels of stress were correlated with PRT and OSDI, (r = -0.4, p=0.022; r=0.4, p=0.045 respectively). At the ovulation phase (day 14), the general health score was correlated with OOC scores (r=0.4, p=0.047). At day 14, exercise frequency correlated with PRT (r =-0.4, p=0.028) and caffeine intake was positively correlate with both; TBUT (r=0.5, p=0.020) and PRT (r=0.5, p=0.014). At the luteal phase (day 21), we found no correlations between lifestyle factors and DE signs or symptoms
The effect of lifestyle factors on DE sign and symptoms appeared to be more pronounced during the ovulation phase compared to the follicular and luteal phase of the menstrual cycle in young healthy women. Misalignment of these factors with the ocular health during the luteal phase could be attributed to pre-menstrual syndrome and elevated levels of progesterone. Natural hormonal changes during menstrual cycle should be considered for the association between lifestyle factors and DE sign and symptoms in young healthy women
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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