Menopause and tear function: The influence of prolactin and sex hormones on human tear production

Purpose. The onset of dry eye is very common during menopause and may result from the loss of hormonal support. The purpose of this study was to assess the effect that changes in sex hormone and prolactin levels have on tear function in premenopausal and menopausal woman. Methods. Women between the ages of 30 and 60 were solicited to participate in a study concerning menopause and tear function. One-hundred and ten women were given tear function tests (osmolarity, tear volume, tear flow, Schirmer's test) and serum levels were measured for total testosterone, estradiol, prolactin, and follicle stimulating hormone. Results. For all women on hormone replacement therapy, we found a strong negative correlation between serum prolactin level and tear function. For women in menopause, total testosterone correlated positively with tear function, whereas for premenopausal women there was a negative correlation between total testosterone and tear function. Serum estradiol levels correlated positively with tear function for women 30-39 years of age, whereas for menopausal women the correlation was negative. Conclusions. This is the first demonstration in humans that tear production is correlated with serum prolactin and sex hormone levels prior to and during the menopause.