Objective Intraocular pressure (IOP) is essential in maintaining normal function of the eye. High IOP is associated with glaucoma. Many physiological factors, including age and hormones, can cause variation in IOP. This study was designed to investigate IOP changes in postmenopausal women and the associated factors, which included sex hormones and body mass index (BMI).

Methods This was a cross-sectional study. Ninety-eight women were recruited: 49 premenopausal women and 49 postmenopausal women. IOPs between the two groups were compared. The influence of estradiol, progesterone, testosterone, and BMI on IOP was analyzed by a multivariate method. P<0.05 was considered significant.

Results The age of the premenopausal group was 47.14±3.93 years and that of the postmenopausal group was 52.10±3.04 years. The other factors in both groups, which included BMI, blood pressure, and central cornea thickness, were not significantly different. The mean IOP in the postmenopausal group was significantly higher than the mean IOP in the premenopausal group (15.26±2.96 mm Hg vs. 14.07±2.65 mm Hg, P=0.04). BMI had a weak positive correlation with IOP in premenopausal women (r=0.31, P=0.03). Estradiol was less likely to influence IOP changes in the postmenopausal group as compared with the premenopausal group (B=−0.021, P=0.002). IOP was not significantly related to progesterone and testosterone levels.

Conclusion Menopausal status has a significant effect on IOP, with a significant increase in IOP seen in postmenopausal women as shown by our study. Estradiol was shown to be a protective factor in reducing IOP among postmenopausal women. Through understanding of the influence of postmenopausal status and sex hormones on IOP, glaucoma management may be improved and the target group for disease screening may be more specific.

Significance statement Intraocular pressure (IOP) is essential in maintaining normal function of the eye. High IOP is associated with glaucoma. Many physiological factors, including age and hormones, can cause variation in IOP. Menopausal status has a significant effect on IOP, with a significant increase in IOP seen in postmenopausal women as shown by our study. However, changes in IOP with menopausal status do not appear to have any correlation with sex hormone changes, but body mass index had a weak positive correlation with IOP in premenopausal women. Through understanding of the influence of postmenopausal status and body mass index on IOP, glaucoma management may be improved and the target group for disease screening may be more specific.