Effect of oral contraceptives on tear film in reproductive age group women

Abstract

Background: According to WHO 2009, 60-70% women use one of the method of contraception. 8.8% to 15.4% women use oral contraceptives. Objective of present study was to investigate the effect of oral contraceptives on androgen profile and tear film parameters in females within child bearing age.Methods: Present study involve 100 healthy women between 20-45 years, who presented in family planning clinic. Two groups were made according to the use of oral contraceptive pills. Study group consist of 50 women who were on OCPs (Oral contraception pills) and 50 as control group were not taking any hormonal contraceptives. Serum testosterone and DHEA levels of all subjects was done by Enzyme Immuno Assay on blood samples which were collected during 3th to 7th day of menstrual cycle. Quantitative test for tear secretion was done by Schirmer’s test. Stability of tear film was measured by Tear Breakup time (TBUT). Statistical analysis was done to determine the correlation between use of OCPs and androgen profile and tear film parameters.Results: Present results shows decreased androgen levels in women taking oral contraceptives as compared with age matched women who were not taking oral contraceptives. Tear secretion was significantly reduced in study group as indicated by decreased Schirmer’s test values in study group as compared to control group, the tear film stability was also significantly decreased in women taking oral contraceptives.Conclusions: Present study suggest that androgen profile decrease in women taking oral contraceptives. These results support that use of oral contraceptives may be an important etiological factor in pathogenesis of dry eye disease reproductive age group women.

Effect of hormonal contraceptives on the ocular surface and the tear film

“…22,23 This normal androgen bioactivity is seen in normal values of tears secretion and stability in women who used combined oral contraceptives, three monthly injections, and subdermal implant hormonal contraceptives. A study by Sharma et al, 3 also found that the serum androgen level (testosterone and DHEA) was slightly decreased by 12% in the hormonal contraceptives group compared with the control, but the tear film parameters are still within normal limits. However, this study does not measure the androgen serum level of all participants, so the relationship between the type of hormonal contraceptives and androgen bioactivity on the lacrimal and meibomian gland is not yet confirmed.…”

“…A similar result was also reported by Idu et al, 10 which found no significant differences in tear secretion and tear stability between women on injectable hormonal contraceptives and women not using hormonal contraceptives. Sharma et al, 3 reported different results that they found a significant decrease in tear secretion in women using oral hormonal contraceptives (13±3 mm) than in the control group (31±7 mm/5min) with p=0.00. Nevertheless, they do not find any significant difference in TBUT value between the two groups.…”

“…The hormonal imbalance that influences tear physiology may be manifested with the use of hormonal contraceptives or menopause when significant changes from the normal hormonal state occur. [3][4][5] Hormonal contraceptives are a known risk factor for DES. However, there is still an unclear association between hormonal contraceptive use and exacerbation of DES in women of childbearing age.…”

“…6,[8][9][10] Another studies reported that women using oral contraceptives were more likely to experience DES than women not using it. 3,11,12 The effect of hormonal contraceptives on the ocular surface was still not apparent. Versura et al 4 reported that the impairment of tear production and stability, ocular surface dryness, and inflammation are significantly related to hormonal fluctuations in the menstrual cycle, especially in patients with DES.…”

Correlation of Blood Glucose Level and Tear Production Among Young Adult Women

“…Our study was supported by the findings of Ihesuilor et al [15] who found that gender significantly influence tear production after the administration of bromfenac. According to Sharma, et al [16] , this could be as a result of a decrease in androgen levels in women taking oral contraceptives. It was concluded from the study that the use of oral contraceptives is an important etiological factor in pathogenesis of dry eye disease in women of reproductive age.…”