Female Reproductive Factors as Risk of Open-Angle Glaucoma: A Systematic Review: Female Reproductive Factors as Risk

Alyssa Gunawan; Boyke Kuhurima; Fulgensius Atin

doi:10.59747/smjidisurabaya.v3i2.120

Authors

Alyssa Gunawan Widya Mandala Catholic University https://orcid.org/0000-0002-8993-7734
Boyke Kuhurima Siloam Hospital, Kupang, Indonesia
Fulgensius Atin Widya Mandala Catholic University

DOI:

https://doi.org/10.59747/smjidisurabaya.v3i2.120

Keywords:

Estrogen, Female reproductive factor, Human and health, Menopause, Open-angle glaucoma

Abstract

Background: Glaucomatous optic neuropathy arises through multifactorial vascular and mechanical pathways, and estrogen is thought to play a neuro-modulatory role protecting retinal neurons. Given that women constitute a majority of glaucoma patients worldwide, the influence of female reproductive factors on open-angle glaucoma (OAG) risk warrants systematic evaluation.

Objective: This systematic review aims to examine the correlation between female reproductive factors such as age at menarche, parity, menopause, and postmenopausal hormone (PMH) use and the risk of developing OAG.

Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, a comprehensive literature search was performed in PubMed and ScienceDirect databases for studies published between 2010 and 2025. Eligible studies included original articles in English that examined reproductive factors and OAG in adult women.

Result: The initial search identified 3080 articles from PubMed and 208 from ScienceDirect. After screening, only five studies met the inclusion criteria. Overall evidence indicates an association between earlier onset for natural menopause and increased OAG risk, while estrogen-only PMH use may offer a protective effect, particularly among African-American women.

Conclusion: Evidence suggests that female reproductive history may influence the risk of OAG. Early menopause appears to increase OAG susceptibility, whereas estrogen-only hormone therapy might reduce it. Given the limited number and heterogeneity of available studies, further large-scale, well-controlled research is needed to clarify these associations.

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Female Reproductive Factors as Risk of Open-Angle Glaucoma: A Systematic Review