Skip to main content Accessibility help

Visual sensitivity across the menstrual cycle

  • ALVIN EISNER (a1) (a2), SARA N. BURKE (a3) and MAUREEN D. TOOMEY (a1) (a2)


This study was designed to evaluate the hypothesis that hormonal change can affect lower level light-adaptation processes, which are likely to be retinally based. Foveal visual sensitivities were measured across several menstrual cycles of four women not using hormonally acting medication and across several menstrual cycles of three women using a triphasic oral contraceptive. One woman, diagnosed with premenstrual syndrome (PMS), was a subject for both groups. Sensitivities were measured for a series of test wavelengths for 580-nm backgrounds of 2.0 and 4.0 log td. Of the six individuals tested, one had clear evidence of visual-adaptation changes occurring in phase with the menstrual cycle. Prior to using the oral contraceptive, this individual (the PMS subject) experienced changes of short-wavelength-sensitive (SWS)-cone-mediated sensitivities of up to about 1.4 log unit on the 4.0 log td background. Her SWS-cone-mediated sensitivities tended to be highest near ovulation and lowest premenstrually. Threshold-versus-illuminance (TVI) curves confirmed that the rate of sensitivity decrease with increasing background illuminance (i.e. the TVI slope) was greater premenstrually. The degree of background-induced desensitization within her middle-wavelength-sensitive (MWS)/long-wavelength-sensitive (LWS) cone pathways also appeared to vary cyclically, but the magnitude of the variation was smaller and the time course appeared to be different. When this subject began oral contraceptive use, the patterns of sensitivity change were all altered. None of the other five subjects experienced changes of SWS-cone-mediated vision that were cyclic and significantly adaptation-state dependent. However, there was evidence for a limited degree of cyclic adaptation change within the MWS/LWS cone pathways of at least one additional subject. We conclude that hormonal change can—for some unknown proportion of women—be linked to alterations of retinal function. However, the alterations are not the same for all visual pathways, and there are pronounced individual differences. The data also demonstrate that individuals' visual adaptation capabilities can vary substantially over periods of weeks.


Corresponding author

Address correspondence and reprint requests to: Alvin Eisner, Neurological Sciences Institute, Oregon Health & Science University, West Campus, 505 NW 185 Avenue, Beaverton, OR 97006, USA. E-mail:


Hide All


Calkins, D.J. (2001). Seeing with S cones. Progress in Retinal and Eye Research 20, 255287.
Cleveland, W.S. (1979). Robust locally weighted regression and smoothing scatterplots. Journal of the American Statistical Association 74, 829836.
Dacey, D.M. (2000). Parallel pathways for spectral coding in primate retina. Annual Review of Neuroscience 23, 743775.
Eisner, A. (1986). Multiple components in photopic dark adaptation. Journal of the Optical Society of America A 3, 655666.
Eisner, A., Austin, D.F., & Samples, J.R. (2004). Short wavelength automated perimetry and tamoxifen use. British Journal of Ophthalmology 88, 125130.
Epperson, C.N., Haga, K., Mason, G.F., Sellers, E., Gueorguieva, R., Zhang, W., Weiss, E., Rothman, D.L., & Krystal, J.H. (2002). Cortical gamma-aminobutyric acid levels across the menstrual cycle in healthy women and those with premenstrual dysphoric disorder: a proton magnetic resonance spectroscopy study. Archives of General Psychiatry 59, 851858.
Felius, J. & Swanson, W.H. (2003). Effects of cone adaptation on variability in S-cone increment thresholds. Investigative Ophthalmology and Visual Science 44, 41404146.
Freeman, E.W. (2003). Premenstrual syndrome and premenstrual dysphoric disorder: Definitions and diagnosis. Psychoneuroendocrinology 28 (Suppl. 3), 2537.
Garcia-Segura, L.M., Azcoitia, I., & DonCarlos, L.L. (2001). Neuroprotection by estradiol. Progress in Neurobiology 63, 2960.
Goldzieher, J.W. (1990). Selected aspects of the pharmacokinetics and metabolism of ethinyl estrogens and their clinical implications. American Journal of Obstetrics and Gynecology 163, 318322.
Gruber, C.J., Tschugguel, W., Schneeberger, C., & Huber, J.C. (2002). Production and actions of estrogens. New England Journal of Medicine 346, 340352.
Guttridge, N.M. (1994). Changes in ocular and visual variables during the menstrual cycle. Ophthalmic & Physiological Optics 14, 3848.
Holmes, T.T. & Rahe, R.H. (1967). The social readjustment rating scale. Journal of Psychosomatic Research 11, 213218.
Hood, D.C. (1998). Lower-level visual processing and models of light adaptation. Annual Review of Psychology 49, 503535.
Kaja, S., Yang, S.H., Wei, J., Fujitani, K., Liu, R., Brun-Zinkernagel, A.M., Simpkins, J.W., Inokuchi, K., & Koulen, P. (2003). Estrogen protects the inner retina from apoptosis and ischemia-induced loss of Vesl-1L/Homer 1c immunoreactive synaptic connections. Investigative Ophthalmology and Visual Science 44, 31553162.
Katzenellenbogen, B.S. (2000). Mechanisms of action and cross-talk between estrogen receptor and progesterone receptor pathways. Journal of the Society for Gynecologic Investigation 7, S33S37.
Kobayashi, K., Kobayashi, H., Ueda, M., & Honda, Y. (1998). Estrogen receptor expression in bovine and rat retinas. Investigative Ophthalmology and Visual Science 39, 21052110.
LaGuardia, K.D., Shangold, G., Fisher, A., Friedman, A., & Kafrissen, M. (2003). Efficacy, safety and cycle control of five oral contraceptive regimens containing norgestimate and ethinyl estradiol. Contraception 67, 431437.
Lambert, J.J., Belelli, D., Peden, D.R., Vardy, A.W., & Peters, J.A. (2003). Neurosteroid modulation of GABAA receptors. Progress in Neurobiology 71, 6780.
Leavitt, W.W., Cobb, A.D., & Takeda, A. (1987). Progesterone-modulation of estrogen action: Rapid down regulation of nuclear acceptor sites for the estrogen receptor. Advances in Experimental Medicine and Biology 230, 4978.
Marin-Castano, M.E., Elliot, S.J., Potier, M., Karl, M., Striker, L.J., Striker, G.E., Csaky, K.G., & Cousins, S.W. (2003). Regulation of estrogen receptors and MMP-2 expression by estrogens in human retinal pigment epithelium. Investigative Ophthalmology and Visual Science 44, 5059.
McCullough, L.D. & Hurn, P.D. (2003). Estrogen and ischemic neuroprotection: An integrated view. Trends in Endocrinology and Metabolism 14, 228235.
McEwen, B. (2002). Estrogen actions throughout the brain. Recent Progress in Hormone Research 57, 357384.
McEwen, B., Akama, K., Alves, S., Brake, W.G., Bulloch, K., Lee, S., Li, C., Yuen, G., & Milner, T.A. (2001). Tracking the estrogen receptor in neurons: Implications for estrogen-induced synapse formation. Proceedings of the National Academy of Sciences of the U.S.A. 98, 70937100.
McEwen, B.S., & Alves, S.E. (1999). Estrogen actions in the central nervous system. Endocrine Reviews 20, 279307.
Munaut, C., Lambert, V., Noel, A., Frankenne, F., Deprez, M., Foidart, J.M., & Rakic, J.M. (2001). Presence of oestrogen receptor type beta in human retina. British Journal of Ophthalmology 85, 877382.
Nilsson, S. & Gustafsson, J.A. (2002). Biological role of estrogen and estrogen receptors. Critical Reviews in Biochemistry and Molecular Biology 37, 128.
Ogueta, S.B., Schwartz, S.D., Yamashita, C.K., & Farber, D.B. (1999). Estrogen receptor in the human eye: Influence of gender and age on gene expression. Investigative Ophthalmology and Visual Science 40, 19061911.
Pugh, E.N. & Mollon, J.D. (1979). A theory of the pi1 and pi3 color mechanisms of Stiles. Vision Research 19, 293312.
Ross, C., Coleman, G., & Stojanovska, C. (2003). Prospectively reported symptom change across the menstrual cycle in users and non-users of oral contraceptives. Journal of Psychosomatic Obstetrics and Gynaecology 24, 1529.
Schmidt, P.J., Nieman, L.K., Danaceau, M.A., Adams, L.F., & Rubinow, D.R. (1998). Differential behavioral effects of gonadal steroids in women with and in those without premenstrual syndrome. New England Journal of Medicine 338, 209216.
Segal, M. & Murphy, D. (2001). Estradiol induces formation of dendritic spines in hippocampal neurons: Functional correlates. Hormones and Behavior 40, 156159.
Shapiro, A.G., Beere, J.L., & Zaidi, Q. (2003). Time course of S-cone system adaptation to simple and complex fields. Vision Research 43, 11351147.
Smith, M.J., Keel, J.C., Greenberg, B.D., Adams, L.F., Schmidt, P.J., Rubinow, D.R., & Wassermann, E.M. (1999). Menstrual cycle effects on cortical excitability. Neurology 53, 20692072.
Speroff, L., Glass, R.H., & Kase, N.G. (1999). Clinical Gynecologic Endocrinology and Infertility, 6th edition. Baltimore, Maryland: Lippincott Williams and Wilkins.
Wickham, L.A., Gao, J., Toda, I., Rocha, E.M., Ono, M., & Sullivan, D.A. (2000). Identification of androgen, estrogen and progesterone receptor mRNAs in the eye. Acta Ophthalmologica Scandinavica 78, 146153.
Wilkinson, L., Blank, G., & Gruber, C. (1996). Desktop Data Analysis with SYSTAT. Upper Saddle River, New Jersey: Prentice Hall.
Williams, D.R., MacLeod, D.I A., & Hayhoe, M.M. (1981). Punctate sensitivity of the blue-sensitive mechanism. Vision Research 21, 13571375.
Wong, C.G., Bottiglieri, T., & Snead, O.C. (2003). GABA, gamma-hydroxybutyric acid, and neurological disease. Annals of Neurology 54 (Suppl. 6), S3S12.
Yankova, M., Hart, S.A., & Woolley, C.S. (2001). Estrogen increases synaptic connectivity between single presynaptic inputs and multiple postsynaptic CA1 pyramidal cells: A serial electron-microscopic study. Proceedings of the National Academy of Sciences of the U.S.A. 98, 35253530.
Yilmaz, H., Erkin, E.F., Mavioglu, H., & Sungurtekin, U. (1998). Changes in pattern reversal evoked potentials during menstrual cycle. International Ophthalmology 22, 2730.
Zhang, J.Q., Cai, W.Q., Zhou, D.S., & Su, B.Y. (2002). Distribution and differences of estrogen receptor beta immunoreactivity in the brain of adult male and female rats. Brain Research 10, 7380.



Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed