Intraocular pressure (IOP) is a dynamic physiological parameter influenced by circadian rhythm, systemic health, corneal biomechanics, and hormonal status. In women of reproductive age, cyclical variations in estrogen and progesterone during the menstrual cycle may modulate aqueous humor dynamics. The available evidence, however, remains heterogeneous. This updated narrative review synthesizes human studies published between 2000 and 2024 that evaluate IOP across menstrual cycle phases and integrates contemporary endocrine – ocular literature. A structured search identified 214 records, of which 38 underwent full-text review, and 13 phase-specific human studies met eligibility criteria for core synthesis. Across studies, reported IOP changes were generally modest (1–3 mmHg) and frequently within the range of normal diurnal variation or tonometric measurement error. Some investigations report slightly lower IOPs around ovulation or in the mid-luteal phase, whereas others demonstrate no statistically significant phase-dependent differences. Methodological heterogeneity –particularly in menstrual phase verification, sample size, and tonometric technique – limits the strength of conclusions. Current evidence does not support routine clinical modification of IOP measurement timing based solely on menstrual phase. Greater methodological rigor, including biochemical phase confirmation and standardized ocular biometry, is required to determine whether hormonal fluctuations exert clinically meaningful effects on IOP.

Corneal biomechanics, estrogen, intraocular pressure, menstrual cycle, ocular physiology, progesterone