Does Retinal Aging Differ Between Women and Men?
Women and men do not necessarily show the same patterns of aging.
Hormones, metabolism, body composition and cardiovascular risk change differently across the lifespan. A 2026 study suggests that some of these differences may also be visible in the retina.
Using artificial intelligence, researchers examined retinal photographs from more than 71,000 UK Biobank participants.
They found that retinal age could be estimated with similar accuracy in women and men. But what an older retinal age was associated with showed some interesting differences.
What is retinal age?
Retinal age is an estimate of age generated by artificial intelligence from a photograph of the retina.
Researchers compare this estimate with chronological age to calculate the retinal age gap.
A higher retinal age gap means that the retinal features detected by the model appear older than expected for a person’s actual age.
It does not mean that the entire body has aged by the same number of additional years.
What was different in women and men?
The ability of artificial intelligence to estimate chronological age was very similar in both sexes.
The differences appeared when researchers looked at the relationship between retinal age and other aspects of health.
In men, a higher retinal age gap showed stronger associations with metabolic syndrome and several related metabolic factors.
In women, the picture was more complex.
Some relationships between retinal age and health differed depending on whether women were premenopausal or postmenopausal.
This suggests that sex alone may not tell the whole story. The stage of a woman’s life may also matter.
What happened around menopause?
Postmenopausal women had a higher retinal age gap than premenopausal women.
Researchers also found that some health associations in older and postmenopausal women became more similar to those observed in men.
This is biologically interesting because menopause is accompanied by major hormonal and metabolic changes, including declining estrogen levels and changes in cardiovascular and metabolic risk.
However, the study cannot tell us whether menopause itself caused the differences seen in retinal age.
Women before and after menopause also differ in age and in many other health characteristics. The findings therefore show an association, not proof that hormonal changes directly accelerate retinal aging.
Could hormones influence retinal aging?
Possibly, but the evidence is not yet sufficient to answer this with certainty.
The study found that hormone replacement therapy was associated with a lower retinal age gap. This raises an interesting question about whether hormonal exposure may influence retinal aging patterns.
But this finding should be interpreted cautiously.
Women who use hormone replacement therapy may differ from women who do not in many ways, including health status, healthcare use and other lifestyle or clinical factors.
The study was not designed to determine whether hormone replacement therapy makes the retina biologically younger.
Why could these differences matter?
Many risk assessments in medicine have historically treated age as a relatively simple variable.
But aging biology may be more complex.
The same marker may carry somewhat different information depending on sex, hormonal status and stage of life.
The retinal-age findings suggest that future aging biomarkers may need to account for these differences rather than applying exactly the same interpretation to everyone.
For women in particular, the transition through menopause may eventually prove important when interpreting some biomarkers of aging.
That possibility is scientifically interesting, but it still requires further research before it can guide individual clinical decisions.
