Going through menopause is a challenging time in any woman’s life. Your friends or your doctor may have warned you about hot flushes, insomnia, or mood swings. But they may not have mentioned dry eyes.
Is there a link between menopause and dry eyes? Researchers believe there is, although the mechanism is as yet unclear. Several studies have found correlations between decreased hormones and dry eyes.
Here’s what you need to know about menopause and eyes.
Menopause and Dry Eyes
To understand why women are more prone to dry eyes during menopause, we first need to look at what causes dry eyes in general.
If you often get a burning or stinging sensation in your eyes, that’s probably because they’ve become dry. This means there’s a problem with tear production. Your eyes produce tears continuously and blinking ensures that your eyes get moisturized.
Here are the main dry eyes symptoms according to the UK's National Health Service:
- Blurry or double vision
- Sore eyes
- Watery eyes (as the eyes try to produce more tears to combat dryness)
- Increased light sensitivity
What Causes Dry Eyes
You can get a dry eye episode at any time in your life. But the problem is more common in the elderly. Here’s why.
Reduced Tear Production
As you age, tear production decreases, which is why older adults, both male and female, complain of dry eyes. As most women go through menopause sometime in their 50s, this is reason enough to experience dry eyes. But it’s not the only explanation.
Low Quality Tears
Older adults also produce tears of a low quality that evaporate quickly, leaving the eyes dry. Tears are more than just water. They’re a mixture of water, oils, and mucus. If the meibomian glands that produce oils become clogged, the tears will become less oily and evaporate faster.
Many types of drugs interfere with normal tears production, including antihistamines, blood pressure medication, or antidepressants.
Women on hormone replacement therapy (HRT) may be at a higher risk of having dry eyes. However, this issue is hotly debated among experts. Many advocate that HRT can reduce problems associated with menopause symptoms and dry eyes.
Hormones and Dry Eyes
All the problems plaguing women during menopause have to do with changing hormone levels. Fluctuations in sex hormone levels are to blame. And it’s not just about menopause, as hormone levels also vary during pregnancy, while on birth control pills, as well as during the menstrual cycle.
Let’s have a look at the way hormone levels fluctuate during menopause and see how this affects your eyes.
- Estrogen is the primary female hormone. Its key role is to promote the health of the reproductive organs. Estrogen levels in the body start declining during perimenopause, the years that precede actual menopause. This isn’t a continual decrease, but a chaotic one with estrogen levels fluctuating wildly. During certain periods, estrogen levels can be way higher than before perimenopause. Lower estrogen levels can cause dry eyes.
- Testosterone is primarily a male androgen hormone. But women also produce testosterone, in a lower amount. The drop in testosterone levels is age-related and begins years before you even start thinking about menopause. Lower androgen levels interfere with many parts of the body, including the eye glands that produce oily substances. This explains the link between menopause and dry eyes.
HRT and Dry Eyes
In the Western world at least, post-menopausal women are often prescribed HRT to balance their hormone levels. There’s a huge controversy concerning the effectiveness and the possible side effects of HRT. But how does this affect dry eyes menopause issues exactly?
In the past, several studies have suggested that with high estrogen dry eyes are less of a problem for menopausal women. For instance, a 1998 study on women complaining of dry eyes found that higher estrogen levels associated with HRT alleviate the symptoms.
This study prompted many doctors around the world to offer HRT to women suffering from dry eyes. But not all were happy with the results.
Oddly enough, there’s a high risk that HRT actually makes your eyes dry. The problem reported by many patients was confirmed by a study published in 2016.
The study concluded that higher estrogen levels cause dry eyes rather than cure them. Participants in the study who were placed on HRT reported more problems with dry eyes than the women who received a placebo.
Finally, a large study conducted on more than 25,000 postmenopausal women found that HRT has a negative effect and increases dry eyes complaints.
Women on long-term HRT seem to be the worst affected. Each 3-year increase in the duration of this treatment raised by 15% the risks of developing dry eyes and experiencing severe symptoms.
The bottom line: it’s hard to tell whether HRT causes dry eyes or cures them. If you’re a post-menopausal woman, you should evaluate the benefits as well as the side effects of HRT. You might be one of the lucky women for whom HRT improves the dry eyes issue associated with menopause.
Treatment for Menopause Dry Eyes
Before resorting to the controversial hormone replacement therapy, there are other things you can do to alleviate the symptoms associated with dry eyes.
OTC Medications for Dry Eyes
There are various OTC medications you can use, but you need to read the insert carefully as prolonged use of certain eye drops can irritate the eyes.
Artificial tears are generally safe. But some of the formulations can contain preservatives that irritate the delicate surface of the eyes.
Ointments and gels provide a long-lasting effect as far as eye dryness is concerned. But you might find them inconvenient as they tend to cloud your vision.
This refers to various drugs that promote and sustain tear production in older adults. These drugs, collectively known as cholinergics, are available in various forms, including eye drops.
Drugs that reduce the inflammation of the eyelids can be helpful. When you have an eyelid inflammation, this may keep the oily substances from mixing with the tears, resulting in poor-quality tears that are unable to properly moisturize the eyes.
Other drugs, such as corticosteroids, combat the inflammation of the cornea, alleviating menopause dry eyes symptoms.
Special Contact Lenses
Chances are that after menopause you’ll be needing glasses anyway. Talk to an expert about special contact lenses designed to trap moisture and prevent irritation of the eye.
Eye Health Supplements
Look also into eye health supplements that can improve the quality of your tear film and boost your overall eye health. If certain nutrients lack from your diet, your eyes suffer.
A full-spectrum eye health supplement like SightC packs antioxidants and other key nutrients that can help alleviate dry eyes.
Dry eyes are one of the many frustrating problems associated with menopause. While getting older certainly plays a role in it, the changes in hormone levels also lead to dry eyes. While HRT may get you rid of the dry eyes issue, several studies point that higher estrogen levels can in fact cause dry eyes.
If you are unsure about HRT, try more conventional treatments, such as eye health supplements and OTC or prescription medications. They can to boost tear production and improve the quality of those tears.
Do you experience dry eye symptoms? Catching the condition early makes it easier to treat. A quick and easy dry eyes test can be the first step in the right direction.