The Link Between Dry Eyes and Menopause

Dry eye disease, which is often referred to as dry eye syndrome or simply dry eyes, is a highly common optometric condition that occurs when your body does not produce enough tears to keep your eyes lubricated and comfortable. Dry eyes can be uncomfortable, oftentimes creating symptoms like burning or general eye redness.

While dry eye syndrome is one of the most common eye health concerns among both men and women, women seem to have more problems with dry eyes than men. It is estimated that nearly five million people over 50 years of age have problems with dry eyes; at least three million of these people are women, whereas only 1.68 million are men.

Researchers tout several reasons why women may be more prone to dry eyes than men. For example, dry eyes are oftentimes blamed on environmental factors like exposure to cosmetics. However, women are also more prone to dry eyes due to estrogen fluctuations. This explains why women who are taking birth control, are in menopause, or who are pregnant often have dry eyes.

The tear film produced by the tear glands and ducts has three important layers: mucous, aqueous fluid, and fatty oils. Normally, this combination of agents ensures the eye's surface remains well lubricated, smooth, and protected from foreign debris. However, people with dry eyes have some kind of disruption or dysfunction in their tear production. The two primary things that can go wrong include a decrease in tear production and an increase in tear evaporation, and, sometimes, people can have problems with both.

Aging, certain medical conditions, and even insensitivity of the corneal nerve can lead to lacking tear production. Eyelid issues, eye allergies, exposure to dry air, and even less frequent blinking can cause problems with heightened tear evaporation. Some of the things that can contribute to dry eyes for either lacking tear production or heightened tear evaporation include.

• Low vitamin A intake

• Wearing contact lenses

• Prior refractive surgery

• Prolonged screen times

• Overuse of certain eye drops

Regardless of whether you are male or female, your risk of developing dry eye as you get older grows. This is because tear production naturally wanes with age. However, postmenopausal women can be more at risk.

Large-scale studies have shown that almost double the number of women who are over 50 years of age have problems with dry eyes compared to men in the same age group. This, along with several studies, points to the fact that there is a hormonal factor behind women being more susceptible to dry eye syndrome.

Researchers have found a link betweenlow estrogen production and dry eyes, even though the exact relationship between the two issues is not entirely clear. There has been some speculation that lacking estrogen production affects the glands in the eyes that produce tears, which can lead to inflammation of the eyelids and reduce tear quality.

Beyond estrogen, androgens, which are sex hormones that both men and women produce, are also thought to play a role in dry eyes. Women naturally have lower androgen levels than men, and those levels drop substantially after menopause. Therefore, the change could lead to a disruption of tear production

Dry eye treatment with HRT is a relatively modern idea, and not all doctors will recommend HRT for dry eyes alone. Menopause can come along with quite a few undesirable symptoms, such as hot flashes, mood swings, and decreased sex drive, all of which may be something a doctor would be more comfortable treating with HRT.

The reason behind the hesitation to treat dry eyes with HRT is twofold. One, there is not a great understanding of exactly how hormones play a role in tear production or tear evaporation, even though most research points to the fact that there could be a link. Secondly, the largest cross-sectional study published to date offered conflicting results. Dry eye severity and symptoms among women on HRT and not on HRT was highly varied, and some women reported worsening dry eye symptoms with longer HRT treatment.

While some women may experience better outcomes with dry eye symptoms while undergoing HRT, many women may need a little something extra to better support eye function. That extra option is something easily accessible: fish oil. Fish oil contains omega-3 fatty acids, which may help with tear production, decrease tear evaporation, and combat the symptoms of dry eyes related to menopause.

The type of fish oil needed to deter problems with dry eyes is something to consider. Not every fish oil supplement delivers the same level of nutritional value. Look for fish oil that contains re-esterified triglycerides and at least 2,000 milligrams of the two omega-3 fatty acids, DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid).

In a randomized study of 105 subjects with dry eye disease, those given this particular form of supplement experienced a significant difference in things like tear osmolarity, tear break-up time, and overall eye lubrication. In order to achieve these results, the subjects took the supplement for three months. Therefore, you should expect taking a good fish oil supplement for dry eyes to take a little while to yield benefits. Usually, people start to see a difference at around two or three months.

Even though dry eyes may not be the most worrisome symptom of low hormone levels, this optometric issue can be both frustrating and uncomfortable. With a better understanding of how hormones play a role in eye health, professionals are better equipped to manage your symptoms.

If you are dealing with low hormone levels and dry eyes, be sure to talk to your doctor about HRT, and look for a good fish oil supplement that can also help. Reach out to us at Harbor Compounding Pharmacy for more information about how we can help.  Make sure to also visit our Bioidentical HRT for Women page to find out Harbor Compounding Pharmacy can personalize HRT therapy for you.