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Menopause and Dry Eye

Smiling Mature Woman
Women have a greater risk for developing chronic dry eye than men, especially as women age. According to research published in the American Journal of Ophthalmology, 8.8 percent of women have this diagnosis, compared to 4.5 percent of men. Along with well-known symptoms, such as hot flashes, dry eye is often part of the menopausal transition. If you're a woman who is in or just went through menopause, take a look at what you need to know about dry eye.

What Is Dry Eye?

Everyone's eyes feel dry at some point. Tens of millions of adults in the United States experience mild, non-chronic dry eye during their lifetime, according to the National Women's Health Resource Center. The weather, seasonal allergies, environmental irritants, and a host of other issues can all contribute to the scratchy, often uncomfortable feeling.
When dryness becomes a consistent condition, the eye care specialist may diagnose you as having dry eye. This eye issue is an umbrella condition, with multiple causes that range from autoimmune disorders to hormone fluctuations.

What Role Does Menopause Play?

Research indicates that age and sex (being a woman) raise the dry eye risk. This means menopausal and post-menopausal women are more likely to experience this condition. While science hasn't pinpointed a definitive cause, experts believe that hormonal changes are the culprit behind this eye disorder.
Estrogens and androgens are hormones that can affect tear production. During and after menopause, most women experience a change in hormonal balance, primarily when it comes to sex hormone production and regulation (estrogens and androgens). This hormonal shift is the probable cause of chronic dry eye.

Does Hormone Replacement Therapy Correct the Issue?

If hormonal changes are the cause behind dry eye, it would make sense that replacing or regulating hormones would reverse the eye issue. But this isn't necessarily the case. Hormone Replacement Therapy (HRT) is a common treatment to combat menopausal and post-menopausal symptoms. But when used for dry eye, research shows this treatment may aggravate or contribute to the problem.
A study using data from 25,665 post-menopausal women, published in JAMA, found that using HRT may put women at a higher risk for developing dry eye. Women who took estrogen-only therapies were the most likely to have this uncomfortable eye issue.

What Treatments Are Available?

Given that HRT may not help hormonal menopausal or post-menopausal dry eye, what can help? An evaluation and exam by an eye care professional are the first steps to resolving this problem. The eye care expert will assess the symptoms (and your eyes), looking for other potential underlying causes.
While there is no cure for dry eye, you don't have to suffer with this condition. Artificial tears are a primary type of treatment for dry eye whether it's menopause or non-menopause related.
If artificial tears don't work, some menopausal women respond well to androgen hormone treatments. When used to treat dry eye, this hormonal therapy is not the same as HRT used for general menopause symptoms. This treatment is most effective for menopausal women who have abnormally low testosterone levels, and this option may not work for everyone. Given the potentially serious side effects of androgen therapy, an eye drop (topical) route is preferable.
Punctal plugs are another option that may help to relieve the symptoms of dry eyes. This device stops tear duct drainage, helping to keep moisture in the eye. The insertion procedure is typically a minimal process that has little pain.
Do you have dry eye? Contact Carolina Cataract & Laser Center, P.A. for more information on your options. We can help you ensure that you have the best eye health possible.