Dry Eye and Menopause

Published September 3, 2020

Approximately 61 percent of perimenopausal and menopausal women are affected by dry eyes. 

Menopause causes many hormonal changes. During menopause, the body produces less androgen, estrogen and progesterone, causing a variety of uncomfortable symptoms— hot flashes, sweating, insomnia, and even depression.

Among these physical symptoms, menopause can also cause dry eyes. 

Symptoms of dry eyes

  • Burning
  • Iitching
  • Red eyes
  • Gritty feeling in eyes
  • Excessive tearing
  • Foreign body sensation
  • Blurred vision

Biological changes that can affect your eyes 

During menopause, the androgen hormone decreases, affecting the meibomian and lacrimal glands in the eyelids.

When these oil and fluid producing glands are affected, the eyelids can become inflamed, reducing tear production and tear quality— consequently leading to dry eyes.

Some researchers believe that changes in estrogen levels are also linked to dry eye. This may be the reason for an increase in dry eye symptoms during certain times of your monthly cycle, or while taking birth control pills.

Hormone replacement therapy

Hormone replacement therapy is prescribed for the treatment of many uncomfortable menopausal symptoms.

Since hormone changes during menopause are associated with vision changes and ocular disease, your eye doctor may recommend hormone therapy to restore your estrogen levels.

However, while restoring estrogen levels may reduce the risk of eye disease, patients who undergo hormone therapy are four to seven times more likely to develop dry eye symptoms.

The effects of dry eyes

Eye allergies. Increased dryness may lead to increased eye allergies— with less tears to flush the allergens away from the eyes, allergy symptoms may worsen.

Contact lenses. Wearing contact lenses can become uncomfortable with dry, itchy, sore eyes.

Sjögren’s syndrome. When symptoms are severe, it may be a sign of Sjögren’s syndrome, a systemic disease that causes dry eye and dry mouth.

How is hormone-related dry eye treated?

Since reduced hormones during and after menopause generally causes meibomian gland dysfunction which results in dry eye, treatment may be focused on this condition.

Treatments generally include artificial tears lubricating eye drops, eyelid hygiene, warm compresses, oral antibiotics, corticosteroid eye drops, and punctal plugs once the tear film is healthy again.

Moreover, since the dry eye symptoms experienced during menopause are hormone related, studies suggest keeping hormone levels in check to help reduce the risk of dry eye syndrome.

While hormone replacement therapy may be an option for some women, others may prefer a more natural approach to controlling their menopause symptoms.

 The most common natural recommendations include:

  1. Taking herbal supplements including St. John’s wort, ginseng, red clover, black cohosh, dong quai, kava, and evening primrose oil.
  2. Consuming a diet rich in vitamin D or taking a vitamin D supplement to obtain a daily dose of 600 I.U.
  3. Going for acupuncture and massage
  4. Practicing yoga and mindful breathing

Environmental changes to help prevent dry eye

Making lifestyle changes can help to reduce dry eye irritants and prevent worsening of symptoms.

  • Lower your computer screen: If your eyelids are lower, and your eyes are less open during prolonged computer use, you can reduce the surface area from which the tears evaporate.
  • Remove drafts: Avoid using a ceiling fan while you sleep, and turn air vents away from your face.
  • Wear wraparound sunglasses when you venture outdoors.

When to see your doctor

If you are experiencing dry eye, your eye doctor can provide an effective way to treat your symptoms.

As you journey through this new stage in life, discuss any concerns you may have with your eye doctor.