The Link Between Dry Eye and Menopause

An Overlooked Effect of Menopause

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For people who are perimenopausal (nearing menopause) or already in menopause , there can be many symptoms to deal with from hot flashes to night sweats and insomnia. In some cases, some people may experience the onset of dry eye syndrome.

Dry eye affects about 61% of people in perimenopause and menopause. Menopausal people with dry eyes may experience light sensitivity, blurred vision, swollen lids, and increased tearing. These fall under the umbrella of chronic dry eye syndrome.

Mature woman with dried mud around the eye area.

 Henrik Sorensen / DigitalVision / Getty Images

Menopause and Dry Eye

It appears that fluctuating hormones may leave you vulnerable to dry eye. At this point, it's unclear exactly why those edging toward menopause or in the midst of it are more vulnerable. However, it's known that they do suffer from more dry eye symptoms.

Here are a couple of ways hormonal changes may have an impact on your eyes:

  • Your androgen hormone levels decrease when menopause occurs. This impacts both your meibomian glands (which secrete oil for tears) and lacrimal glands (which secrete fluid for tears). These glands located on your eyelids can become inflamed and produce fewer tears of poorer quality.
  • Fluctuating estrogen levels may also play a role as dry eye tends to increase during some parts of the menstrual cycle, as well as in cases where you take birth control pills.

Other Reasons for Dry Eye

But just because you happen to be in either perimenopause or menopause and have dry eye does not necessarily mean that this is the cause. Dry eye can occur for a variety of different reasons.

Dry eye happens when the tears produced are either of poor quality or when there are not enough of them. This can happen to anyone because of issues such as:

  • Environmental factors: These can include everything from staring at a computer screen for too long to living in a dry climate or regularly being exposed to cigarette smoke.
  • Eye stressors: This may come from attempts to improve vision. It may include wearing contact lenses or undergoing refractive surgery with laser procedures such as LASIK or photorefractive keratectomy (PRK), which can decrease tear production.

Complication of Aging

Women over age 50 have dry eye disease more than men of the same age. Research shows that for aging adults, 17.9% of women are impacted by dry eye versus just 10.5% of men.

Some age-related factors that may also contribute to dry eye include:

  • Medications: Antidepressants, decongestants, antihistamines, diuretics (water pills), or blood pressure pills can worsen dry eye issues. Many of these medications are used by people over age 40 in particular.
  • Chronic conditions: Diabetes, thyroid problems, and rheumatoid arthritis can make people more likely to suffer from dry eyes.
  • Hormone replacement therapy (HRT): This therapy used to treat complications of menopause does not appear to reduce the risk of dry eye, and may cause symptoms to worsen.

Any steps to try to remedy dry eye must be done together with full consideration of these other issues.

Dry Eye and Hormone Replacement Therapy

Hormone replacement therapy may be recommended to stave off unwanted effects of menopause like hot flashes and night sweats. The idea of hormone replacement therapy is to give female hormones such as estrogen after the body stops producing as much during menopause.

HRT can help with a lot of problematic effects of menopause. In fact, estrogen may also combat some vision changes and ocular diseases that can occur at this time.

Unfortunately, dry eye is also linked to changes in estrogen levels, which can be a real issue for some people. Those who undergo hormone replacement therapy are also 4-to-7 times more likely to complain of dry eyes.

Dry Eye Relief During Menopause

Fortunately, there are a lot of alternatives for getting relief from dry eyes. These can begin right at home with steps such as these:

  • Taking lots of computer breaks and limiting screen time
  • Increasing moisture in the air with a humidifier
  • Getting plenty of rest
  • Avoiding contact lens use
  • Avoiding excessive smoking and drinking
  • Avoiding spending too much time in air-conditioned and heated spaces
  • Cleaning away any buildup or crusting around your eyelids

You can also possibly get an assist at the drugstore. There you may find a variety of over-the-counter (OTC) medications, as well as prescription options for dry eye such as the following:

  • Artificial tears, gels, and ointments can be used to keep the surface of the eye moist.
  • Restasis (cyclosporine ophthalmic emulsion) may be prescribed in addition to or instead of OTC measures. This not only reduces inflammation but also increases tear production. However, it may take up to three months to notice the benefits.
  • Xiidra (lifitegrast ophthalmic solution) is another prescription that works to tamp down on inflammation associated with dry eyes. With this, some study participants noticed a reduction in dry eye in as little as two weeks.
  • Steroid drops may be prescribed to be used with other medications to reduce inflammation. This, however, cannot be taken for long as extended use of steroid drops can cause an increase in eye pressure or result in the development of cataracts.
  • Punctal plugs, a device placed in the tear drainage area, can help to dam up tears so these remain on the surface longer.

There are also some natural options for reducing dry eye. These include:

  • Eating foods rich in omega-3 fatty acids such as fish, walnuts, and soybean oil. This reduces inflammation and has been shown to decrease dry eye symptoms.
  • Increasing your levels of vitamin A, B12, and D. In particular vitamin D deficiency has been linked to symptoms of dry eye. Vitamins A and B12 are also known to be important for eye health.
  • Reducing blood sugar levels if you have diabetes. Otherwise, nerve damage can occur that can affect the lacrimal glands. The upshot can be poor tear production.

Summary

For those who are menopausal or nearing menopause, hormonal fluctuations can bring on symptoms of dry eye. Managing this can be done through a combination of approaches including diet, over-the-counter and prescription medications, and lifestyle modifications.

A Word From Verywell

If you're in menopause, it may seem that dry eye is just one more thing to worry about. Menopause can bring changes that are both physically and emotionally challenging. This is especially true when these symptoms are all occurring at the same time.

When dealing with your dry eye, try to take this on a day-by-day basis and focus on what you need most at the moment to soothe your dry eyes. This kind of outlook may serve you well in navigating dry eye symptoms during menopause.

Frequently Asked Questions

  • Do dry eyes improve after menopause?

    During menopause some people rely on hormone replacement therapy to navigate side effects such as mood swings, hot flashes, and vaginal dryness that can occur during this time.

    However, this is not without risks such as increased potential for breast cancer and many of these symptoms pass after a few years. So, many people discontinue this therapy when they can. Hormone replacement therapy has also been linked to dry eye. Those who stop taking this medication may see an improvement in their dry eye.

  • Why does menopause affect dry eyes?

    This appears to be linked to your fluctuating hormones. In particular, your meibomian and lacrimal glands may be affected by a reduction in androgen levels. These glands produce oil and fluid for our tears. The result may be tears with less oil that evaporate quicker and cause dry eyes.

    Also, some think estrogen levels may be a factor. This is why people who menstruate can experience more dry eye symptoms during certain times of the month. Likewise, those taking hormonal birth control pills can experience more dry eye symptoms.

    If you are taking hormone replacement therapy, this can also spur dry eyes.

  • What is the best treatment for dry eyes during menopause?

    Symptoms of dry eye whatever the cause can always be treated with remedies such as artificial tears and gels. These can help restore the amount of tears available and also keep tears around longer.

    Use of prescription medications such as Restasis and Xiidra can also help to tamp down on inflammation linked to dry eye. Also, in some cases use of small plugs put in the tear ducts may likewise help to keep tears around.

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12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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