How Menopause and Hormonal Changes Impact Dry Eye

“God, middle age is an unending insult” -Dorothea Benton Frank

Your body has a number of ways to send messages within itself. The preferred method depends on the nature of the cue one is reacting to. Nerves work very quickly and are thus better for relaying urgent information and commands than hormones — if you see a tiger running at you, an electrical zap is far better suited to tell you to hightail it than the slow bubbling cauldron of chemicals that are hormones.

Hormones are not without their dominion, however. Everything in the body from the highest functions of the brain to fingernail growth depends on them. No one will ever know this better than a woman going through menopause, one of the two greatest hormonal upheavals they will experience in their life.

The eyes are no exception to the rule that hormones govern everything. Six out of ten menopausal women report dry eyes. This is a valid perception: The eyes’ meibomian glands, which are responsible for the production of the oily secretions that prevent tear evaporation, are directly impacted by estrogen. A deficit in estrogen resultingly impairs the meibomian gland’s function. In fact, “drying” is a common symptom of many body parts due to their attributing glands being similarly affected. Imagine the eye as a boiling pot and the meibomian secretions as the lid — take away the lid and that water is going to evaporate a lot sooner.

This all begs the question: what to do about dry eyes as the results of hormonal changes during menopause? An intuitive proposal to treat dry eyes from menopause would be to replace the deficient hormones that cause it. This is, however, not the case. Women who receive estrogen alone are at an even greater risk of getting dry eyes. Our understanding of the delicate interplay of hormones within the body has not yet advanced to the point where we can successfully “replace” them.

At the root of the problem is the lessened function of the meibomian gland, and drugs which specifically promote its function are often prescribed to some effect. Additionally, warm compresses, which themselves provide layers of moisture that seal in the eye’s natural fluids, are effective. Many drugs prescribed to women of menopausal age may dry eyes, particularly antidepressants and some heart medications. Ask your doctor whether this may be the case and pursue alternatives if you feel your eyes are being negatively impacted.

Some remedies effectively address dry eye regardless of their cause: Correctly administered eye drops, sufficient eye rest, and a diet containing omega-3 fatty acids. A specific diet that promotes optimal hormonal function will include whole grains and fewer sugary and processed foods. Additionally, a diet with foods rich in iron, like meat and eggs, is advisable for menopausal women in general. Environmental factors cause and worsen dry eyes as well. Pollution, pollen, and the wind all irritate the eyes and wick away their moisture and are best avoided by all those with dry eyes. Let us know what experiences you’ve had with this! We know it can be irritating, but stick with those treatments, and you’re sure to have successful relief.


One Love,

Dr. Jenna Zigler

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Dr. Jenna Zigler on August 24 2017 at 01:18PM

Great question, Michelle! Here we are referring to a few different medications. First of all, a high-quality omega 3 formula for dry eye is going to help the meibomian glands produce the correct oils needed to lubricate the eyes. Other options, especially for those with acne rosacea, are azithromycin (usually topically) and tetracycline oral antibiotics like doxycycline. Restasis has also been shown to be advantageous in those with MGD.

Michelle Fournier-Dyke on August 23 2017 at 07:16PM

Dr. Jenna Zigler – what drugs are you referring to that promote Meibomian gland function in the article above? I’d like to address with my eye dr.

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