Dry Eyes in Menopausal Women : Contributing Factors & Treatment

Dry eyes are becoming a huge problem amongst the general population today. Due to rising pollution and high levels of stress, many people are getting affected by this problem. However, perhaps the most unlikely group that is primarily affected by dry eyes is women over the age of 50 years, meaning those who are menopausal. Nearly 60 percent of menopausal women are affected by dry eyes. While it seems to be a minor health problem compared to what all goes on when you go through menopause, dry eyes can affect the quality of your life and make it difficult to do many things. It particularly makes life difficult when it begins to affect your vision. It is likely that the many hormonal changes you experience during menopause are responsible for causing dry eyes, though the exact reason remains unknown.

Dry eyes happen when you don’t produce sufficient amount of tears, or when the quality of your tears deteriorate, making them ineffective. Dry eyes make you feel like something is stuck in your eyes. Dry eyes also cause burning, stinging, irritation, red or swollen eyes, watery eyes, and blurry vision. Dry eyes are a little known symptom of menopause.

With age, tear production decreases in the body. After crossing the age of 50, your risk of dry eyes increases substantially, regardless of what is your gender. Menopausal or post-menopausal women are especially susceptible to dry eyes. This is thought to occur due to tremendous hormonal changes that take place in the body during menopause. It is believed that the sex hormones estrogen and androgens have an effect on the production of tears in some way. However, the exact relationship between these hormones and tear production is still unknown.

Earlier researchers used to assume that dry eyes were caused in postmenopausal women because of the low levels of estrogen. However, new research has been focusing on the role of androgens, instead. Androgens are known as the male sex hormones, but both men and women have it. Women have low levels of androgen, and these levels tend to become even lower once they reach menopause. It is, therefore, possible that androgens play a part in tear production.

Postmenopausal women suffering from dry eyes also suffer from watery eyes. This is because while tears are being produced, they are unable to ‘stick’ to the eyes well and the front of the eyes tends to thus dry out.

Dry eyes are known as a multifactorial disease, meaning that many different factors end up contributing to the condition. Dry eyes can happen from the following:

• Decrease in tear production
• Tear evaporation, meaning that tears are drying up
• Ineffective tears or tears are of a bad quality

Environmental triggers can also be responsible for contributing towards dry eyes. Some of the main environmental factors that cause tear evaporation include:

• Wind
• Dry winter air
• Air conditioning
• Contact lenses
• Allergies
• Outdoor activities such as running, boating, skiing, etc.

Menopause does not happen overnight. It is important to understand that the transition to menopausal takes place over a number of years. In these years, women begin to experience symptoms of hormonal changes such as irregular periods and hot flashes. This is also the time around which women over the age of 45 years begin to develop dry eye problems.

Postmenopausal women who tend to suffer from dry eyes frequently may experience certain complications, including:

• Increased risk of eye infections: Your tears are responsible for protecting your eyes from any outside irritant. Without an adequate supply of tears, you become exposed to a wide variety of factors that cause eye infections.
• Vision problems or damage: If you suffer from severe dry eyes, it can lead to tears on the surface of the eye along with inflammation. In the long run, this is likely to cause vision problems, pain, or even corneal ulcers in some cases.

Many menopausal women turn to hormone replacement therapy (HRT) to help them deal with the symptoms of menopause. Therefore, it is but common to wonder whether HRT can be of help in treating dry eyes. There is no clear answer to this as of yet. It is, in fact, a question of controversy amongst doctors. While some research studies have shown that HRT can actually help improve the condition of dry eyes, there are many others that show that HRT can worsen dry eye symptoms.

One of the biggest study conducted on this topic found that long-term use of HRT can actually increase the risk and severity of dry eye symptoms. The study showed that large doses of HRT actually worsens the symptoms, and the longer women were on HRT, the more severe their problem of dry eyes became. As of now, research continues to be conducted on this and there is no clear solution on whether HRT can actually be of any help.

Other treatment options for dry eyes in menopausal women include:

It is recommended that you visit a doctor if you feel you are experiencing dry eyes from menopause. Your doctor will prescribe you medications keeping in mind your symptoms and overall health. Some of the different types of medications that are commonly prescribed for dry eyes in menopausal women include:

• Drugs to ease inflammation of the eyelids. Swelling of the eyelids is common in dry eyes. This inflammation around the corners of your eyelids prevents the oil being secreted from the glands from mixing with your tears, thus making your tears ineffective. Many times doctors prescribe antibiotics to counteract this condition.
• Drugs to stimulate tear production. These drugs are known as cholinergics and they help boost the body’s production of tears. Some common medications include pilocarpine (brand name Salagen), cevimeline (brand name Evoxac), etc. These medications are available as an eye drop, in gel form, or even as a pill.
• Special contact lenses. These can help capture moisture and protect your eyes from getting irritated.
• Drugs to reduce inflammation of the cornea. Often times, dry eyes cause inflammation of the eye surface. This can be treated with prescription eye drops. Some doctors recommend eye drops that contain an immune-suppressing medication known as cyclosporine (brand name Restasis), corticosteroids.
• Eye drops made with your own blood. In cases of severe dry eye that does not respond to any other treatments, it is possible that you will be prescribed eye drops made from your own blood. This happens in extremely rare cases.

Usually, there are many over-the-counter medications available for treating dry eyes in menopausal women. Artificial tears have been found to be the most helpful in easing dry eye symptoms. You can also choose from many eye drops that are easily available over-the-counter. While choosing eye drops, do consider the following:

• Avoid using eye drops that contain preservatives as these can irritate your eyes if used for a long time.
• Available in single-serving droppers, eye drops without preservatives are the better option to choose as these are safe to be used for more than three to four times a day.
• If you are using drops for decreasing the redness in your eyes, then do not use them for too long, otherwise, they can cause irritation.
• There are many ointments and gels that provide long-lasting lubrication and form a thick coating around your eyelids, however, they can cloud your vision causing you to see blurry.

There are also many things you can do yourself to avoid this condition from becoming worse and to get relief from the symptoms. These include:

• Protect your eyes: Wearing sunglasses when stepping out of the house will help you block wind and dry air from further drying out the surface of your eyes. These are especially helpful if you are exercising outside, or while running or biking.
• Limit your computer time: Take a couple of breaks from time to time if your job involves working on the computer all day long. Even just closing your eyes for a couple of minutes or blinking rapidly for a few seconds is a good break for your eyes and prevents them from drying out.
• Keep a humidifier in your room: A humidifier adds moisture to the air of the room, which is important to prevent your eyes from drying out. Adding a humidifier to your bedroom is a good idea as while you sleep, your eyes will get the chance to rest and remain moist.
• Avoid irritants or known triggers: Smoke, pollen, dust, etc., are likely to worsen your symptoms. Therefore, avoid these triggers as much as possible while indulging in outdoor activities.
• Maintain a healthy diet: It might surprise you, but a healthy diet can often take care of half our health issues. Consuming a diet rich in omega-3 fatty acids and vitamin A will help in boosting the production of tears.
• Avoid wearing contact lenses: Think about switching to glasses or even special contact lenses designed to trap moisture. Contact lenses are known to irritate the surface of the eye and make dry eyes worse.

Menopause can be a challenging time for many women. If you think you might be experiencing dry eyes because of hormonal changes, then seek the help of your doctor. There are many ways of treating dry eye symptoms and many treatment options available as well that will provide you relief from dry eyes. Do not self-medicate as that may cause more harm. Always talk with your doctor before beginning any form of treatment for dry eyes.

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