Menopause and Dry Eye Disease: Symptoms & Treatment
Written by Kristen Stewart
Menopause isn’t a disease. It’s a natural part of a woman's reproductive cycle. But menopause can affect your daily life with uncomfortable side effects, and one less-talked-about symptom is dry eye.
Notoriously, the hormonal changes of menopause can trigger hot flashes, night sweats, and irritability. But menopause might also cause dryness, itching, and burning in your eyes, which can add discomfort to the already uncomfortable bodily changes that menopause brings.
Medical researchers and healthcare professionals are making progress in understanding the full scope of menopause’s effects on your body. Modern treatments are available to ease your symptoms and help you regain control over an often tricky stage in your body’s development.
We explain more about the relationship between menopause and dry eye and how to treat and manage both health concerns.
Does menopause cause dry eye?
Many women experience dry eyes during menopause. If your body responds to menopause in this way, you might wonder if this bodily change contributes to your eye discomfort.
While every woman's health situation is different, there’s a strong connection between menopause and dry eye. Dry eye symptoms can often present before menopause, while you’re still menstruating, then continue to get worse as your hormones shift.
To understand the link between the two, it’s important to note that people often misuse menopause to describe the end of a woman's childbearing years. However, there is much more to the process than simply stopping your monthly cycles.
The three stages of menopause
Three stages make up the menopause transition:
- Perimenopause. The timing is different for everyone, but perimenopause typically lasts from four to eight years. It begins with changes in the length of your cycles and ends 12 months after your last period.
- Menopause. A doctor confirms you’ve reached your menopause when this period-free year is up. It typically occurs in women between 45 and 60 years of age but might onset earlier for women who have undergone surgery to remove their ovaries.
- Postmenopause. This begins after menopause and lasts for the rest of a woman's life. Even once you’ve entered postmenopause, symptoms of perimenopause and menopause can linger for several years.
Every stage involves hormonal changes that can lead to physical issues, including dry eyes.
Common symptoms of dry eye
Living with dry eye may not sound like a big issue compared to some other unpleasant effects of menopause. But it can have a significant impact on your comfort, productivity, and even your general health.
When people think of dry eye, they may imagine a bit of scratchiness when blinking. But dry eye and menopause can also lead to more severe symptoms, including:
- burning eyes, which can be painful
- a gritty feeling like there’s something in your eye, which can be distracting and distressing
- watering, excessive tearing, and even blurred vision
Can menopause affect eyesight?
Menopause can and does affect eyesight in different ways. Dry eye due to menopause can have wide-reaching repercussions.
- Eye allergies might produce more severe symptoms. If you have an eye allergy, your symptoms may become more bothersome. This is because there’s not enough moisture to flush pollen and other allergens out of your eyes.
- It might become harder to wear contact lenses. You may also feel discomfort when wearing contact lenses due to a lack of lubrication.
- You have a higher risk of eye infection. Dry eye means that you’re more likely to experience an infection or an eye injury like a corneal ulcer. Without enough tears, your eyes are less protected from both.
These and other menopause eye problems can cause discomfort and distress.
Dry eye causes in menopausal women
Hot flashes and burning eyes can work in tandem to trigger the effects of dry eye. Several different menopause-related conditions (or a combination of them) can contribute to reducing the moisture in your eyes.
Menopause-linked health issues can cause dry eye’s characteristic itching and burning by:
- decreasing tear production
- making tears that evaporate or dry up quickly
- producing tears that aren’t as effective as a barrier against infection and injury
Hormones are chemical messengers in your bloodstream that trigger critical processes in organs and tissues. But sex hormones like androgens and estrogen don’t only play a role in reproductive health.
They also affect many vital bodily functions, including development, growth, and metabolism. Hormones even affect your mood — as women going through menopause will be all too aware.
Female hormones and dry eye
While experts have determined that hormonal changes can contribute to dry eye, they’re still unsure how. We know that the circulation of the sex hormone androgen decreases during menopause, affecting both the meibomian and lacrimal glands.
The meibomian glands sit along the edge of the eyelids and close to the eyelashes. The upper eyelid has 25 to 40 glands, while the lower eyelid has 20 to 30. The lacrimal glands are just above each eyeball.
A drop in androgen levels means that the glands don’t create and secrete as much oil and fluid. This reduces tear production and affects the quality of those few tears that do reach the eye’s surface.
Estrogen changes and the eyes
Estrogen, the female sex hormone, often triggers dry eye for women in the following scenarios:
- during a course of birth control pills
- at specific points during their menstrual cycle
Some researchers suggest that fluctuations in estrogen levels may contribute to dry eye. Researchers have also speculated that low levels of estrogen in postmenopausal women could also play a role in its development.
How to treat dry eye disease
Dry eye and menopause can go hand in hand for many women. The good news? A variety of treatment options are available to bring relief to women living with this uncomfortable condition.
Eye drops and other over-the-counter remedies
Eye drops are one easy and frequently successful way to ease the unpleasant symptoms of dry eye. They typically work by providing extra lubrication and maintaining moisture on the eye’s outer surface.
Some eye drops contain preservatives, while others are preservative-free. Typically, larger multi-dose bottles have preservatives added to prevent bacterial growth in the drops.
However, these chemicals may irritate some people's eyes, especially those who use the drops too frequently.
Preservative-free dry eye drops
Many people who live with dry eye prefer preservative-free eye drops, which usually come as a single dose. These drops can help relieve dry eye in everyone with the condition. But they particularly help those who have a moderate-to-severe presentation of its symptoms.
Other options include ointments and gels designed to lubricate the eyes by creating a thick coating. However, their viscosity might temporarily make your vision blurry.
Prescription medications and treatments
Over-the-counter (OTC) eye drops work well for many people. They might not resolve symptoms for everyone, but a doctor can prescribe stronger medications for those whose dry eye is severe or persistent.
The type of prescription medication will depend on the underlying cause of the dryness:
- Prescription eye drops. If inflammation is occurring on the surface of the eye, prescription eye drops like Klarity eye drops are available. These contain an immune-suppressing medication called cyclosporine. Corticosteroids may also ease discomfort and swelling.
- Eye inserts. These sit between the eyeball and eyelid, releasing a lubricant substance over time. They can help you reduce the effects of dry eye related to menopause.
- Oral antibiotics. If eyelid swelling prevents oils from combining with the tears, oral antibiotics may counter the inflammation and bring down the swelling.
- Tear-stimulating medications. Other medications can stimulate tears in patients whose natural tear production has slowed due to an underlying condition.
- Specialized contact lenses. A particular type of contact lens can help you keep moisture in and irritants out.
Avoiding environmental triggers
Several environmental triggers can contribute to your itching and burning during dry eye, including
- Air temperature and moisture. Indoor air conditioning, the wind outdoors, and dry winter air can affect the moisture content in your eyes.
- Allergies. An adverse reaction to irritants like pollen can also contribute to dry eye.
- Smoke exposure. Smoke irritates the eyes, so exposure can produce dry eye symptoms.
If you're struggling with feelings of itching, burning, or grittiness in the eyes, try to avoid these possible causes.
To help with dry eye symptoms during menopause, there are several lifestyle measures and home remedies you can adopt to feel more comfortable.
Try to incorporate the following tips into your everyday routine on top of your prescribed eye drops:
- Eat a balanced, nutritious diet. Make sure your daily food intake provides enough vitamin A and omega-3 fatty acids to encourage the production of tears.
- Use eye protection. Protect your eyes with sunglasses that will keep out wind and dry air. Wrap-around-style sunglasses give optimal protection.
- Take breaks from screen use. Try not to spend too much time staring at a computer monitor or other screens. When it’s unavoidable, such as during work hours, be sure to take breaks. While you’re giving your eyes a rest, close your eyes or blink several times.
- Use a humidifier. Air with a higher water content can help prevent the eyes from drying out.
Hormone replacement therapy
Given the general belief that changes in sex hormones can contribute to dry eye, and considering many doctors’ use of hormone replacement therapy (HRT) to relieve the effects of menopause, it's natural to ask whether HRT could also help you manage symptoms of dry eye.
The answer, however, is unclear.
While hormone replacement therapy’s estrogen boost could help, research has produced mixed results. One study found that symptoms improved for women under the age of 50 years. Other data has shown that taking HRT might even increase your risk of dry eye.
Approach HRT with caution for dry eye symptoms. It might be best to ask your doctor about alternatives, such as prescription or over-the-counter dry eye drops.
Other causes of dry eye
While dry eye and menopause often go hand in hand, this challenging time of life isn't the only cause of dry eye.
Underlying medical conditions
Certain medical conditions can affect tear production and quality, as well as eye dryness. These include:
- rheumatoid arthritis
- Sjogren's syndrome
- thyroid problems
- Parkinson's disease, due to a lack of blinking
- eyelids that turn inward or outward, which increases how rapidly tears evaporate
Any of these diseases and conditions can prevent the eyes from creating enough moisture.
Medication side effects
Many medications can cause dry eye as a side effect, including:
- drugs for treating high blood pressure
- some preservative-containing eye drops
Some methods of vision correction
Wearing contact lenses may also cause or worsen dry eye disease. So can LASIK surgery, but the issue is typically short-term after this procedure and self-corrects over time.
Simply getting older can also increase your chance of developing dry eye disease. Menopause usually onsets as a result of aging, for example.
Other menopause eye problems
There are some menopause vision problems aside from dry eye, including:
- blepharitis (eyelid inflammation)
- blurred vision
- eye pain
Try these home remedies for menopause eye problems:
- fish oil supplements
- warm compresses
- a humidifier
- OTC eye drops
These can return comfort and moisture to your eyes.
If these dry eye treatments don’t help to soothe your menopause eyesight problems, speak to an eye doctor and have them recommend a tailored treatment plan for your symptoms. As every person’s body is different, an eye doctor can recommend a course specific to your optical needs.
Dry Eyes and Menopause - In Summary
Dry eye can be uncomfortable and disruptive, especially when you’re facing other physical difficulties during menopause. The resulting blurred vision (or other menopause-related vision changes) can impact daily activities like reading, driving, and working.
However, dry eye can also lead to other health problems, such as eye infections, and can even damage the eye’s surface. Going without treatment for dry eye could mean that it progresses to corneal ulcers and vision loss.
There are many ways to manage the condition and keep your eyes as healthy as possible. These include regular eye drops, eating a healthy diet, and avoiding potential triggers like dry air, allergens, and excessive screen use.
Menopause may cause unpleasant symptoms, but dry eye doesn't have to be one of them. Talk to our team of experienced eye doctors about trying Klarity cyclosporine eye drops — they can be a simple, low-cost solution during an uncomfortable time of your life.