Eye Exams, Hormones & Menopause

Did you know that having dry eyes is a lesser known symptom of menopause? I sure didn’t, but I learned this new tidbit when I went for an eye exam this past week. After having the dilation exam and going over the outcome from that, she asked me if I noticed that I didn’t tear up as much, or itchy dry eyes, and discomfort.  After thinking about it a bit, I realized that in fact I don’t. So the cause….yep…you guessed it….once again it’s those hormones that are to blame. The primary ones are thyroid hormone, insulin, and sex hormones like estrogen and androgens  that affect tear production, although the exact relationship is not yet known.

Some research has shown that androgens, “male” hormones like testosterone, that men and women both make, but women have lower levels of androgens to begin with play a bigger role in managing the delicate balance of tear production more than estrogen. Whether you're a man or woman, lower androgen levels may affect how well certain glands make tears or the oily film that keeps the surface of your eye moist.

Doctors call dry eyes a multifactorial disease, which generally means several different things may contribute to the problem. Typically, dry eye problems stem from one or more of the following:

  • decreased tear production
  • tears drying up (tear evaporation)
  • ineffective tears

Dry winter air (time to move to Mexico for winter!), wind, allergies, contact lenses, various pollutants can all contribute to dried-out eyes. Unless someone has come up with a way to completely control your world (anyone, Buehler?), being aware of how these elements and making some small shifts can help provide some relief. For instance, on windy days, wearing glasses or sunglasses helps block the wind from wicking your eyes dry. Adding a humidifier in your house can bring some relief to your eyes and also your skin. Keeping your air conditioner’s filter cleaned or changing out periodically also can help keep eye-irritating pollutants from entering your home.

By now, I’m guessing you’re ready to hear how to get some relief for those dry, itchy eyes!

Try Over-the-Counter Eye Drops

My eye doctor gave me a sample of a tear substitute (quick-acting) to use morning and night. Gel drops are a longer-acting solution but can blur vision. For women allergic to preservatives, there are also some preservative-free formulations. Caution: Avoid the ‘get the red out’ and ‘clear eye’ drops as these can cause rebound redness, inflammation and even more dryness if used for prolonged periods.

Take It Easy on Your Eyes

Start batting those baby blues greens, browns…) more often! Blinking more helps to lubricate your eyes. If you wear contacts, try and limit how many hours a day you wear them and switch out with glasses to give them a rest.

Eat Right

Besides being good for your heart, omega-3 fatty acids are good for your eyes. A 2011 study from the Mount Sinai School of Medicine found that eating unsaturated fatty acids can effectively treat dry eyes. Aim for at least two portions of fish a week, of which one should be oily fish like salmon, tuna, or mackerel. If fish isn’t your thing, find a good omega-3 fatty acid supplement.

Talk to Your Doc

Hormone (and eye!) happiness in menopause just might mean finding the right experts to provide the relief needed. In addition to talking with your perimenopause and menopause specialist about any and all menopausal symptoms that are difficult, an ophthalmologist (eye surgeon) might also be helpful. Look for an ophthalmologist with knowledge of anatomy, physiology and diseases of the eye along with knowledge in the unique eye changes that occur during menopause.

One of the undeniable and inevitable facts of life is that we are all aging. It was Bette Davis who said, “Old age ain’t no place for sissies!” As a hot flasher for close to 15 years and now a dry eye sufferer I guess I’d have to add that ‘menopause ain’t for sissies’ either!

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