It was hypothesized that estrogen replacement therapy would help alleviate dry eye symptoms in menopausal women. A study involving thousands of women found that this therapy did not improve the condition and that estrogen with progestin actually made dry eye worse.

Summary. The condition may be called “dry eye,” “red eye,” “computer eye strain,” “allergy eye,” “irritated eyes,” “tired eyes,” “sore eyes,” “itchy eyes,” “puffy eyes,” or “swollen eyes.” Dry eye is experienced by nearly everyone and Bio-Logic Aqua Research predicts that within 20 years, dehydration related eye diseases could become a global health crisis. This “Eye Hydration” series is intended to promote individual health choices based on education that is up-to-date, accurate and “outside the box” where necessary. The fourteenth report describes the impact of hormone fluctuation on dry irritated eyes, particularly during menopause.

Hormones are naturally occurring chemicals in the body that exert a stimulatory effect on living cells, often working through the nervous system. There are hormone triggers for both normal tear production, which supplies the tear film and maintains moist, comfortable eyes; and for reflex tearing, which occurs when one cries, is extremely fatigued, or when foreign substances enter the eye.

Persistent, long term increases in ocular dryness, caused by declining tear production, are associated with increases or decreases in certain triggering hormones. Increased incidence of dry irritated eyes is known to correlate with hormone related factors such as age, gender, pregnancy and certain diseases.

Hormones. Primary hormones thought to influence tear production are the “male” hormones testosterone and androgen, and the “female” hormones estrogen and prolactin (every normal male and female, regardless of age, produces all four hormones. However, females produce more female hormones and males produce more male hormones). Animal studies show that lacrimal (tear) glands shrink when androgen is lacking.

Menopause. One interesting aspect of hormone and dry eye interaction occurs with “hormone replacement therapy” (HRT) used to alleviate menopause symptoms. Since the incidence of dry eye is higher among menopausal and post-menopausal women than pre-menopausal women, it was theorized that estrogen replacement should help alleviate dry eye. However, a study involving thousands of women found that estrogen did not improve dry eye and that estrogen with progestin actually made dry eye worse. Apparently, simply being menopausal does not trigger dry eye.

[1] Dr. William Mathers, Tear Film and Treatment of Dry Eye Disease, © 2004 RxSchools.com. Funded and sponsored by Bio-Logic Aqua Research (Bio-Logic Aqua Technologies) and Nature’s Tears® EyeMist® .