The Menopause Underbelly of Dry eyes

I was queuing up for my HRT script at a chemist last week when I overheard a lady asking the chemist counter staff to advise her on what to get for her right gritty uncomfortable eye. I was pleased to see the same lady in front of me in the queue to pay for our respective purchases and was curious to see what she was advised to get. So I struck up a conversation with her about her gritty uncomfortable eye and what she got for it. These days I talk with anyone and everyone about menopause. Even men! The eye was normal to look at, she had the symptoms for 2 days and she couldn't work out why she got up with a gritty uncomfortable eye. She told me she is 53 years old without asking. I managed to tell her about dry eyes in menopause and I suggested she speaks to her GP or a health professional. She paid for her artificial tears, collagen supplements and a few other portions that she had picked up, I paid for my HRT and waved each other goodbye with a smile.

This is typical of menopause. We have symptoms but we don't know why? We rightly seek help for the symptoms but often end up spending a small fortune on different treatments. We expect to feel better, so sometimes we do get better, but as we start to feel better, another symptom pops up. As menopausal women, we inevitably get other symptoms of menopause, the more of these unexplained symptoms we get the more sad and depressed we become. We might decide to go to our GP, who will have the same round of treatment to offer, but women promptly tell the doctor that they have tried that particular treatment but didn't work. In fact, women often come to see doctors with all their " expensive portions" in their carrier bags. The doctor may scratch their head and say, "Ha! But you've not tried this brand, it works really well!". The doctor may even recommend a referral to a specialist . But the issue is not the dry eyes! The issue is menopause! So long as menopause and estrogen deficiency is not addressed properly, women continue to waste their money and time and eventually give up seeking medical help. In the end, we give up, shut up and put up with it! Welcome to the Menopause underbelly frustration!

Dry eyes during menopause can be attributed to hormonal changes that occur in the body. Estrogen, one of the leading female hormones, plays a role in maintaining the health of the eyes and the production of tears. When estrogen levels decline during menopause, the composition of tears can change, leading to dryness and discomfort in the eyes.

Additionally, hormonal fluctuations can affect the functioning of the meibomian glands, which are responsible for producing the oily layer of tears that helps prevent evaporation. When these glands do not produce enough oil, tears evaporate more quickly, resulting in dry eyes.

Other factors that can contribute to dry eyes during menopause include:

#1 Aging:

The aging process itself can cause changes in the eyes, including reduced tear production and decreased oil production by the meibomian glands.

#2 Reduced androgen levels:

Androgens, such as testosterone, also play a role in maintaining tear production. During menopause, androgen levels may decrease, further impacting tear production.

#3 Medical conditions:

Certain medical conditions, such as Sjögren's syndrome, an autoimmune disorder that affects the moisture-producing glands, can cause dry eyes. Menopause may exacerbate these conditions.

#4 Medications:

Some medications, such as certain antihistamines, decongestants, and antidepressants, can cause or worsen dry eyes.

You don't have to " suck it up and get on with it" there's help available. Speak to your doctor about your symptoms and expect to be listened to. If you're dismissed or fobbed off with non-evidence-based treatment, seek help from a doctor who is willing to take the time to listen to you and explain all the treatment options that will benefit your current and future health. Various strategies, lifestyle changes, and medical interventions are available to help manage your symptoms and improve your overall well-being during perimenopause and menopause. Body-identical HRT is a safe and effective treatment for menopause.

Dr Purity Carr is a GP and Menopause Doctor in Harvey, Western Australia