Dry eyes in menopause – and natural ways to prevent them

By Dr. Mary James, ND

You may not realize that dry eyes are a common symptom of menopause. More than 60% of menopausal women are dealing with this uncomfortable and persistent problem.

Here’s what you can do to help your eyes feel — and look — their best…

9 symptoms of dry eyes

Dry eyes during menopause have related symptoms that can bring on the sudden urge to touch or rub your eyes, which can end up making you feel even worse. These related symptoms include:

• Itchiness
• Scratchy or gritty feeling
• Excessive tearing from the irritation
• Increasingly tired eyes during the day
• Irritation from smoke, wind or air movement
• Stringy mucus excreted by the eyes
• Sensitivity to light
• Blurred vision
• Problems wearing contact lenses

Changes in your hormone levels in perimenopause and menopause can produce many uncomfortable symptoms. Dry eye syndrome is one of them.

How hormonal imbalance causes dry eyes

Just about every structure in the eye, including those responsible for making your tears — such as the lacrimal gland (producing the watery portion of tears) and the Meibomian gland (producing the oily portion of tears) — are influenced by your sex hormones.

The opposing effects of estrogen and androgens (such as testosterone) on tear production appear to reverse at menopause. Specifically, estrogen now appears to inhibit tear production and testosterone enhances it. With menopause, both hormones drop, but the decline in testosterone (already lower in women than men) may have a bigger effect now on your tear production.

When your eyes stay dry for too long, the result is localized, often painful, inflammation and damage to the surface of the eyeball. This immune response generates the release of various inflammatory substances that can make your eyes red, itchy and swollen. The onset of dry eyes often coincides with other symptoms in menopause, like sore joints, dry mouth and dry vaginal tissue.

Also keep in mind that the hormonal changes in perimenopause can trigger autoimmunity in susceptible women, which may include an unmasking of Sjögren’s syndrome, an autoimmune condition that causes dry eyes. If your symptoms are severe, and especially if you have another autoimmune condition, such as rheumatoid arthritis or lupus, get evaluated by your doctor.

Restoring a natural balance between estrogen, progesterone and testosterone is an important, effective remedy for dry eyes, even if you rarely hear that in a conventional eye doctor’s office.

Factors that worsen your dry eyes

On top of menopausal hormone changes, there are other factors that can make your dry eyes worse:

• Staring at computers or reading without blinking often enough to redistribute eye fluid
• Wearing contact lenses that absorb eye fluids
• Having LASIK surgery, which cuts some eye nerves, reducing the impulse to blink
• Taking medications like allergy pills, diuretics, beta-blockers, birth control pills or other drugs that have a tendency to dry out tissues
• Diets without sufficient omega-3 essential fatty acids or other anti-inflammatory foods
• Living and working in dry or windy environments
• Certain health conditions, particularly autoimmune disorders like diabetes, arthritis, lupus and Sjögren’s syndrome

Why eye drops aren’t a long-term solution

The most common conventional treatment for dry eye is drops or “artificial tears” that temporarily restore fluid to the eye. These drops can make it easier to blink in the short term and help to prevent the irritation that results from chronic dryness. However, they should be administered regularly. In contrast, eye doctors do not recommend regular use of those over-the-counter drops that promise to “take the red out,” since they constrict blood vessels and your eye needs adequate circulation to function properly.

Hydrating eye drops, though helpful, produce only temporary relief. For lasting relief you’ll need to take a systemic approach that can help prevent dry eye in the first place.

6 natural tips that work for dry eye

1. Eat the right eye health nutrients consistently. Choose foods and supplements with a good balance of essential fatty acids, especially the omega-3s, EPA and DHA. Also include the antioxidant Vitamin E, which helps protect the omega-3s.
2. Balance your reproductive hormones. Supporting your hormones with targeted herbal ingredients can help your body balance its natural levels of estrogen, progesterone and testosterone.
3. Evaluate your medications. Talk with your doctor about whether a medication could be contributing to your dry eyes. There may be alternative drugs that cause fewer side effects to the eyes.
4. Hydrate your body and humidify your environment. Dehydration can draw fluid from the eyes, so remember to drink plenty of fluids throughout the day. Try using a humidifier to reduce tear evaporation. Make sure to clean it daily to avoid introducing more irritants into the air.
5. Blink! Blinking is the only way to distribute tears across the eye. Try to blink at least every five seconds or so, particularly when looking at a computer or phone screen. It may also be helpful to lower your computer monitor a bit so your eyelids cover more of your eyeballs while you look at it. That saves moisture.
6. Get more sleep. Beyond giving your eyes a chance to rest and refresh, good quality sleep reduces the stress that can contribute to hormonal imbalances. Your body detoxifies and repairs itself while you sleep, which helps soothe inflammation in all of your systems.

If your dry eyes and all the other symptoms that go along with it are really bothering you, find a safe, soothing artificial tear product to use while you pursue other long-term approaches that may take more time to bring relief.

What are other surprising signs of perimenopause and menopause? Dr. Mary James, ND reveals other symptoms you might not realize are connected to your hormonal imbalance.