What symptoms do you think of when it comes to menopause? Hot flashes, insomnia, skin dryness, mood swings, fatigue, headaches — all the usual suspects, right? Yet one symptom affects more than 60% of women and they don’t even know it’s connected to menopause: dry eyes. And more often than not, other imbalances that affect the eye are also at work but only become evident when hormones begin to fluctuate.

Eyes are the windows of the soul, it’s said. But in my experience they are also windows into your physiology and can turn dry, itchy, red, and irritated in, literally, the blink of an eye. Symptoms of dry eye are an invaluable warning that something deeper is brewing in your system and needs to be looked at — a truth many Eastern practitioners have known for millennia.

Dry eye is not an isolated condition, one that is best served by covering up the symptoms with drops or blocking the eye’s tear drainage system. At Eye & Vision, we’ve had tremendous success treating dry eye from the inside out. So let’s take an up-close look at dry eye because it can affect so many of us and learn how to restore balance to the body and the eyes.

Identifying the cause of dry eye by imbalances that lead to many cases of dry eye extend much deeper, particularly for women in perimenopause and menopause.

Hormones play an important role in tear
production and lubrication.


Hormonal changes and dry eyes
The degree to which your hormones affect your eye health depends largely on your individual blueprint and lifestyle. However, studies have linked androgen (testosterone) and estrogen receptors on the cornea of the eye and on the meibomian gland. This indicates a correlation between the production of tears and our sex hormones.

Before menopause, the more testosterone you have, the fewer tears you produce, while an increase in estrogen means more tear production. However, this equation reverses during menopause — more testosterone means more tear production, while more estrogen means less tear production. And while we still need to learn more about how this mechanism works, it’s clear that hormones play a significant role in lubricating our eyes. It makes sense that dry eyes may result from estrogen deficiency, progesterone deficiency, testosterone deficiency or possibly from an imbalance of any of the three.

When your eyes stay dry for too long, the result is localized inflammation. This immune response releases all kinds of inflammatory substances which make your eyes red, itchy, and swollen. The appearance of dry eyes often coincides with other signs of “drying” in menopause, like sore joints and dry vaginal tissues. Restoring a natural internal balance between estrogen, progesterone and testosterone is an important remedy for dry eyes. This is something we study and hear about in a doctor’s office.

Moreover, the inflammation connection is being supported by the growing trend among doctors to add omega-3 supplements or fish oil to their standard dry eye treatment protocol. A recent study reported that women with a diet rich in omega-3 fatty acids reduced their risk of dry eye by 20% compared to women with low levels of omega–3.

Increasing your intake of omega-3 fatty acids — either in supplements or by eating fish like mackerel, tuna, or wild salmon or certain nuts and seeds — does several things that benefit the eye by benefiting your entire body. For one, they have been shown to naturally moderate inflammation. They also aid in the stimulation of tear secretion and increase the oils in that secretion. Additionally, they may moderate excess estrogen production. And all of these benefits get at the root of dry eyes by providing natural lubrication rather than temporary “artificial” relief.

Conventional dry eye treatments and “artificial tears”

The most common conventional treatment for dry eye is drops or “artificial tears” that temporarily relieve symptoms by restoring fluid to the eye. These drops can be invaluable in the short term for many people with dry eyes by making it comfortable to blink. The unfortunate side effect of drops, though, is that they offer only temporary relief of dry eye symptoms, not a systemic response that helps prevent recurrences and can worsen symptoms over time!

If your symptoms of dry eye are really bothering you, it’s worth finding other long-term approaches, be sure to ask your practitioner for samples. When buying, remember that preservatives irritate some eyes, and drops designed to “get the red out” are not designed for dry eyes.

Keep in mind that using drops is like pouring water into a dry well instead of looking for a new spring — to find permanent relief you need to start digging.

Relief for dry eyes: the Eye & Vision approach

At Eye & vision, we’ve helped many women recover and prevent dry eyes. Every body is unique so you may need to experiment to find a combination of changes that work for you. 

If you have questions, don't hesitate to call us at 972-907-2010. We're here to listen and help.

We’re always happy to welcome new patients to our medical clinic in Richardson, Texas, for those who can make the trip.

Information adapted from: The Tear Film Complex: Pathogenesis and Emerging Therapies for Dry Eyes. Special Article Cornea. 24(1):1-7, January 2005. Smith, Ronald E MD