28 November, 2016:
From time to time, we have to remind ourselves and the health-care providers that estrogen and the other sex steroids are actually involved in all the body organs, and that their physiological effects are not limited to fertility, treatment of menopausal symptoms, or cardiovascular and bone protection. Menopause Live has addressed in the past the effects of estrogen on other tissues and bodily functions, such as the skin, the voice or hearing. This time, I put the eye and sight into this context. A small, but double-blind, placebo-controlled study (n = 40, age 63.9 ± 5.1 years, 13.2 ± 6.3 years postmenopause) investigated the outcomes of estrogen, testosterone or their combination in hysterectomized women with dry eyes . The results demonstrated estrogen-related worsening in dryness intensity after 8 weeks of estradiol gel 1 mg/g as compared to placebo; 1% testosterone cream showed a neutral effect, but a combination of the two hormones led to a significant increase in tear secretion.
Dry eye syndrome, also known as keratoconjunctivitis sicca, is a common condition which is the result of low production of tears or too quick evaporation. Symptoms include irritation, redness, discharge, easily fatigued eyes and blurred vision. This can result from meibomian gland dysfunction, allergies, autoimmune disorders, pregnancy, local surgery, smoking, conjunctival infections and other etiologies. Among relevant medications that may cause dry eyes are anti-depressants, which are frequently prescribed in midlife and beyond. Postmenopausal hormone replacement (HRT) has been mentioned in this framework as well. However, there seems to be some controversy in regard to the impact of HRT on dry eyes.