Can Hormone Therapy Help?
Knowing that hormones affect tear production and play a role in dry eye disease, many women wonder whether hormone therapy (HT) might improve their symptoms.
But the answer isn’t straightforward. It’s not as simple as saying low estrogen causes dry eye and more estrogen will fix it, says Nicole Bajic, MD, an ophthalmologist at the Cole Eye Institute at Cleveland Clinic in Ohio.
“It wasn’t found to necessarily reverse or benefit patients who are postmenopausal with dry eye. And in some cases, it can even make their symptoms a little bit worse,” Dr. Bajic says.
Much more research is needed before suggesting hormone therapy as a dry eye treatment, Brissette says.
“If a patient is considering HRT primarily for other symptoms of menopause, such as hot flashes or sleep disruption, dry eye is something to discuss as a possible coexisting problem,” Brissette says. “However, there isn’t enough evidence that hormones alone can provide improvement in the signs and symptoms of dry eye disease. It’s generally not the main reason to start HRT.”
Starting, continuing, or stopping HRT for dry eye symptoms, alongside other symptoms of menopause, should be discussed with your overall healthcare team, including your ophthalmologist, Brissette says.
Kanevsky agrees. “This is an incredibly important discussion to have at length with your gynecologist,” she says. “I always make a point of sending a dry eye report to my patient’s gynecologist and primary care physician because it can make an enormous difference in not just their ocular health but their overall well-being.”
