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From mood swings to hot flashes, the effects of midlife hormonal changes can be a lot to manage. When these symptoms happen along with vision changes, you may wonder whether menopause is affecting your eyes.
As one ThisIsMenopause member shared, “The lack of sleep and pain in my joints have been really bad the last couple of days due to menopause. Oh, and did I mention my eyesight has gotten worse at the age of 52?”
Below, we’ll explore how menopause may affect your eyes and what you can do to manage eye problems.
Menopausal symptoms often begin during the phase leading up to menopause, called perimenopause. Changing levels of hormones, especially estrogen and progesterone, play an important role in this transition.
During perimenopause, estrogen levels rise and fall unevenly before eventually declining. These hormonal fluctuations can cause many physical and emotional symptoms throughout perimenopause and after menopause. You may have symptoms like irregular periods, night sweats, and vaginal dryness.
Hormones are natural chemicals that carry messages throughout your body. They help control many functions, including hunger, growth, sleep, mood, and reproduction. Changes in hormone levels can affect your whole body, including your eyes.
During perimenopause and menopause, changes in estrogen may affect the cornea. The cornea is the clear, dome-shaped front of the eye that helps focus light, and these changes may contribute to blurred vision.
Your eyes are also sensitive to hormones called androgens. Levels of androgens also fluctuate during perimenopause.
Progesterone, estrogen, and androgens can affect the glands and tissues involved in keeping your eyes lubricated. Androgens, in particular, play an important role in the glands that produce the oily part of the protective tear film. Changes in these hormones may contribute to dry, gritty, or uncomfortable eyes.
If hormonal changes during the menopause transition affect your eyes, you may notice dryness, blurriness, or other vision changes.
Dry EyesYour tears contain three main parts — water, oil, and mucus. Hormonal changes can affect the oil layer, causing tears to evaporate too quickly to keep your eyes lubricated. Common symptoms of dry eyes include:
You may find that these symptoms worsen when you blink less often, such as while using a computer. Windy, cold, or dry conditions can also make symptoms worse. Overnight dryness may also cause blurred vision when you wake up.
The risk of dry eye syndrome increases with age, and women are twice as likely as men to have this condition. One study found that almost 80 percent of women experienced dry eyes after menopause.
Blurry VisionSome women may have blurry vision during perimenopause or menopause. Blurred vision can be a symptom of dry eye disease or result from other changes in the eye.
Changes in estrogen levels may affect the cornea, causing stiffness that may affect how light travels through the eye, which can contribute to blurry vision.
An age-related eye condition called presbyopia could also lead to blurry vision. Presbyopia can make it hard to focus up close and commonly develops around the same stage of life as perimenopause and menopause.
Some hormone-related vision changes may improve after menopause. For example, blurry vision may improve as hormone levels become more stable.
However, sudden or severe blurry vision needs prompt medical attention. Contact an eye doctor right away if your vision suddenly becomes blurry or changes significantly.
Contact Lens DiscomfortDry eyes can make wearing contact lenses uncomfortable. Feeling like you have grit, sand, or something else in your eyes may leave you reaching for your glasses instead of your contacts.
If you do put contact lenses in, it might not be long before you want to take them out. Wearing contacts can make dry eye symptoms worse. If contacts are uncomfortable, your eye doctor may recommend wearing them less often or suggest other ways to manage your symptoms.
Even if you don’t currently have dry eyes, contact lens use can increase your risk of developing this condition.
Researchers have looked at whether menopause-related hormonal changes may be linked to certain eye conditions. Although evidence is limited, some studies suggest that there could be a connection between hormones and eye health.
Glaucoma is an eye condition that damages the optic nerve and can lead to vision loss or blindness. Some research suggests that glaucoma risk may be linked to menopause. Women who go through menopause early or have surgical menopause may have a higher risk of developing glaucoma.
Some studies have found higher intraocular pressure (IOP), or pressure inside the eye, after menopause. High IOP is an important risk factor for glaucoma.
Some studies have also found that differences in genes involved in estrogen signaling may be linked to glaucoma. Researchers are still trying to understand this possible connection.
Cataracts develop when proteins in the lens of the eye break down and clump together, making the lens cloudy. Cataracts are more common among women than men. Among people ages 65 to 74, cataracts are reported to affect around 24 percent to 27 percent of women but just 14 percent to 20 percent of men.
Studies have explored whether lifetime exposure to estrogen may be related to cataract risk. Some studies have linked longer exposure, such as having a first period at a younger age or reaching menopause at an older age, with a lower risk of cataracts later in life.
Researchers have also studied whether menopause hormone therapy — also called hormone replacement therapy, or HRT — may be associated with risk after menopause. Some studies have suggested a possible protective effect, but the evidence is not clear enough to recommend hormone therapy for this purpose. Hormone therapy is not approved to prevent or treat cataracts.
Age-related macular degeneration (AMD) is an eye disease that leads to gradual loss of central vision over time. Because inflammation plays a key role in AMD, researchers have studied whether estrogen may help protect against the condition.
Some studies suggest that estrogen and hormone therapy may be linked to a lower risk of some types of AMD, particularly advanced forms. However, findings have been inconsistent. More research is needed to understand the relationship between hormones, hormone therapy, and AMD.
If menopause is affecting your eyes, several strategies can help relieve symptoms and protect your eye health. The right treatment depends on the type and severity of your symptoms.
For many people, artificial tears can be a good first step. These lubricating eye drops can help relieve dryness, burning, irritation, and the feeling that something is in your eye. If you use artificial tears more than four times a day, preservative-free formulas may be a better choice because they’re less likely to irritate your eyes.
If over-the-counter eye drops don’t provide relief, your eye doctor may recommend prescription treatments. Depending on the cause of your dry eye, treatment may include prescription eye drops or oral medications that reduce inflammation or increase tear production. In some cases, your eye doctor may recommend punctal occlusion, which blocks tear drainage to help tears stay on the eyes longer.
Simple lifestyle changes can also make a difference. Strategies that may provide relief of dry eyes include:
Research findings on whether hormone therapy is an effective treatment for dry eye are mixed. One large study found that postmenopausal women using hormone therapy were more likely to have dry eye syndrome than those who didn’t use hormone therapy.
In that study, estrogen-only therapy was linked to a higher risk of dry eye syndrome than estrogen plus progesterone therapy. The risk increased the longer hormone therapy was used.
If you’re considering hormone therapy for menopause symptoms, talk with your doctor about its potential benefits and risks based on your health history and treatment goals. Be sure to tell your doctor about any eye symptoms you’re experiencing.
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