hormones and dry eyes

[Natalie06]

Ouchie

Hello from a fellow endometriosis and dry eye patient.

I use Lupron Depot to control the endo and have been doing research about the hormone/dry eye connection. A lack of Androgens (a form of testosterone) seems to be what they are finding as the cause for dry eye. Not progesterone which is the active ingredient in your BCP. As you age, your testosterone levels drop. I suspect that BCP's and other hormonal flucutations must also affect them (Many women get dry eyes post partum) but that's just my theory. I haven't found any scientific evidence to back that up. Hormone fluctuations are considered the #1 reason that our Meibomain Glands get clogged up, making what tears you produce evaporate more quickly, meaning dry eyes. There may also be a link between androgens and actual tear production. The warm compresses have helped my swollen, puffy, itchy eyelids a lot but the thing that's helped "unclog" the glands is minocycline, a form of Tetracycline and something you have to get from your eye MD.

I am hoping to try some type of Androgen drops but they are in clinical trials and not available yet.

So, I have no hard answers for you but I would not expect much from the BCP you are taking.

Natalie

Oh, and don't consider Lasik with dry eyes, endometriosis and hormonal suppression. That's how I ended up here.

[ouchie]

?

Based on Eileen's answer, it sounds to me like the progestin minipill i am taking would have a benefit....no estrogen interfering (since i have endo, i already produce too much estrogen naturally thus no need to add it to encourage endo symptoms). Is progesterone a primary component of progestin therefore a link to testosterone? That's what I am understanding from Eileen's answer below..am i misunderstanding?

Hi Laine,
I have severe dry eye secondary to sudden onset of menopause this past summer. I'm 43. It is thought that hormonal causes of dry eye is more related to a relative drop in androgens (male hormones) produced in the ovaries. One's blood levels of testosterone may still be in normal range but may not be as much as one was producing before perimenopause or menopause. Listening to your symptoms it makes sense that you would have more pain in the first 2 weeks of your cycle because estrogen is dominant at that time. Then at mid-cycle a peak of testosterone is released and progesterone levels climb until they abuptly fall off just before your next period. Unopposed estrogen therapy has been shown in women's hormone replacement studies to cause worsening of dry eye symptoms. Women who took estrogen and progesterone combination did a little better. There was a small study of older women (ave. age 60) taking estratest (estrogen-testosterone) for relief of dry eye which did help but some of the women developed an increase in intraocular pressure which stopped the study.
I'm currently on the birth control pill (estrogen/progesterone) to help prevent osteoporosis and I'm taking a small dose of estratest to see if the testosterone will make a difference. So far I don't know. I'm also on DHEA (androgen precursor) eye drops which I take twice a day which helps some.
Has your doctor checked your FSH level (follicle stimulating hormone) on day 3 of your period? If it's above 10, then that would be an indication that you are in perimenopause. If it's above 30-40, then you are probably in menopause.
Anyway, my biggest frustration is in finding a doctor (gynecologist or ophthamologist and psychiartrist!!) who knows how to treat women who develop severe dry eye from menopause. My ophthamologist is treating my eyes but didn't even know about the androgen dry eye connection. My gynecologist is plying me with hormone replacement but didn't know that too much estrogen is bad for dry eye. I end up bringing copies of studies to office visits and giving tutorials to my doctors who also happen to be my colleagues at work (I'm a pediatrician).
Ask your ophthamologist about the DHEA eye drops. There is a section on this website about new treatments, etc. which has some posts about DHEA. It might help you alot.
Eileen

[ouchie]

I am getting a lil concerned about the usage of Flonase Nasal Spray and see with its side effects that I've been having (been using this for reoccurring sinus infections) include these symptoms:

bleeding nose; perforated septum (inside left of nose); increased pressure in the eyes, glaucoma, or tearing of the eyes;


It also says that usage of steroid based prescription nasal spray can as a result effect the absorption of this drug into your system can inhibit your body's ability to fight off infections.

I have most of these symptoms! I just started my period and yes, this has caused (along with the sinus issues) much eye pain!!! I can't make the aching stop and I cannot even read my books for homework they hurt so bad! Fun Labor Day weekend, huh? ugh....the warm compresses help a lil..but....not enough!

I've read in some dry eye sufferers postings that they've had plugs put in? What does that do, and am I a candidate???

I got some antibiotics from the doc...he had some broad sprectrum on hand as samples to give me thank God, and I also asked him for a referral to an opthamologist for when i have health insurance.....!! any insights MUCH appreciated!

[Eileen]

Hi Ouchie,
Progestin is a progesterone only pill and does not contain any testosterone. It will lower your body's production of estrogen because it shuts down the ovaries and thus serves as a birth control method. Progestin only birth control pills are usually used by breast-feeding mothers who wish to prevent another pregnancy during the post-partum period.

If your eyes hurt you during periods, you may want to talk to your doctor about trying a birth control pill such as seasonale which reduces periods to 3-4 episodes per year. I think you need a combination bcp which contains low dose estrogen and some progesterone. You could also try half-strenght estratest (estrogen and testosterone) and then add prometrium 100 mg a day (progesterone). If you are 40, you may want to get your blood checked for perimenopause. FSH levels on day 3 of your period should be less than 10.

Plugs are certainly worth a try when you get insurance.

Eileen

[Juliettie]

I'm really interested in this topic. My eyes became very dry about 3 years ago, although I've had some episodes of dry eye (middle of the night waking with eyelids stuck together) for decades. My mom has rheumatoid arthritis and I have slight psoriasis, so I was tested for RA, Sjogren's, lupus, and those tests were okay. My Schirmer was adequate (9mm) and my TBU test was lousy. Docs have said it's MGD, but I often wonder if it's ocular psoriasis. When I became pregnant last spring, everyone told me to buckle up, that my eyes were going to get much worse. The absolute opposite happened. They were PERFECT. No nighttime dryness, no excessive running tears during the day, no redness, no grittiness. Nothing. I know I am not in perimenopause yet, since I went through a fertility workup and my hormone levels were checked many times. I'm wondering if there's a link with progesterone. Isn't there a lot more progesterone when you're pregnant? Or maybe it is ocular psoriasis and the lowered immune system when you're pregnant calmed that all down....

Whatever it is, I wish I could find a doctor who would help me figure it out. I'd do just about anything to feel as good as I felt four months ago when I gave birth!

Nieka

[ran123]

pregnancy and dryeye

hi, am a dry eye sufferer since 2006 and am 27. Reason for dry eye: LASIK. I have severe dry eye. Cant watch computers for long time not even for 2 hours /day. This happens to be one of the worst problems dye eye created. I became pregnant last spring and suddenly my dry eye symptoms disappeared completely. (then i had to terminate my pregnancy for medical reasons). Eyes remained great even after termination, but only for 5months. Now my eyes are getting dry day by day. I mean eyes are getting back to how they were before pregnancy slowly. Ever since i had LASIK, i have given up trying any thing for my dry eyes(though I have tried restasis, plugs, a.tears with no positive outcome). But once i noticed the miracle difference pregnancy(harmon fluctuation)brought to my dry eyes, am interested to try birth control or some thing, that could help relive my dry eye pain. How should I go about it. Should I get my harmon levels checked? help me