hormones and dry eyes

[laine]

I definately notice a connection between my dry eyes and my menstrual cycle. I am at my worst after my period has ended up until about a day after mid cycle. I get terrible dryness around midcycle, including dry mouth and nose also. My eyes ache intensely during those two weeks as well. The aching eases off after midcycle.
Has anyone else here noticed a connection?
I am currently seeing a doctor who specializes in bio identical hormones. Natural hormones that mimic the hormones your body produces. I am currently using natural progesterone cream. Which by the way really helps me endometriosis. She is testing me for estrogen deficiency in a couple of months.
Elaine

[Eileen]

Hormonal causes

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

[laine]

thanks eileen

Thanks so much for all of the info. I have heard of the androgen connection. I will speak with my doctor in a couple of months and ask her is she is familiar with this and if there is anything that can be done. The DHEA eyedrops sound interesting. Do they put dhea into your regular eyedrops? I ask this as I can only use Bion Tears, everything else so far irritates my eyelid disorder.
My dry eyes started a year after my mum died (very suddenly) and I cried almost everyday for a year. I think I put myself through so much stress and it affected my hormones. Did you have any signs of dry eyes before menopause? I can't even imagine my eyes getting any worse but once I hit menopause I think things won't be good. I am 37.
Thanks again for your post.
p.s I quite often get called Eileen!.
Elaine

[Eileen]

Elaine,
The DHEA eye drops are made from finely ground up DHEA and come in two versions, preservative-free which need to be refrigerated and then with preservatives. I've only used the preservative-free version and it still stings quite a bit for a few seconds after putting them in. So I don't know if they would be a good option for you. I don't know what liquid base they are dissolved in. I get them from Leiter's pharmacy (internet). To tell you the truth I'm not sure how much they are helping. I've only been using them for 2.5 mos. My eyes definitely feel better for 1-2 hours after using them. I also have all four tear ducts plugged which has helped the most. I'm also on birth control pill and a very low dose of estratest which is an estrogen testosterone combination. I did not notice any worsening of dry eye symptoms with the HRT. I think it's important for women who go thru early menopause to use HRT to protect their bones and cardiovascular health (as long as there is no personal hx of breast ca or strong fam hx). I didn't have any eye problems before going thru menopause. I wouldn't worry about your eyes worsening during menopause. It is a common reason for women to develop dry eye but MOST women go thru menopause with no eye symptoms. I think I developed it because of the suddeness of my menopause. I had a baby in Jan. 2006 and then never had a period and then developed dry eye which led to the menopause dx.
I'm sorry about your mother.
Eileen

[sazy123]

Hi eileen who was your doctor who persribed you dhea eye drops? and where is he based?

thanks

[Eileen]

DHEA drops

Hi Sazy,
I am a doctor (pediatrician) so I ordered it for myself via phone with the pharmasist at Leiter's pharmacy in San Jose, CA. I had spoken to my ophthamologist who wasn't too familiar with the drops but he was OK with me trying it. I spoke with the PhD (Sullivan) up at Boston's Schepens' Eye Institute who is doing the research on DHEA drops and he referred me to Leiter's pharmacy. The preliminary research looks promising with either DHEA or testosterone drops but I can't say for sure if they are helping me. I just stopped them last week since I got an acute case of viral conjunctivitis over X-mas (from my son!) and I didn't want to use anything in my eyes but systane drops. I have all four tear ducts plugged which has helped the most. I think the DHEA drops help soothe my eyes for an hour or two after use. I can only use them twice a day or they get too irritating. I couldn't tolerate restasis due to severe burning 5 weeks after starting them.
I would think most ophthamologists would be Ok with you trying them for a month or two. They can locate Leiter's pharm on the internet and call in an order with their DEA number. It costs about $80 for a bottle which lasts me 6 weeks. I get the preservative-free which needs to be refrigerated after it's opened.
By the way, is that your daughter in the picture with you? Very cute.
Eileen

[neil0502]

By the way, is that your daughter in the picture with you? Very cute.

Since Eileen's a pediatrician, you've just been given a PROFESSIONAL opinion that you have a cute daughter.

It doesn't get any better than that

[Rebecca Petris]

I would think most ophthamologists would be Ok with you trying them for a month or two. They can locate Leiter's pharm on the internet...

www.leiterrx.com

Leiter's is exhibiting at ASCRS in San Diego in April - I don't know if they regularly do this or if that's a new thing for them but it will be a good opportunity for more ophthalmologists to get familiar with some of the interesting things they are doing in dry eye treatments (among other things).

[dianat]

...and pediatricians really know cute!

[sazy123]

Hi eileen.

I have left you a private message. I have a question i need to ask.

Thanks

[Eileen]

Hi Elaine

Elaine,
I replied to your private message. Sorry it took so long.

Eileen

[atta]

progesteron gel apply on eye lid?

Hi everyone,
My dry eye condition, and inflammation is worst 1 or 2 days before my period start. And I feel the best from 11 days(from the first day of period) and last for a week. I've read that 11 days till 14 days is the most female hormon produced.
I've had dry eye since I was a child and in the last 5 years its getting worse. Now I'm suffering from dryness and redness. I've tried a lot of things, but none of them cures me, sometimes they help, sometimes not. I think I should try some harmon theraphy. I've also read about progesteron and from an german article, I've read that the eye cream with 15%progesteron helps by dry eyes.
I've also seen some bio product of natural progesteron, but I'm not sure how to use it. Besides, is harmon medicine suitable for people at my age? Do they lead to cancer?

[ouchie]

Progestin BC Pills Making Eyes Worse?

I've been on camilla a bc pill for the last yr which as done wonders for my endometriosis, but it seems that it is making me eyes worse....for yrs i was dependant on visine for red eyes, and one eye doc told me to stop using it since it is not letting my eyes regulate themselves...he had no idea about it being dry eye then obviously...

I'm 40 yrs old and am noticing my eyes the last 6 mo are tearing a lot (especially morning) and are puffy, tired, sore, lids are sticking together in the morning and they ache more than ever!!! I thought progesterone was a good thing with Dry Eye? Or no??? I am using the synthetic version with the progestin-only bc pill which i love for my endo...but my eyes feel and look like crap!! I just want it to go away! Any thoughts?

[atta]

Hi Ouchie

Do you have inflammation on your eyes? My experience is after long period of dryness, the eyes get chronic inflammation. And inflammation cause more dryness.
Maybe you should try Restasis, which helps to reduce inflammation. Maybe it wont cure your dry eyes but it makes you feel better.
Wish you luck

[ouchie]

yes, they are really inflamed today, all wk they have been but today its really bad!! I never heard of this product, but i will check into it once i have health insurance...trust me, i wish i could go and get some today!

After reading all the great info on here, i think i will try some warm compresses today to find some relief...the computer usage isn't helping but i am learning so much!!

i'm just confused why the camilla isn't providing relief?