Menopause and hormonal decline, eye health care is important

With menopause, a new delicate chapter opens in the life of women. This change, which begins around the age of 50-52, has multiple effects in life, including on an emotional level. The drop in hormones related to menopause does not spare the functionality of the eyes: there may be problems with dryness, burning and discomfort in the eye. About 35-40% of women complain of symptoms and discomfort of dryness and a sensation of a foreign body inside the eye. The statistics worsen in the advanced menopause stage, when 70-80% suffer from these problems.

Perceiving your body change and feeling a general change in yourself can generate real physical and psychological stress. The menopause, in fact, has effects that involve all the functions of the organism, caused by a considerable drop in female hormones, estrogen. This translates into real physiological upheavals that the woman has to face such as heat, dehydration of the mucous membranes, a sense of fatigue.

Ocular health, like most of our body’s functions, depends on androgens and estrogens. In childbearing age, the tear glands are very active and constantly produce protective liquid, capable of providing proper lubrication and forming a barrier against environmental dust, dehydration and pathogens. “With menopause – explains Dr. Claudio Savaresi, Primary Ophthalmology Unit of the San Marco Polyclinic – Zingonia (BG); CBV Director of Palazzo della Salute – Sant’Ambrogio Clinical Institute – Milan; Scientific Responsible VISTASystem Ophthalmology Research Center – Milan – estrogen deficiency also affects the lacrimal glands, as well as all the exocrine glands, hindering the correct lubrication of the conjunctiva. In addition, the surface of the eye has receptors for both estrogen and progesterone in the cornea, conjunctiva and meibomian glands. For this reason, a variation or lack of these components compromises the correct tear function, the ability to see clearly and even the transparency of the cornea. Even the images can be deformed because transmitted altered on the retina and not perfectly clear ”.

The reduction of the hydrolipidic film, which normally keeps the surface of the eye hydrated and protects from external insults and atmospheric agents, gives the sensation of having dry and red eye and often this degenerates into a real dry eye syndrome. We must not forget that the tear film also performs a protective function against pathogens: this is why when it thins or shrinks, the eye risks being more vulnerable to inflammation of the conjunctiva (conjunctivitis) and cornea (keratitis). Other more common ailments in menopausal women are photophobia, burning, the sensation of pressure in the eye, as well as fatigue in the area, swollen eyelids and the sensation of having sand in the eyes.

How can these problems be avoided?

“Prevention is, as always, the winning weapon, especially in periods that involve significant changes such as the menopausal one. Advanced age and female sex are risk factors for the onset of problems such as dry eye, so it is advisable to periodically go to the ophthalmologist. In fact, during the first years of the menopause period, the ocular disorders related to it are still controllable, even if it is a variable period depending on the habits and characteristics of the patient. For example, those who have worn contact lenses for a long time or have vision defects will be earlier in developing any eye problems related to menopause. After this period of time, the involution of the lacrimal glands and the sub atrophy of the same becomes irreversible ”, Savaresi specifies.

An early intervention is also useful to prevent the possible onset of macular degenerations, cataracts and glaucoma that could occur early and of which the period of menopause can be a facilitator. It is also very important to tell the specialist if and what drugs you are taking. Some formulations, beneficial for other pathologies, risk having an inhibitory effect on certain nerve receptors and cause blockage in the stimulation of the lacrimal glands and components related to them such as the goblet cells of the conjunctiva. Even other drugs can alter the internal structures of the eye. The specialist will be able to determine which is the best solution for the patient. As Dr. Savaresi reassures “today we have special equipment designed specifically to increase the stability and duration of the tear film which is lacking in the menopause period. They act on all the factors of tear dysfunction, which are: instability of the hydrolipidic film, corneal malfunction or suffering and the consequent inflammation of the conjunctival layers “. The latest generation tear substitutes can also be very helpful, as they are able to regenerate the corneal epithelium and thus protect the ocular surface. “An important component for dry eye is sodium hyaluronate, specially prepared to associate its moisturizing properties with the ability to create a protective” scaffold “for the ocular surface that filters and incorporates external agents. It, in synergy with Xanthan Gum, with its lubricating properties, acts to increase the thickness and stability of the tear film. Glycine and betaine are also excellent allies to ensure the maintenance of cellular homeostasis which, in case of dryness, is altered. Finally, we must not neglect nutrition: supplementing the diet with polyunsaturated fatty acids and vitamin D3 can be a solution to control the production of free radicals and the correct tear function “concludes Dr. Savaresi.


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