Dry Eye Syndrome a Symptom of Hormone Replacement Therapy

Updated: Jun 18, 2020

Hormone replacement therapy or HRT has been linked to a whole host of serious health problems, most notably an increased risk for stroke, cancer, and dementia. According to new research published in JAMA, hormone replacement therapy may also be the cause of the less serious, but certainly uncomfortable, dry eye syndrome.

What Is Hormone Replacement Therapy?

Hormone replacement therapy is a popular treatment for menopausal and postmenopausal women which provides the body with laboratory-synthesized hormones in order to alleviate the symptoms and health disorders associated with menopausal estrogen-deficiency. Different types of hormone replacement therapy exist: estrogen-alone hormone replacement therapy, or estrogen and progestin combination HRT.

Risks and Side Effects of Hormone Replacement Therapy

HRT news

Many clinical trials on hormone replacement therapy have revealed grave health risks, most ominously an elevated risk for breast cancer. Following studies have shown that hormone replacement therapy can also cause less-dangerous, but more atypical symptoms, like dry eye syndrome.

Dry eye syndrome

Technically known as keratoconjunctivitis sicca, dry eye syndrome is a disorder where the eyes feel chronically and severely painful and dry, and can result in ocular damage and infection. Dry eye syndrome is a major reason for visits to the ophthalmologist, but unfortunately current treatments rarely offer sufficient symptom relief.

Hormone replacement therapy and dry eyes

Strangely, many women on HRT have reported dry eye syndrome. Although little research has investigated the problem, some research has shown that estrogen may have an impact on the tear ducts. Hormone replacement therapy thus could trigger the development of this condition.

In order to get to the root of the issue, Schaumberg et al. led a study of the link between hormone replacement therapy and dry eye syndrome which was part of the same Women's Health Initiative that demonstrated hormone replacement therapy's carcinogenic effects.

This cohort study followed 39 876 postmenopausal American women aged 45 to 84 currently using hormone replacement therapy (HRT).

Over the course of four years, patients currently taking hormone replacement therapy as well as women in a control group were assessed as to the occurrence and intensity of dry eye syndrome. The investigators asked the following questions: “How often do your eyes feel dry (not wet enough)? How often do your eyes feel irritated? Have you ever been diagnosed by a clinician as having dry eye syndrome?”

The report revealed that use of hormone replacement therapy was strongly linked to the development of dry eye syndrome. While subjects who had never undergone hormone replacement therapy were the least likely to develop the condition, women on estrogen-alone hormone replacement therapy suffered from the most cases (9.1%). Women on combination estrogen-progestin hormone replacement therapy had a smaller prevalence (6.7%). Women on HRT also experienced the most intense symptoms of dry eye syndrome.

Menopausal or postmenopausal women in the midst of making a decision about hormone replacement therapy are advised to take the results of this study into account. If dry eyes become a problem, alternative treatments to HRT should be considered for the relief of menopause symptoms.