HRT and Dry Eyes

More than a third of all post menopausal women use Hormone Replacement Therapy (HRT). The use of HRT for relief of menopausal symptoms and to prevent osteoporosis is well established. The use of HRT as a heart disease preventative has also become popular. However, a major trial in the early 2000’s (The Women’s Health Initiative) was abandoned in 2002 because women receiving a combination estrogen and progesterone therapy were shown to have an elevated risk of invasive breast cancer. Estrogen treatment, by itself, however, did not carry such a risk.

A 2001 study that was published in the Journal of American Medical Association found that women who use HRT are at an increased risk of developing dry eye syndrome. In fact, the odds of developing the condition were 70% greater for post menopausal women who used HRT. The study was based on a 3 question survey in which women were asked how often their eyes felt wet, how often their eyes felt irritated and if they had ever been diagnosed by a clinician as having dry eye syndrome. Other, subsequent studies, appear to be at variance with the findings of the 2001 study. This is possibly due to the fact that the 2001 study was based upon patient symptoms while the others used clinical diagnosis. It is apparent , however, that postmenopausal women taking HRT do have an increased likelihood of developing dry eye syndrome. It is not understand at this tine why that is the case.

(JAMA 2001;286:2114-9)

(Maturitas 2003;44:63-8, J Assoc Acad Minor Phys 2000;11:44-9).