Why Dry Eye Affects More Women Than Men

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If you find your eyes are constantly irritated, you may suffer from dry eye syndrome, also known more simply as dry eye. Dry eye syndrome can cause your eyes to feel scratchy or gritty, and it can also make your eyes sting or burn. Some people with dry eye complain about feeling like they have something stuck in their eye, a condition sometimes called ‘foreign body sensation.’

Certain people are more likely to develop this uncomfortable problem than others, notably people over age 50 and women—it’s a double threat if you’re both female and over 50. In fact, about twice as many women as men in the United States suffer from dry eye syndrome. Not only that, but women tend to report much more severe symptoms than men, too.

5 Things You Didn't Know About Dry Eye

The Role of Tears

First, a little explanation about dry eye syndrome. Your tears are actually a mixture of oils (also known as lipids), water, and mucus. Dry eye can be caused by an imbalance in the composition of the tears, meaning the oil, water, and mucus levels coating your eyes aren’t balanced, so your tears evaporate too quickly. It can also be caused by decreased tear production.

Hormonal Changes Raise Your Risk

Women are at increased risk for developing dry eye than men, and a big reason for that seems to be the involvement of reproductive hormones. Since estrogen can decrease the oily level of your tears, it may drive many cases of dry eye in women. Common reasons women experience fluctuations in hormone levels include:

  • Pregnancy. Those hormonal changes that accompany pregnancy may stir a deep craving for pickles and ice cream, but they can also cause your eyes to be dry and scratchy.

  • Use of oral contraceptives. Many oral contraceptives contain hormones like estrogen that can lead to decreased tear quality or production.

  • Menopause. The fluctuating hormone levels of menopause have been acknowledged as a culprit, but so has hormone replacement therapy (HRT), which many women have embraced to address some of the side effects of menopause. HRT containing only estrogen seems especially likely to cause dry eye, although a progesterone-estrogen combo can cause dry eye symptoms, too.

Autoimmune Disorders Also Contribute

Sometimes your own body sets you up for increased risk. Women are at elevated risk for developing a number of autoimmune disorders that also seem to cause dry eye syndrome. For example, rheumatoid arthritis (RA) is one such autoimmune disorder that can lead to decreased tear production.  As with dry eye, natural hormone fluctuations, as well as the use of oral contraceptives containing hormones like progestin and estrogen, seem to play a role in the development and flare-ups of RA.

Other autoimmune diseases more common in women that seem to increase your risk for developing dry eye include thyroid disorders, lupus and Sjogren’s syndrome, which tends to cause dry eye and dry mouth.

Don’t Blow Off the Symptoms

If you’re experiencing symptoms of dry eye on a regular basis, don’t hesitate to contact your healthcare provider. Untreated dry eye syndrome can, over time, lead to permanent damage of the cornea. And if your cornea gets damaged enough, it could threaten your vision. Talk to your doctor about starting with over-the-counter artificial tears or ointments that may provide welcome relief to your dry eyes. If those don’t work well enough, a prescription treatment may be the next step

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Jun 13
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