Post-menopausal hormone support and eye health

 

Recent studies have demonstrated the benefits of estrogen support for several eye problems.  This is not a surprise.  Many of us offering post-menopausal hormone support in the past few decades have noted improvement in eye health with baseline estrogen support.  As is true with progesterone and testosterone, these hormones are not just about conception and pregnancy, or even female specific health benefits.  They play many supportive roles in human physiology that are many times independent of gender; although as in this case for estrogen, women may see more benefit as it is one of their primary hormones through much of life.  These studies found that post-menopausal estrogen support lowered the risk of four different types of eye disorders:

   -glaucoma 1,2,3,4

   -cataract 1

   -diabetic retinopathy 1

    -flesh pterygium 1 (a growth of pink, fleshy tissue on the white of the

       eye, often due to excess sun exposure over time)

      In every tissue in the body there are hormone receptors that play a role in healthy physiology.  The Korean study discussed how1  ‘estrogen affects vascular tone and blood flow in organs and tissues and also exerts neuroprotective effects via nonvascular mechanisms’ as one mechanism of how benefits were accrued in their findings.  One of the most common ocular benefits that I have seen in my 25 years of using bio-identical hormone therapy is the reduction of post-menopausal dry eye problems.  I can’t begin to count the number of women who initially had to quit wearing contacts; “my eyes got too dry and irritated” and later had the option to use them again when their dry eye problems resolved after months of balanced hormone support therapy.

     While it is too soon to advocate hormone therapy specifically for eye disorders, these findings once again demonstrate that hormone support therapy at any age may have benefits apart from the traditional ‘just for treating hot flashes’ rationale.

1 The Ocular Benefits of Estrogen Replacement Therapy: A Population-Based Study in Postmenopausal Korean Women.  Kyung-Sun Na, Dong Hyun Jee, et.al.  Published: September 11, 2014 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0106473

2 Postmenopausal Hormones Containing Estrogen May Reduce Glaucoma Risk.  http://media.jamanetwork.com/news-item/postmenopausal-hormones-containing-estrogen-may-reduce-glaucoma-risk/

3 The Potential Association Between Postmenopausal Hormone Use and Primary Open-Angle Glaucoma.  Paula Anne Newman-Casey, MD, MS; Nidhi Talwar, MA; et.al. JAMA Ophthalmol. 2014; 132(3):298-303. doi: 10.1001/jamaophthalmol.2013.7618

4 Estrogen Receptors Alpha and Beta and the Risk of Open-angle Glaucoma: The Rotterdam Study.  Simone de Voogd, MD, PhD; Roger C. W. Wolfs, MD, PhD; et.al. Arch Ophthalmol. 2008; 126(1):110-114. doi: 10.1001/archopht.126.1.110

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