Women at Greater Risk for Eye Diseases
Women at Greater Risk for Eye Diseases
Women in their forties and fifties are disproportionately affected by eye issues, and are also 12% more likely to experience vision loss, compared to men. (Source)
Some suggest that gender disparities in vision problems are cultural, as often women have less access to routine vision care, and earn a lower income (on average) than men, and so are unable to pay for such care. Another factor may be that women live longer than men, and so have more time to develop eye diseases, which become more common the older we get.
Menopause
However, there may be a more specific reason that women have more eye problems than men, and that has to do with their hormones. More than 65% of blindness occurs in older women, and this appears to be due to the hormonal changes associated with menopause. The dangerous part of this particular hormonal change is that many of the symptoms do not manifest until much eye degeneration has already occurred.
As menopause kicks in a woman’s body chemistry changes, hormone levels (particularly estrogen) decrease, and this can affect parts of the eye, changing eye shape and impacting vision. Changing of eye shape may seem difficult to understand when looking at a sex hormone, however estrogen does affect the elasticity of the cornea, which in turn changes the way that light travels through the eyes.
Since even small variations in the elasticity, shape, and even moisture of the eyes can have negative effects on our vision, diminishing estrogen levels over time can lead to partial or full vision loss. Some observable symptoms of these changes to be aware of include dry eyes (especially after time spent at the computer), itchy eyes (especially during allergy season, if that was never an issue in the past), and observable vision weakening. We can all (men included) shrug off these symptoms as simply a byproduct of aging, but “a stitch in time…” (another symptom of aging is trotting out worn tropes).
Therefore, such symptoms should be a sign that something is out of balance not just in the eyes, but also in the body. And, in the body, what may be out of balance is the hormones. We will address what can be done for the hormones further on, but for now we will continue to look at the link between female hormones and the eyes.
Sex Hormones
Female hormones do much more than regulate menstruation and reproduction, and this is evidenced by looking at the brain and central nervous system, which have more receptors for the so called “sex hormones” than anywhere else in the body. Given that the eyes are a big part of the central nervous system, it came as no surprise to find that the sex hormones played a big part in eye health. (Sex Hormones and Optic Nerve Disorders: A Review)
The sex hormones (estrogen, progesterone, and testosterone), when we are young and fertile, support the specialized tissues of the eyes, helping to keep them moist and vital. This changes when menopause occurs and the amount of sex hormones in the body decreases dramatically.
All three of the sex hormones work together to control our eyes’ oil glands, so when they decline one of the first symptoms to be aware of is the condition known as Dry Eye Syndrome. (I have covered natural approaches to treating this problem in this blog: Dry Eye Syndrome and Eye Health)
Imbalance in the sex hormones have been linked to the most common eye problems, so now we will have a brief look at those ailments and how estrogen plays a role.
Glaucoma
Our eyes make fluid which nourishes the parts of the eye that do not have blood vessels. However, if too much fluid builds up (“intraocular pressure”) damage to the optic nerve can occur, causing peripheral vision loss. This condition, affecting the optic nerve at the back of the eye, is known as glaucoma, and studies have suggested that low estrogen levels increase a woman’s risk of developing “primary open-angle glaucoma” (POAG), during menopause.
One study concluded that “increasing evidence suggests that lifetime exposure to estrogen may alter the pathogenesis of glaucoma. Estrogen exposure may have a neuroprotective effect on the progression of POAG but further studies need to confirm this finding”. (Source)
AMD
Age-related macular degeneration (AMD) begins with the deterioration of the retina at the back of the eye, and results in blurry vision and central vision loss. Age-related macular degeneration (AMD) is “a multifactorial eye disease that is associated with aging, family history, smoking, obesity, cataract surgery, arteriosclerosis, hypertension, hypercholesterolemia and unhealthy diet”. (And excessive blue light exposure. For more on that subject: Protecting the Eyes from Macular Degeneration and Blue Screen Damage)
So, how does low estrogen tie into AMD? Well, while the link between estrogen and AMD is still being studied, it has been established that estrogen has the capacity to be an antioxidant and to have anti-inflammatory properties.
And, the “pathogenesis of AMD involves constant oxidative stress, chronic inflammation, and increased accumulation of lipofuscin and drusen. Estrogen has both anti-oxidative and anti-inflammatory capacity and it regulates signaling pathways that are involved in the pathogenesis of AMD. This implies that lower estrogen levels may cause an increase in inflammation and oxidation”.
(Source: Estrogen signaling in the pathogenesis of age-related macular degeneration)
(See also: Melatonin and Macular Degeneration)
Cataracts
As we age our eyes can accumulate a film that blocks the light from getting through. This film is known as a cataract, and it is the leading cause of blindness worldwide. Most older people experience problems with cataracts at some point, but studies have shown that women with low estrogen levels are much more likely to develop cataracts
“Data from Australia and the Barbados eye studies indicated that female gender is one of the risk factors for cortical and nuclear cataract. A number of previous epidemiologic studies have also shown an increased prevalence of cataract in women compared with men. It was suggested that the estrogen may play a role in the cataract formation and progression.”
So, naturally these researchers concluded that hormone replacement therapy, with estrogen, could help prevent cataracts in post-menopausal women. They did, at least, acknowledge that “recent studies have shown the consistent evidence of an increased risk for breast cancer and endometrial cancer in females with long-term use of hormone replacement therapy”.
(Source: The Effects of Postmenopausal Hormone Use on Cataract: A Meta-Analysis)
Solutions
So, where does that leave us, when estrogen can help prevent a range of eye diseases, but ERT also has a number of potential dangers? What is necessary is to find a safe, natural way to balance not only estrogen levels, but that of the other metabolic hormones as well (cortisol, DHEA, insulin, progesterone, testosterone, and thyroid).
The safest medical approach is to use a natural progesterone cream (which requires a prescription in Canada). Progesterone can be used by the body to build estrogen and, if needed, testosterone, and it will only produce as much as is needed by the body. Thus, progesterone is far safer than estrogen replacement therapy, and has the bonus of being proven to also protect bone density. (Source)
An alternative approach is to use adaptogen herbs which support adrenal health. It is the job of the adrenal glands to support the production of the sex hormones by making DHEA (dehydroepiandrosterone), a “mother” hormone which can be used to build the sex hormones (estrogen, progesterone, testosterone).
When the sex organs (testes and ovaries) decline in their production of the sex hormones, due to menopause (and andropause in the case of men), it is up to the adrenals to take up the slack by producing extra DHEA. However, if the adrenals are exhausted from a lifetime of excess stress and stimulants, they are unable to do the extra work required of them.
This is where a product like AdrenalStart comes in. A combination of adaptogenic herbs, AdrenalStart has proven to be of great benefit to many people suffering from hormonal imbalance, and in fact, one of our clients actually did a DHEA test before and after using AdrenalStart for two months. She found that it increased her DHEA production by 20-25%. (Like progesterone, supplemental DHEA requires a prescription in Canada.)
Like all adaptogenic herbs, AdrenalStart will also reduce cortisol levels, and since the adrenals work in tandem with the thyroid gland, it will also benefit this gland and the ensuing thyroid hormone production. Taking extra iodine and L-tyrosine will further support thyroid function, and for our last metabolic hormone, insulin, I recommend supplementing with berberine.
Many foods are also helpful to maintain vision, such as liver for vitamin A, and leafy green vegetables (kale, parsley spinach, swiss chard), red grapes, carrots, pumpkin, and egg yolks, as sources of the carotenoids lutein and zeaxanthin (which help protect us from macular degeneration).
Another well researched nutrient for eye health is omega-3 fatty acids, found in fatty fish and chia and flax seed oils. The eye has the highest concentration of omega-3s in the body, and these fatty acids are essential for retinal health. Aside from general eye health, the omega-3s are particularly good for dry eyes. In one dry eye study that used both regular fish oil and krill oil, the krill oil was found to confer more benefit than other fish oils.
“A moderate daily dose of both forms of long-chain ω-3 EFAs, for 3 months, resulted in reduced tear osmolarity and increased tear stability in people with DED. Omega-3 EFAs in a predominantly phospholipid form (krill oil) may confer additional therapeutic benefit.” (Source)
Conclusion
Good vision is essential to healthy and happy aging, so it behooves us to be proactive about our eye health, and not ignore mild symptoms until they become too entrenched to reverse. Since many of the hormonally-induced changes to the eyes are asymptomatic, it is important to get regular eye check-up once one hits menopause.
For those who have not read my blog A Perspective On Vision, it is worth checking out for both genders.