title: Dry eye in postmenopausal women: a hormonal disorder.
abstract: OBJECTIVE
  This review examines the etiology and pathophysiology of dry eye disease in postmenopausal women, and describes the steroid reproductive hormone influences that may contribute to its development.
  
  
  METHODS
  We have reviewed the relevant studies on dry eye disease related to hormonal status and hormone therapy (HT) in both animal models and humans.
  
  
  RESULTS
  Although both low and high estrogen levels have been associated with symptoms of dry eye disease, low androgen levels are a more consistent factor in its etiology. Postmenopausal HT with estrogen or estrogen plus progestogen has shown a limited benefit for dry eye symptoms and may even result in progression of meibomian gland dysfunction, decreased tear film break up time, and tear flow reduction. However, systemic or local androgen treatment has shown promising results in improving dry eye symptoms.
  
  
  CONCLUSIONS
  Because of the high incidence of dry eye among postmenopausal women that may be related to the hormonal treatment, we propose that a multidisciplinary approach should be considered between gynecologists and ophthalmologists in management of this disorder.
authors.affiliation: 1Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand 2Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA 3Department of Cell and Neurobiology, Keck School of Medicine, University of Southern California, Los Angeles, CA 4Department of Physiology and Biophysics, Keck School of Medicine, University of Southern California, Los Angeles, CA.
authors.forename: Intira
authors.initials: I
authors.lastname: Sriprasert
authors.forename: Dwight W
authors.initials: DW
authors.lastname: Warren
authors.forename: Austin K
authors.initials: AK
authors.lastname: Mircheff
authors.forename: Frank Z
authors.initials: FZ
authors.lastname: Stanczyk
mesh_terms: D000728:Androgens / Q000097:blood / Q000627:therapeutic use; D015352:Dry Eye Syndromes / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D015914:Estrogen Replacement Therapy / Q000009:adverse effects; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D017698:Postmenopause; D011372:Progestins / Q000627:therapeutic use
chemical_list: D000728:Androgens; D004967:Estrogens; D011372:Progestins