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[Wrensong]

Hi Jett,

There is talk of Testosterone helping with dry eye can anyone help me by sharing experiences of this?

I spent some time researching HRT in relation to dry eye syndrome a few years ago when my pre-existing dry eye condition worsened after oophorectomy & I suspected the loss of T was responsible.  I've done quite a few posts on it on here!  I've used various prescription drops for dry eye over a 30+ yr period + heat masks & I'm still under Ophthalmology for it.  Also referred to Rheumatology for Sjogren's investigation.

You're right, there is research suggesting that androgens are important for the health of mucous membranes & glands involved in lubrication & that androgen deficiency is implicated in the development of dry eye, but seems it's not straightforward & more research is needed.  The role of oestrogen & the heartsink suggestion it may promote dry eye is also debated.  When I last looked into it the overall impression was that it's probably an imbalance between the sex hormones that's involved in causation - a relative deficiency of androgens, as confusingly apparently the high androgen state found in PCOS is also associated with dry eye.  To complicate matters further, there's some evidence that genetics also determine how individuals respond to oestrogen & androgens in this respect. 

I've had a trawl through some bookmarked articles this morning (links below) but no time today to reread them in full or copy out extracts, so apologies if they're repetitive.  They may help you decide though, whether testosterone may be an avenue worth exploring.  Personally, I do find it helpful for dryness, as was the androgen-derived progestogen Norethisterone in my first HRT - Evorel Conti.
Wx

https://onlinelibrary.wiley.com/doi/full/10.1111/cxo.12147

https://www.healio.com/news/ophthalmology/20120331/gender-and-androgen-imbalances-are-keys-to-dry-eye

https://www.reviewofophthalmology.com/article/hormones-in-dry-eye-a-delicate-balance

https://www.latimes.com/archives/la-xpm-1999-may-31-he-42741-story.html

https://www.allaboutvision.com/over40/dry-eyes-menopause.htm

[Jett]

Hi Wrensong,

Thank you SO much for all the links, amazing information.

My eyes started 3 months after the Mirena- which I see is Levonorgestrel - my eyes were ok on Evorel Conti but I had problems with fibroids and womb lining bleeding.

I have enough info now to as least ask my GP about testosterone so thanks again.  It seems it’s a very delicate individual balancing act.

I had read some of your older posts and got lots of info from them too so thank you for sharing your experience and knowledge.

Jxx

[Penguin]

Hi J,

I have been on Oestrogel and utrogestan for around three or more years. I’m 51.

Last Xmas I started with terrible dry eyes after a long haul flight and I am still struggling with them. I had abrasions on my eye which has left me pretty scared to wear my contacts again.

I have had punctal plugs fitted by the eye hospital (little silicone bungs in the eyes drainage holes) and am on Ikervis prescription drops.

I don’t seem to be getting anywhere and like you, I can’t wear my contacts which means my vision isn’t as good as it could be and it also gets me down.

With the plugs fitted my eyes are streaming most of the time, without them I have to use drops every 5 minutes or so. Neither situation is great.

I recently asked my GP to do some blood tests for testosterone levels and also thyroid. She did these and a whole range of other tests too.

My ANA came back as positive which is an indicator of something autoimmune going on and may have some bearing on my dry eye situation. I have been referred to rheumatology.

My latest discovery on the eye drops front is Hycosan Intense, not cheap but these are working dramatically better than any others I have tried over the last year and I have tried many! I also use Theoloz Duo and ointment at bedtime.

I use a one use steam eye mask at bedtime and a plug in eye mask in the morning, both are bliss!

I wish you well and hope you find a solution as I know how miserable it is.

Take good care.

Ali x

Hi am really interested in the masks you mentioned. What is the plug in one called please? And is the steam one a particular brand? Thanks, Penguin

[Wrensong]

Hi Jett

My eyes started 3 months after the Mirena- which I see is Levonorgestrel - my eyes were ok on Evorel Conti

What I remembered particularly from being on Evorel Conti was a totally unexpected but marked increase in saliva production within days of starting it, but that was before oophorectomy, so I still would have had some ovarian T production in addition to the androgenic nature of the Norethisterone in EC.  I think Levonorgestrel is considered less androgenic than Norethisterone & also systemic effects from it are said to be less with Mirena than with other delivery methods.

It seems it’s a very delicate individual balancing act.

I think it can be Jett, but hopefully you'll get there.
Wx

P.S. perhaps worth bearing in mind when you approach your GP, that dry eye is not an approved reason to prescribe testosterone, but if you also have low libido that may make him/her feel more able to help with a trial of T.