Women are more likely to develop DED in later life and prior studies have reported that women who are postmenopausal present with more severe DED than younger women.
There is a paucity of data, however, directly comparing women who are postmanopausal with age-matched men and younger women.
Women who were postmenopausal demonstrated a significantly higher prevalence of severe DED compared to age-matched men and younger females.
The older women and men had higher Schirmer test scores than younger women (both P <.001).
“Postmenopausal women demonstrate a significantly higher prevalence of severe DED compared to age-matched men and younger females,” according to the researchers.
Dry eye disease (DED) becomes more severe after menopause, driven by tear film instability and meibomian gland dysfunction (MGD), according to results of a cross-sectional study published in Post Reproductive Health.
Women are more likely to develop DED in later life and prior studies have reported that women who are postmenopausal present with more severe DED than younger women. There is a paucity of data, however, directly comparing women who are postmanopausal with age-matched men and younger women.
Study participants were recruited for this study at the Galgotias University in India in 2025. Women who had experienced amenorrhea for at least 12 months (n=102), women aged 25 to 40 years with regular menstrual cycles (n=112), and men age-matched to the postmenopausal cohort (n=105) were evaluated by the ocular surface disease index (OSDI) and underwent clinical evaluation including ocular staining, tear breakup time (TBUT), Schirmer I test, and a meibomian gland assessment.
The 3 groups (women who were postmenopausal, premenopausal, and men) were aged mean 52.93±4.53, 32.19±4.33, and 50.00±7.13 years, respectively.
Women who were postmenopausal demonstrated a significantly higher prevalence of severe DED compared to age-matched men and younger females.
The women who were postmenopausal reported higher rates of burning (56.8% vs 29.7% vs 13.5%; P =.016) and itching (41.1% vs 45.2% vs 13.7%; P =.021) symptoms, they had higher OSDI scores (mean, 24.1 vs 19.8 vs 20.2; P =.042), and more had severe DED (24.5% vs 18.8% vs 16.2%; P =.047) than younger women and men, respectively.
Similarly, the women who were postmenopausal had higher rates of conjunctival symptoms (6.9 vs 3.8 vs 5.3%; P =.048) and redness (6.3 vs 3.4% vs 3.4%; P =.033), higher corneal (both P <.001) and conjunctival (both P <.001) staining scores, and shorter TBUT (both P <.001) than younger women and men, respectively. The older women and men had higher Schirmer test scores than younger women (both P <.001).
At the meibomian gland assessment, the postmenopausal group had the highest gland expression and meibum quality scores and had more lid signs than either comparator group (all P <.001).
In the regression analysis, severe DED was associated with burning symptoms (odds ratio [OR], 2.402; 95% CI, 1.082-5.34; P =.031), lid signs (OR, 1.417; 95% CI, 0.746-2.69; P <.01), postmenopausal status (OR, 1.189; 95% CI, 0.643-2.2; P <.01), and smoking (OR, 0.791; 95% CI, 0.356-1.76; P =.023).
“Postmenopausal women demonstrate a significantly higher prevalence of severe DED compared to age-matched men and younger females,” according to the researchers. “This pattern was associated with tear film instability and greater MGD, suggesting a predominantly evaporative clinical profile inferred from objective ocular surface parameters.”
This study is limited by not measuring hormone levels.
