You or someone you know may have Meibomian gland dysfunction (MGD) right now, yet this common eye condition isn’t one you hear about often. Here are some things you should know about menopause and Meibomian gland dysfunction and how to manage it.

What is Meibomian gland dysfunction?

Your eyelids are home to dozens of tiny oil glands that are located on the margin of the eyelids. They were named after a seventeenth-century anatomist named Heinrich Meibom, who first described them. They are also known as tarsal glands or palpebral glands, but no matter what you call them, their job is to produce an oily substance called meibum that prevents the eye’s tear film from evaporating. This tear film is composed of meibum, mucus, and water and helps keep your eyes moist.

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If the quality or amount of the oil changes for any reason, or if the glands are compromised, Meibomian gland dysfunction can develop. The cause of MGD is usually a combination of factors and can include:

• Age, as the number of Meibomian glands declines over time
• Ethnicity, as Asians are about three times more at risk for MGD than are people of European descent
• High cholesterol and/or triglycerides
• Inflammation of the eyelid or cornea
• Bacterial infection
• Autoimmune diseases such as lupus, rheumatoid arthritis, and Sjogren’s syndrome
• Eye diseases such as allergic conjunctivitis
• Use of estrogen replacement therapy, retinoids, or androgen reducers

Symptoms of MGD can include dry eyes, burning, itching, crustiness, watering, light sensitivity, redness, and intermittent blurry vision. You may also feel like there is something foreign in your eyes.

How is Meibomian gland dysfunction associated with menopause?

As androgen (testosterone) levels decline in perimenopause and menopause, the Meibomian and lacrimal (tear) glands are impacted. This can result in inflammation of the eyelids, reduced tear production, and ultimately dry eyes.

In a 2017 study, experts explored how Meibomian glands may change in premenopausal and postmenopausal women. They found that the glands “exhibit a cyclic change in premenopausal women, as well as sex- and age-related physiologic differences.”

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How can you manage Meibomian gland dysfunction in menopause naturally?

Here are some at-home remedies for managing Meibomian gland dysfunction in menopause:

• Heat and massage. Place a wet, warm washcloth or heat pack on your eyelids. Leave it on for 5 minutes, twice a day. This helps loosen the oil. The addition of light fingertip massage on both the upper and lower eyelids also helps move the oil.
• Eyelid wash. To help remove bacteria and any debris that may be blocking the oil gland openings, use a soft cloth or a cotton swab to gently scrub along the lash line on both your upper and lower eyelids. You can use a very mild soap (e.g., diluted baby shampoo) that will not irritate your eyes. Scrub your lids once a day.
• Omega-3 fatty acids. You can enhance the quality of the meibum by taking omega-3 supplements, such as fish oil or flax seed oil. One to two tablespoons daily is suggested, or take an oral supplement.

when to call your doctor

If your symptoms get worse or you cannot get relief by trying the at-home remedies, contact your doctor. Physicians can help you find ways to improve eye hygiene or show you how to better treat the condition yourself.

bottom line

Meibomian gland dysfunction is one of the leading causes of dry eye syndrome and blepharitis (inflamed eyelids). It is a common condition, affecting about 35 percent of adults. Although it is more common among men, research also shows hormone fluctuations in perimenopause can be a trigger.