Dry Eyes and Menopause: Causes, Relief and When to See Someone

Dry eye disease is more common in women, especially around and after menopause. Estrogen and androgens help regulate the glands that make tears. As they change, tears become less stable, leaving eyes gritty, burning or watery. Lubricating drops, warm compresses and screen breaks help. A painful red eye or sudden vision change needs urgent care.

How strong is the evidence? Moderate. The link between hormones and dry eye is well established, but how menopause and HRT affect it in individuals varies.

What does dry eye feel like?

• Gritty, sandy or "something in the eye" sensation
• Burning, stinging or itching
• Tired eyes, especially after reading or screens
• Blurred vision that clears when you blink
• Watery eyes. Irritated eyes can produce reflex tears.
• Difficulty wearing contact lenses
• Discomfort in air conditioning, wind or heated rooms

Why does menopause affect the eyes?

Tears have three layers: a watery layer, an oily layer that stops evaporation, and a mucus layer that helps tears stick to the eye. A review in the Journal of Mid-life Health explains that sex hormones influence the production of all three.

A 2025 study of midlife women notes that the oil-producing meibomian glands in the eyelids carry sex hormone receptors. Falling androgen and estrogen levels can disrupt these glands, making the tear film unstable and inflamed. In that study, computer-based work was linked with more severe symptoms, while outdoor work was linked with fewer.

Many people notice dryness elsewhere at the same time. See dry skin and vaginal dryness.

Does HRT help or worsen dry eye?

The evidence is mixed. A meta-analysis of seven randomized trials found hormone therapy may improve tear production, but not tear stability. Other large observational studies have linked HRT use with more dry eye. The 2025 study of midlife women describes the effect of HRT on dry eye as controversial. HRT isn’t prescribed for dry eyes.

What else can cause dry eyes?

A TFOS-based review lists diabetes, thyroid disease, rosacea, eye surgery, allergies, some psychiatric conditions, diuretics and beta-blockers as probable risk factors.

What will a clinician assess?

A pharmacist, optometrist or doctor may ask about symptoms, screen use, contact lenses and medicines, and examine your eyes and eyelids. Tests may measure tear production and how quickly tears break up. Persistent dry mouth, joint pain or other symptoms may prompt blood tests for autoimmune conditions.

What helps?

Everyday measures

• Lubricating eye drops (artificial tears), used regularly. Preservative-free drops suit frequent use.
• Warm compresses and lid cleaning for oil-gland problems: a warm compress for 5 to 10 minutes, then gentle lid massage.
• The 20-20-20 rule: every 20 minutes, look at something 20 feet (6 meters) away for 20 seconds, and blink fully.
• Humidify the air, and avoid fans or vents blowing at your face.
• Wear wraparound glasses outdoors in wind.
• Stay hydrated and don’t smoke.

Treatments

• Gels or ointments at night
• Prescription anti-inflammatory drops for more severe cases
• Treating blepharitis or rosacea
• Reviewing medicines that dry the eyes
• Specialist options, such as tear duct plugs

Choosing eye drops

A pharmacist or optometrist can help you choose.

Setting up your screen and workspace

• Position screens slightly below eye level, so your eyes are less wide open.
• Take regular breaks, and blink fully.
• Reduce glare, and keep the room humid if possible.
• Point fans and air vents away from your face.

When should you get help?

See a pharmacist or optometrist if dry eyes persist despite drops.

Seek urgent same-day care if you have:

• A painful red eye
• Sudden blurred or lost vision
• Sensitivity to light with pain
• An eye injury, or chemicals in the eye
• Flashing lights, new floaters or a shadow across your vision

Questions to ask

1. Is this dry eye, and which type?
2. Which drops should I use, and how often?
3. Could any of my medicines be contributing?
4. Should I be checked for conditions such as Sjögren’s syndrome?
5. When should I have regular eye checks? See recommended health checks.

Related symptoms

Dry skin · Vaginal dryness · Burning mouth · Sleep problems

Frequently asked questions

Can menopause cause dry eyes?

Hormone changes around menopause affect the glands that make tears, and dry eye is more common in women at this stage.

Does HRT help dry eyes?

The research is mixed. Some trials suggest better tear production, while some observational studies link HRT with more dry eye.

Are eye drops safe to use every day?

Lubricating drops are generally safe for regular use. Preservative-free types are better if you use them often.

Will dry eyes go away after menopause?

Dry eye often persists and can become more common with age. See do menopause symptoms stop after menopause?

Can I wear contact lenses with dry eyes?

Often yes, with adjustments. Daily disposable lenses, shorter wearing times and rewetting drops may help. An optometrist can advise.

References

1. Peck T et al. Dry eye syndrome in menopause and perimenopausal age group. Journal of Mid-life Health, 2017
2. Dry eye symptoms in midlife women: cross-sectional analysis. Maturitas, 2025
3. Immuno-inflammatory axis of menopausal dry eye (review citing the TFOS DEWS II sex, gender and hormones report)
4. Sex hormone therapy and dry eye in postmenopausal women: meta-analysis of RCTs
5. Association between potential factors and dry eye disease: systematic review and meta-analysis

Editorial status: evidence-based educational article. Last evidence check: September 10, 2026.