If you’re experiencing gritty, itchy, or overly watery eyes during menopause, you’re not alone—and it’s not just a coincidence. Hormonal changes affect much more than mood and temperature regulation. They can also lead to dry eyes, a common but often overlooked symptom that affects over 60% of women during perimenopause and menopause. Here’s what’s happening and what you can do about it.*

How Hormones Impact Your Eyes

Menopause triggers a drop in several hormones—especially androgen, estrogen, and progesterone. Androgens, in particular, play a vital role in the function of the meibomian and lacrimal glands that produce the oils and fluids needed for healthy tears. When these glands don’t function properly, you may experience:

• A burning or gritty sensation,
• Red, itchy, or watery eyes, and
• Blurred vision or a foreign body sensation.
  

Fluctuations in estrogen may also explain why your dry eye symptoms worsen at certain points in your cycle or while using birth control.

Managing Symptoms with and without Hormone Therapy

Hormone replacement therapy (HRT) is often prescribed for menopause-related symptoms, and in some cases, it may help with vision changes. But be cautious—while HRT can reduce your risk of certain eye diseases, it may also increase your risk of developing dry eye by up to seven times.

Non-hormonal treatments that help some people find relief include:

• Warm compresses,
• Lubricating eye drops, 
• Oral antibiotics, and
• Punctal plus (to help the eyes retain moisture).

Some women have also tried natural approaches that include:

• Herbal remedies like black cohosh and red clover,
• Vitamin D supplements or a D-rich diet, and
• Modalities such as acupuncture, massage, yoga, and mindful breathing
  

It may take some experimentation to find what works for you. Speak with your healthcare provider to find a safe and effective treatment regimen.

Lifestyle Tweaks That Can Make a Difference

Small changes at home and work can go a long way to help reduce dry eye discomfort, such as:

• Lowering your computer screen to decrease tear evaporation,
• Avoiding direct airflow from ceiling fans or vents, and 
• Wearing wraparound sunglasses outdoors to protect your eyes.
  

If your symptoms persist—or worsen—it’s time to consult an eye doctor. They can help rule out conditions like Sjögren’s syndrome and recommend a personalized treatment plan.

Don’t brush off dry eyes as an inevitable nuisance of menopause. Relief is possible with the right strategies and support.

*Lazarus, R. (2023). Dry Eye and Menopause [Blog post]. Optometrists Network. https://www.optometrists.org/general-practice-optometry/guide-to-eye-conditions/dry-eye/what-is-dry-eye-syndrome/dry-eye-and-menopause/ 

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