Key takeaways:
Hormonal changes during menopause can affect tear quality and lead to dry eye.
Prescription eye drops and over-the-counter (OTC) artificial tears can help relieve dry eye symptoms and keep your eyes healthy.
Menopause doesn’t increase your chances of developing cataracts, presbyopia, or glaucoma. But you’re more likely to develop these conditions as you get older.
Hormones like estrogen, progesterone, and androgens play an important role in your reproductive health. But that’s not all they do. These hormones can also affect your eye health. As you get older, hormone levels change. During menopause, your hormone levels start to fall. This leads to changes in your menstrual cycle and vasomotor symptoms like hot flashes and sweating. But these hormonal changes can also lead to dry eye.
Here’s what you need to know about the connection between menopause and dry eye and how menopause affects your eye health.
Can menopause cause dry eye syndrome?
Going through menopause increases your chances of developing dry eye. Dry eye syndrome is a medical condition that develops when your eyes:
Don’t make enough tears, or
Makes tears that don’t contain enough oil.
During menopause, your body makes less estrogen and progesterone. Drops in these hormone levels can affect your eyes. The oil glands in your eyes may not work as well when hormone levels change. Without enough oil, your tears become unstable. Unstable tears evaporate too quickly, making it harder for your eyes to stay lubricated. Without this protection, you can develop dry eye.
Scientists are still working to understand how hormone changes are linked to dry eye syndrome. In one study, nearly 80% of postmenopausal women had dry eye symptoms. But that doesn’t mean menopause directly causes dry eyes.
Women are more likely than men to develop dry eye syndrome at any age. And your risk of developing dry eyes goes up as you get older. So, it’s unclear whether hormone changes are directly responsible for dry eyes or if they simply add to a person’s overall risk.
Can perimenopause cause dry eyes?
Perimenopause is the time leading up to menopause. It may last up to several years. During this phase, people may develop menstrual cycle changes, hot flashes, and other symptoms. Some may also develop dry eye syndrome. But it’s still unclear if hormone changes during perimenopause directly cause dry eye symptoms.
Dry eye treatment options
No matter what caused your dry eye, it’s important to get treatment. Dry eye treatment relieves uncomfortable symptoms. It also keeps your eyes healthy and helps you avoid complications like corneal abrasions and keratitis.
There are many treatment options for dry eye syndrome. Some may work better for you than others. Your eye doctor can suggest the best ways to get started with treating dry eye during menopause. But here are some popular options.
Over-the-counter (OTC) lubricating eye drops and gels
Over-the-counter (OTC) lubricating eye drops and gels protect the surface of your eye, just like healthy tears. There isn’t one “best” product for everyone. But preservative-free formulas are a good choice — especially if you have sensitive eyes or need to use drops more than four times per day. You should also avoid drops that claim to “get the red out.” These types of eye drops sometimes contain chemicals that will cause rebound redness.
Fish oil supplements
Taking fish oil supplements will increase your intake of omega-3 fatty acids, which have been shown to help some people with dry eye syndrome. Talk to your healthcare professional to see if supplements are right for you and how much to take.
Warm compresses
Warmth and moisture help open the oil glands in your eyelids, encouraging them to release more oil into your tears. Try laying a warm compress (wrapped in a moist towel) over your eyes for 5 minutes at least once a day.
You can make a warm compress at home:
Fill a clean sock with dry rice and tie it off at one end.
Microwave the sock for 15 seconds.
Test the temperature on your hand to make sure it isn’t too hot.
Wrap the sock in a moist towel.
Lay it over your eyes.
You can also buy reusable warm compresses that are made specifically for dry eye relief.
Humidifier
Humidifiers add moisture to the air, which can help stop your tears from evaporating too quickly. Humidifiers are especially helpful if you live in a dry climate or use indoor heating during the winter.
Prescription medications
If OTC drops and home remedies aren’t enough to relieve your symptoms, prescription eye drops may help treat dry eye syndrome. Restasis or Xiidra are two popular prescription treatments for dry eye. Talk to your eye doctor to see if these options are right for you.
Punctal plugs
A punctal plug is a device that sits in the corner of your eye where your tears drain. It helps keep your tears from draining so they stay in your eye longer. This helps increase eye moisture and ease dry eye symptoms.
Can menopause cause other eye problems?
Menopause has been linked to other eye conditions. Here’s how it may affect your eye health.
Blurry vision
Estrogen and progesterone levels can impact your corneas, the clear covering at the front of your eyes. Changes in your cornea may lead to blurry vision, but this isn’t common.
If you’re experiencing blurry vision during menopause, it’s more likely caused by another eye condition, like dry eye syndrome or presbyopia. Presbyopia is an eye condition that develops around the same time as perimenopause or menopause. It affects your ability to see up close.
If you notice vision changes at any point in your life, It’s important to get an eye exam. An eye doctor can help determine what’s causing vision changes.
Glaucoma
Some research suggests that people who go through menopause at an earlier age are more likely to develop glaucoma. But it’s unclear whether menopause directly increases this risk. Like dry eye, glaucoma becomes more common as you get older.
Glaucoma can lead to permanent vision loss if left untreated. But if caught early, it can be managed with treatment. Your eye doctor will check for glaucoma during your yearly eye exam.
Cataracts
Like dry eyes and glaucoma, you’re more likely to develop cataracts as you get older. Cataracts occur when the eye’s natural lens becomes cloudy. This causes blurry vision that doesn’t improve with blinking or new glasses. Cataracts may also make it harder to see while driving at night.
Hormonal changes from menopause haven’t been shown to directly cause cataracts. It’s more likely that the relationship between cataracts and menopause is due to a person’s age rather than hormone changes.
You can get checked for cataracts during your yearly eye exam. If needed, cataract surgery can help keep your vision clear.
Hormone replacement therapy, eye problems, and menopause
Menopausal hormone therapy — previously called hormone replacement therapy (HRT) — can help relieve some menopause symptoms. But some research suggests it may worsen dry eye, especially if it includes estrogen-only therapy.
More research is still needed to confirm whether HRT that uses both estrogen and progesterone carries the same risk.
If you have dry eye symptoms, talk with both your healthcare team and your eye doctor before starting menopausal hormone therapy. They can help you decide if it’s the right choice for you.
How can I keep my eyes healthy after menopause?
There are ways to keep your eyes and vision healthy throughout your life. Here are some of the best ways to keep your eyes healthy:
Get yearly eye exams
Get treatment for medical conditions that can affect your vision, like diabetes and high blood pressure
Take vitamins for your eye health if you have macular degeneration
Frequently asked questions
Over-the-counter (OTC) lubricating eye drops and gels can help relieve dry eye symptoms that develop during menopause. Always check to make sure eye drops haven’t been recalled before purchasing and using them.
Low estrogen levels may impact your tear production and quality, leading to dry eyes. This can cause eye redness, discomfort, and may even affect your eye’s ability to focus. This can lead to blurry vision. Dry eyes can also make it uncomfortable to wear contact lenses.
Over-the-counter (OTC) lubricating eye drops and gels can help relieve dry eye symptoms that develop during menopause. Always check to make sure eye drops haven’t been recalled before purchasing and using them.
Low estrogen levels may impact your tear production and quality, leading to dry eyes. This can cause eye redness, discomfort, and may even affect your eye’s ability to focus. This can lead to blurry vision. Dry eyes can also make it uncomfortable to wear contact lenses.
The bottom line
Many people develop dry eye during menopause. It’s not clear if menopause directly causes dry eye. But hormone changes may increase your risk of developing symptoms. Luckily, there are steps you can take to help ease your symptoms, like using OTC lubricating eye drops, warm compresses, and prescription eye drops. Getting yearly eye exams can also help keep your vision healthy as you get older.
Why trust our experts?
References
Boyd, K. (2018). How hormones can affect eyes and vision. American Academy of Ophthalmology.
Boyd, K. (2023). Redness-relieving eye drops. American Academy of Ophthalmology.
Boyd, K. (2024). What is dry eye? Symptoms, causes and treatment. American Academy of Ophthalmology.
Deo, N., et al. (2024). Dry eye disease: An overview of its risk factors, diagnosis, and prevalence by age, sex, and race. Cureus.
Garcia-Alfaro, P., et al. (2020). Dry eye disease symptoms and quality of life in perimenopausal and postmenopausal women. Climacteric.
Gorimanipalli, B. (2023). Hormones and dry eye disease. Indian Journal of Ophthalmology.
Hulsman, C. A. A., et al. (2001). Is open-angle glaucoma associated with early menopause? The Rotterdam study. American Journal of Epidemiology.
Peck, T., et al. (2017). Dry eye syndrome in menopause and perimenopausal age group. Journal of Mid-Life Health.
Schaumberg, D. A., et al. (2001). Hormone replacement therapy and dry eye syndrome. JAMA.
Vimont, C. (2024). Can fish oil relieve dry eye?. American Academy of Ophthalmology.
