Menopause dry eyes: why they happen and what helps

Name: Menopause dry eyes: why they happen and what helps
Creator: MenoWoman

Yes, menopause can cause dry eyes: falling hormone levels affect the glands that make the oily layer of your tears, so tears dry out faster. Lubricating eye drops, warm compresses and eyelid care are the first steps. An optician or eye doctor can offer more if these are not enough.

Researched by the MenoWoman team. Edited by Marcela Sat. Updated 7 November 2026. We may earn from links.

Get same-day care from an eye doctor or emergency service for eye pain, sudden blurred or lost vision, a very red eye, strong light sensitivity, halos around lights, an eye injury or a chemical splash. Get checked if symptoms persist despite over-the-counter drops, and mention any very dry mouth or joint pain.

What dry eye feels like and how common it is

Dry eye can feel gritty, sore, itchy or burning. Eyes may look red, feel sensitive to light, or blur. Oddly, they can also water a lot, because irritated eyes make more watery tears.¹ Many women notice dry, blurry eyes when they wake up.¹

Johns Hopkins Medicine says more than half of women get dry eye symptoms as periods slow and stop.¹ In 2026, a UK optician chain surveyed 1,000 women around menopause.² In that survey, 42% reported dry eyes, but only 23% knew menopause could be linked.² Because the survey came from a company that sells dry eye treatment, treat the figures with some caution.² Grittiness, itchiness and blurriness were the most common complaints.²

Why menopause can cause dry eyes

Tears have three layers: water, oil and mucus. The oil, made by tiny glands along the eyelids (meibomian glands), stops tears from evaporating.¹

Estrogen, progesterone and testosterone all fall around menopause, and these changes affect the oil glands. Less oil, and poorer-quality oil, means tears evaporate too fast.¹

Everyday factors make it worse. Staring at screens reduces blinking, and cold, windy or dry air speeds up evaporation.¹ Some medicines, such as antihistamines and diuretics, and smoking can also add to dry eye.⁴

HRT and dry eyes: the mixed evidence

It might seem that replacing hormones would help, but the evidence does not clearly support that. In the US Women's Health Study of more than 25,000 postmenopausal women, those using HRT were more likely to have dry eye, not less.³

About 9% of women taking estrogen alone reported dry eye.³ The figure was 7% for estrogen with a progestogen, and 6% for women who had never used HRT.³ The risk rose the longer HRT was used.³

That study was observational and relied on women's own reports, so it cannot prove that HRT caused the dry eye.³ HRT is not a treatment for dry eye. If you use HRT (hormone replacement therapy) and have dry eyes, mention it to your eye doctor. Do not stop or change HRT without talking to your prescriber.

What helps with dry eye after menopause

Eye care guidelines use a step-by-step approach, starting simple and adding treatments if symptoms persist.⁴

Lubricating eye drops (artificial tears). Available over the counter. Preservative-free drops are often advised if you use them often.⁴ Drops with an oil (lipid) component may suit evaporative dry eye, as most drops do not replace the oil layer.^1,4
Warm compresses and eyelid hygiene. Warmth helps the oil glands work, and gentle eyelid cleaning is a first-step treatment.^1,4
Screen breaks and blinking. Regular breaks from screens help, because people blink less when they concentrate on a screen.¹
Contact lenses and fluids. Wearing contact lenses for shorter periods and drinking enough fluids may ease symptoms.¹ Ask your optician whether a different lens type would suit you better.
Your surroundings. A humidifier, avoiding drafts and air vents, and wraparound sunglasses outdoors can reduce evaporation.^1,4
Prescription and in-clinic treatments. If simple steps are not enough, eye doctors may prescribe anti-inflammatory drops.⁴ They may also fit tiny plugs that keep tears in the eye, or offer in-office treatments for the oil glands.^1,4 Which treatments are available differs by country.

Omega-3 supplements are often suggested, and some eye clinics still list them as an option.¹ But a large 12-month trial found no benefit over placebo for moderate to severe dry eye.⁴

Untreated dry eye can scratch the surface of the eye.¹ This raises the risk of infection or scarring that could affect sight, so get checked if it does not settle.¹

What helps: options rated

Option	Evidence	What the research shows
Lubricating eye drops (artificial tears)	Strong evidence	A first-step treatment in major eye care guidelines; preservative-free or oil-containing drops may suit some women better.^1,4
Warm compresses and eyelid hygiene	Some evidence	Recommended as a first step in guidelines, especially when the oil glands are involved.^1,4 Based largely on expert consensus.
Screen breaks, humidifier and wraparound glasses	Some evidence	Advised by eye specialists to reduce tear evaporation, though there are few trials of these steps on their own.^1,4
Prescription anti-inflammatory drops and punctal plugs	Some evidence	Recommended in guidelines as a later step for moderate dry eye when simple measures are not enough.⁴ Rated some because the evidence differs between these options. An eye doctor decides which suits you.
Omega-3 supplements	Weak evidence	Some clinics list them as an option,¹ but a large 12-month trial found no benefit over placebo in moderate to severe dry eye.⁴
Hormone therapy (HRT)	Weak evidence	Not a dry eye treatment. A large observational study linked HRT use with more dry eye, not less.³

Ratings explained: how we rate. Always talk to a doctor or pharmacist before starting a medicine or supplement.