Gritty, painful eyes aren’t often the first thing people link with menopause, but dry eyes in perimenopause and beyond are more common than most think. If your eyes feel scratchy, irritated, sensitive to light or screens, or you find yourself tearing one moment and parched the next, you’re in the right place.

This guide will walk you through why dry eyes might happen during menopause, what signs to watch for, how to manage symptoms, and when to talk to a specialist.

What are dry eyes?

Dry eyes occur when your eyes are not sufficiently lubricated by natural tears, either because you’re producing fewer tears, or the tear film (the layer that coats your eye) is altered. This can result in a persistent gritty sensation, burning or stinging, sensitivity to light or wind, and irritation when working at screens or in dry environments.

In the context of menopause, hormonal changes and HT use play a role. Sex‑hormone receptors exist in the meibomian and lacrimal glands that support tear production and quality. When estrogen, androgen and other hormone levels shift, the balance of the tear film can be disrupted.

Symptoms can include an irritating and persistent itching or gritty sensation in the eyes, discomfort when working with screens, and increased sensitivity to light and air conditioning. It can also cause your eyes to feel sore in general, tear up frequently, and sometimes look red.

How common are dry eyes during menopause?

Dry eyes are more common in women, particularly during perimenopause and menopause, due to fluctuations in hormones like estrogen and androgens. Your lifestyle can play a role too. Wearing contact lenses or spending long hours looking at screens can increase your chances of experiencing dry eyes.

Hormone therapy (HT) is now also thought to contribute to dry eyes in some cases. Certain medical conditions can also increase your risk of dry eyes, including blepharitis, Sjögren’s syndrome, and lupus.

Some medications may cause or worsen dry eyes. These include:

• Diuretics (water pills)
• Antidepressants
• Antihistamines
• Beta-blockers (e.g., propranolol)
• Some acne treatments
• Certain eye drops for other conditions
• Some cough medicines

These triggers can compound the effects of hormonal changes, making dry eye symptoms more noticeable during menopause. Dry‑eye symptoms become noticeably more common after menopause.

Read more about the stages of menopause.

What are the signs of dry eyes?

You might notice one or more of the following:

1. A burning or stinging sensation in your eyes
2. A gritty or scratchy feeling like sand is under your eyelids
3. Discomfort when exposed to bright light, wind or air conditioning
4. Sticky, red, swollen or tired‑feeling eyes
5. Increased tearing (yes, sometimes watery eyes are a dry‑eye sign)
6. Difficulty working on screens or reading for long periods
7. Feeling like your eyes are fatigued, heavy or uncomfortable

Tips to help with dry eyes during menopause

Read up on the research

Some ophthalmologists recommend omega‑3 fatty acids or other supplements for dry‑eye relief, but findings are mixed. One study found improvements in tear evaporation with omega‑3s, while others found no change. Supplements may interact with medications or health conditions, so always check with your healthcare provider before taking any supplements or vitamins to treat dry eyes. 

Remove makeup and clean your lids gently

The oily layer of your tear film comes from glands in your eyelids. If eyelids are inflamed or blocked (for example by eye makeup), that layer can weaken, leading to dry eyes. Remove eye makeup every night using a gentle remover, avoid eyeliner on the inner rim of your eye, and consider sterile eyelid wipes formulated for eye use. If your eyelids feel irritated or heavy, a warm compress for a few minutes twice daily may help unload the gland blockages.

Reduce screen time and blink more often

When you’re looking at screens (phones, tablets, computers) you’re blinking, impacting tear film renewal and contributing to a range of dry eye syndromes. Take regular breaks: every 20 minutes look away for 20 seconds and blink deeply. You can also work to raise your screen, reduce glare, increase ambient lighting, and try to avoid prolonged reading or screen use without a break.

Use artificial tears, gels or overnight ointments

Over‑the‑counter lubricants are an effective first‑line tool. There’s no clear “best brand”, so choose whatever works best for you. We suggest drops or gels during the day, and limiting use of ointments to night.

If you’re using artificial tears more than four times per day long‑term, choose preservative‑free brands to avoid irritating your eyes. If you wear contact lenses, check that your drops are compatible with lenses. When in doubt, ask your pharmacist or optician for advice. 

Swap contact lenses for glasses when you can

Contact lenses can aggravate dryness by reducing tear film stability. Give your eyes a break by switching to glasses (even part‑time) to support natural tear film spread and comfort.

Avoid environmental triggers

Wind, direct air from AC/heaters, smoke, dust, pollen and allergens all worsen dryness. Consider using a humidifier in dry rooms, shield your eyes outdoors (wrap‑around sunglasses help), avoid smoking and try not to let cool/hot air blow directly onto your face.

Can hormone therapy (HT) help?

Research on the risks and benefits of HT for those experiencing dry eye symptoms is mixed. Some studies suggest that dry eyes improve with HT, while others suggest that HT makes dry eye symptoms more severe. 

HT can effectively treat other symptoms associated with menopause, such as hot flashes, mood changes, and sleep disturbance, among others. Read more on HT risks and benefits. 

HT is not suitable for everyone. Speak to your healthcare provider if you would like to find out more about the best treatment for you.

Dry eyes and menopause FAQs

Why do dry eyes happen during menopause?

Research suggests that changes in hormone‑levels during menopause affect the glands that produce the watery, oily and mucin layers of your tear film. Estrogen and androgen imbalances can reduce tear quantity, change the composition of the film, or impair the glands that regulate it. All of these factors contribute to persistent dry, gritty, or irritated eyes.

Do dry eyes affect your immediate health?

Yes. If your eyes cannot properly lubricate and protect themselves, you might experience blurred vision, discomfort in bright light, sensitivity to wind or screens, and a reduced ability to focus or read for long stretches. Persistent dryness can interfere with daily activities and cause eye fatigue.

Do dry eyes affect your long-term health?

They can. When dryness is unaddressed it may lead to inflammation of the ocular surface, abrasions on the cornea, increased risk of infection, and in severe cases corneal ulceration or long‑term vision issues.

When should you see a healthcare provider?

You should schedule a visit if:

• Your dry‑eye symptoms persist despite consistent home care
• You notice worsening redness, swelling, discharge or unexplained discomfort
• You experience changes in your vision (blurring, flashing lights, double vision)
• You use hormone therapy (HT) and notice dry‑eye symptoms starting or worsening

Seek urgent care if:

• You have moderate to severe eye pain or sensitivity to light
• Vision changes suddenly or significantly (e.g., blind spots, flashing lights)
• You develop yellow/green discharge or signs of infection

Learn more – the latest research

• Cleveland Clinic, Dry Eyes
• Healthline: Menopause and dry eyes
• Healthline: ​​Over-the-Counter Eye Drops: Potential Risks
• Lowth Mary, Dry Eyes, Patient, 2018 
• Lurati Ann R., Menopause and Dry Eye Syndrome, Nursing for Women’s health, Vol. 23, Issue 1, 2019, Pages 71-78
• Mayo Clinic: Sjogren’s syndrome
• Medical News Today: Dry eyes and menopause
• Peck, Travis et al. “Dry Eye Syndrome in Menopause and Perimenopausal Age Group.” Journal of mid-life health vol. 8,2 (2017): 51-54. doi:10.4103/jmh.JMH_41_17 
• The North American Menopause Society: Menopause and Eye Health