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“Menopause is similar to puberty - but in reverse. It's a time when we undergo huge hormonal changes.”

Does menopause affect your eyes?

Eye surgeon explains the link

Hot flushes, mood swings, and night sweats - symptoms we all recognise as part of menopause. But not many people make the link between menopause and eye health. It can take years for menopause to present itself, and the first signs often manifest in your eyes.

Up to 60% of menopausal women may experience red eyes, blurred vision, a scratchy or stinging feeling in the eye, or a build-up of mucus along the eyelids. These are all indicators of Dry Eyes, which affect twice as many women as men over 50. We break down exactly what goes on with your eyes during menopause and some helpful (science-based) advice to help you manage.

How Perimenopause Affects Your Eyes

Difference Between Perimenopause & Menopause

Perimenopause and menopause are two distinct stages in a woman’s reproductive life.

Perimenopause is the transition period that occurs before menopause and lasts several years. During this time, a woman’s ovaries produce less and less estrogen, leading to changes in menstrual cycles, including shorter or longer cycles, lighter or heavier bleeding, and more irregular periods. Other common symptoms of perimenopause include hot flashes, night sweats, mood swings, and vaginal dryness (see list below).

Menopause, on the other hand, is a more final stage in a woman’s reproductive life and marks the end of menstrual periods. It is diagnosed after a woman has gone 12 months without a menstrual period. After menopause, a woman’s ovaries stop producing eggs, and estrogen levels continue to decline.

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How menopause affects your eyes

  • One of the most common eye problems associated with menopause is dry eyes. This occurs when there is not enough moisture in the eyes, which can cause discomfort, redness, and a gritty feeling. The decrease in estrogen levels can lead to changes in the tear ducts and reduce the production of tears.

  • Itchy and sore eyes during menopause can result from hormonal changes and dry eyes. As the body produces less estrogen during perimenopause, the tear glands can produce fewer tears, leading to dry eyes. This can cause the eyes to become itchy and sore, as the lack of moisture can cause irritation and inflammation. Additionally, hormonal changes during menopause can also increase the sensitivity of the eyes to irritants, such as wind, smoke, and dust, which can also cause itching and soreness.

  • During menopause, a woman’s body produces less estrogen, which can affect the production of tears, leading to dry and watery eyes. This is because estrogen helps regulate the production of tears, and a decrease in estrogen levels can cause the tear glands to produce fewer tears. The decreased tear production can cause the eyes to become dry, irritated, and prone to watering. Additionally, menopause’s hormonal changes can increase sensitivity to irritants, such as wind, smoke, and allergies, which can also cause watery eyes.

  • Eye floaters, which are small, floating spots in the field of vision, can become more noticeable during menopause. Hormonal changes can cause changes in the vitreous humour, the jelly-like substance in the eye, leading to the formation of floaters.

  • Some women may experience increased light sensitivity during menopause. This can be due to hormonal changes or other factors, such as migraines, which are more common during this time.

  • Hormonal changes during menopause can cause fluctuations in blood sugar levels, leading to temporary blurred vision. Hormonal fluctuations can also affect the shape of the eye and the clarity of the lens.

  • Difficulty seeing at night is due to hormonal fluctuations that can affect the shape of the eye and the clarity of the lens.

  • The decrease in estrogen levels can also affect the immune system and increase the risk of eye infections such as conjunctivitis.

  • Menopause increases the risk of eye diseases such as cataracts, glaucoma, and age-related macular degeneration (AMD). These conditions can lead to vision loss if not detected and treated early.

  • Some women may experience migraines during menopause, which can cause visual disturbances such as flashing lights or blind spots.

  • “During menopause, the oils that keep your eyes nourished and moisturised, turn from an olive oil, silky smoothness to a sticky, toothpaste-like consistency. This leads to scratching and inflammation as your eyeballs move around their sockets.”

    menopause eye treatment - how to manage the symptoms

  • Tiredness makes a huge difference to the eyes in menopause, so try to get as much sleep as possible and allow your eyes to rest. This means minimising time spent on screens when possible and taking regular screen breaks when it’s not.

  • The oils you ingest impact the oil makeup in your glands. Opt for foods rich in Omega-3 and 6, such as oily fish, nuts, seeds, eggs and leafy greens to keep your eye’s oil levels in balance. This also helps reduce your risk of cardiovascular, neurodegenerative and osteoporotic disease with menopause.

  • Pollutants, air conditioning and air travel, can all play havoc with your eyes. Although these factors are often unavoidable, it’s worth taking extra care of your eyes if you fly regularly or spend long hours in air-conditioned environments.

  • Keep your eyes in check by getting regular eye tests and taking breaks from wearing contact lenses. This will help you monitor any changes that might crop up, so you can take steps before things get worse.

  • Stress drives inflammation in the body, making Dry Eye symptoms worse. Anything you do to improve your well-being will positively impact your eyes, so stay socially, physically and cognitively active.

  • If you’re already feeling the effects of Dry Eye, a hot shower, bath or hot flannel can emulsify the hardened fluid build-up and provide much-needed lubrication to your eyes.

  • Eye Sprays, anti-inflammatory drops, and wipes are available that help with the cleansing and healing process and provide relief against Dry Eye symptoms.

  • Current studies offer differing opinions on whether Hormone Replacement Therapy (HRT) helps or hinders eye health. Taking a pragmatic and holistic approach to eye health during menopause by following some of the tips above would be a good approach.

  • “Once the symptoms of Dry Eye occur, it creates what’s known as an ‘inflammatory cascade’, making it harder to remedy at home without medical treatment”

    can hormones affect your eyes?

    Dry eyes & hormone imbalance

    Any time you transition to hormonal balance, the regulation of certain glands in your body will change. During puberty, biological changes are overshadowed by enormous personal and emotional shifts. With menopause, however, the changes start from a period of relative homeostasis – making them feel much more impactful.

    Those going through menopause often assume that Dry Eye is simply a reaction to their body’s natural ageing process and moisture loss. But it’s caused by changes in the body’s androgen levels and oestrogen. These fluctuations can impact the fluid coating your eye, making it dry or irritated.

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    It starts in the meibomian and lacrimal glands, located under your eyelids. These glands secrete lipids (fats, oils and hormones). During menopause, the change in hormonal balance causes these lipids to thicken to a toothpaste-like consistency. Over time this may harden and block some of your glands, leading to scratching and inflammation in your eyes and lids.

    Menopause can also affect the goblet cells in your eyes. They produce and secrete less mucin (the bottom layer of your tear film) onto the eyes’ surface.

    Once the symptoms of Dry Eyes occur, it creates what’s known as an ‘inflammatory cascade’, making it harder to remedy at home without medical treatment. A combination of prevention and maintenance is essential to prevent this.

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    What are the Symptoms of Menopause?

  • One of the first signs of menopause is irregular menstrual cycles. Women may experience lighter or heavier bleeding, or their periods may become more or less frequent.

  • Hot flashes are a common symptom of menopause, characterised by a sudden feeling of heat that spreads throughout the body. This can be accompanied by sweating, redness, rapid heartbeat and palpitations.

  • Night sweats are hot flashes that occur during sleep, leading to disrupted sleep and insomnia.

  • Hormonal changes during menopause can cause fluctuations in mood, leading to irritability, anxiety, and depression.

  • Decreased estrogen levels can cause the vaginal tissues to become thinner and drier, leading to discomfort during sexual intercourse and an increased risk of vaginal infections.

  • Due to vaginal dryness and thinning of the vaginal tissues, some women may experience pain or discomfort during sexual intercourse.

  • Menopause can also cause a decrease in sexual desire or libido. This can be due to physical and emotional symptoms, such as vaginal dryness and mood swings.

  • Some women may experience increased headaches, particularly migraines, during menopause.

  • Menopause can cause weight gain, especially around the abdominal area. This weight gain is often due to hormonal changes and increased body fat.

  • Some women may experience fatigue and decreased energy levels during menopause - due to reduced hormone levels and trouble sleeping.

  • Decreased estrogen levels can cause joint pain and stiffness, particularly in the hands, wrists, and knees, due to hormonal changes and increased inflammation.

  • Hormonal changes during menopause can cause memory problems, including difficulty concentrating and forgetfulness.

  • Menopause can increase the risk of urinary tract infections, urinary incontinence, and frequent urination.

  • Menopause can cause dry, itchy skin and a loss of elasticity due to decreased estrogen levels.

  • Some women may experience hair thinning and loss during menopause - especially around the hairline and crown.

  • Menopause can affect the eyes, including dry eyes, eye floaters, light sensitivity, blurred vision, and more. Read the section above.

  • Hormonal changes during menopause can cause muscle cramps, especially in the legs.

  • Menopause can cause changes in body odour due to hormonal changes and increased sweating.

  • Menopause can cause digestive problems such as bloating, indigestion, and constipation.

  • Some women may experience ringing in the ears or tinnitus during menopause.

  • Symptoms can vary in severity and duration, and not all women will experience all of them.

  • Alex Ionides (ophthalmic surgeon) answers your menopause questions

  • Dry, tired gritty eyes. Sometimes red, sore eyes. Your glands (meibomian and lacrimal) and microbiomes in the mucin layer of your tears are affected by hormonal changes during menopause. It's gradual (almost in the background) and increases as perimenopause and menopause progress.

  • Yes, you can. With allergies, your eyes have a constant itching feeling - and when you look under the microscope, the surface of your eyes looks like cobbled streets. You'll also get morning stickiness (stringy mucus) and possibly an irritated, runny nose. Also likely to trigger asthma. Antihistamines (tablets or drops) can help with this. With menopause, you get a dry, sore, deep achy feeling. You just feel like you want to close your eyes. Drops, sprays and a good, targeted supplement will help alleviate this.

  • It has always been known that perimenopause and menopause cause symptoms in your eyes. I'm not sure why it's not talked about more widely.

  • Apart from HRT, approach it more naturally - a good diet with plenty of omegas and green leafy vegetables. You will have some good days and some (very) bad days. When you’re having a bad day - remember that the good days are just over the horizon. It tends to worsen in the wintertime, in urban areas with pollution, or when you’ve had less sleep. Get yourself some preservative-free drops and sprays - to help you through this. You should see an optician if it becomes unmanageable (even after the drops and sprays).

  • During menopause, the secretions from your meibomian glands go from an olive oil to a stiff toothpaste-like consistency. Warm compresses and hot showers help melt these...almost like butter in a pan.

  • Menopause is a chapter in your life that eventually finishes. Unfortunately, the symptoms can continue for some people.

  • Your cornea needs this silky, smooth, soothing mucin layer to cover it. During menopause, with the changes in your glands and secretion, you get dry patches on the surface of your eyes. This causes 'reflex tearing' - when you get tears streaming down your face. This tearing doesn't solve the dry patches and creates a vicious loop. The mucus, water and oil in your tear film are out of kilter. Use preservative-free drops and sprays to help stabilise your tear film.

  • When you have poor tear quality, the top fat layer in your tear film cannot contain the water layer beneath, resulting in dry patches on the eye's surface. Your eyes respond by tearing – but the issue of dry patches remains. Using a liposomal eye spray reinforces the top fat layer of the tear film and seals in the water layer, removing the dry patches. It may sound counter-intuitive, but when you're tearing excessively, apply more liposomal eye spray - to strengthen and seal your tear film. Eventually, this will stop the dry patches and deal with the streaming tears.

  • That's a whole topic on its own. Dawn's written a whole blog on Eye Makeup and your Eyes.

  • Yes, they do. With age, you tend to get more redness, yellowness, and sometimes a bumpy vein on the surface. With age, your lids change shape as your skin changes. This affects how your eyelids shut and how they spread tears across the surface of your eyes.

  • In short, you can't. I suggest you minimise the risk of infections and keep your eyes moisturised. Any drops or sprays must always be preservative-free to avoid sensitivity reactions. There are many vasoconstrictors (stopping or reducing blood to the surface of your eyes) on the market. But the long-term effects have not been studied, and I urge caution. Your eyes can also have a 'rebound' vasodilation when you stop using them, making them redder. And once you've got the redness, it's had to get rid of it.

  • “1 in 10 women leaves their job because of menopause symptoms. 59% of women take time away from work because of menopause symptoms. 86% of women are unaware of a connection between menopause and their eye health.”


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    How Menopause affects your eyes - Resources & References

    1. The North American Menopause Society. (n.d.). Menopause FAQs: Understanding the Symptoms.
    2. American Optometric Association. (n.d.). Dry Eye. Retrieved from
    3. Versura P, Campos EC. (2005). Menopause and dry eye. A possible relationship. Gynecol Endocrinol. 20(5):289-98. Retrieved from
    4. The Royal College of Ophthalmologists. (n.d.). Floaters and Flashes.
    5. American Academy of Ophthalmology. (2020). Menopause and Your Eyes. Retrieved from
    6. The Vision Council. (2016). Digital Eye Strain Report. Retrieved from
    7. Gorusupudi A, Nelson K, Bernstein PS. (2017). The Age-Related Eye Disease 2 Study: Micronutrients in the Treatment of Macular Degeneration. Adv Nutr. 8(1):40-53. Retrieved from
    8. American Academy of Ophthalmology. (2020). Facts About Cataract. Retrieved from
    9. American Academy of Ophthalmology. (2020). Facts About Glaucoma. Retrieved from
    10. American Academy of Ophthalmology. (2020). Age-Related Macular Degeneration (AMD). Retrieved from
    11. American Migraine Foundation. (n.d.). Menopause and Mid-Life Migraine.
    12. WebMD. (n.d.). Menopause and Your Eyes. Retrieved from
    13. National Institutes of Health. (2017). Omega-3 Fatty Acids. Retrieved from
    14. Harvard Health Publishing. (n.d.). Menopause-related hot flashes and night sweats can last for years.