Dry Eye Affects More Postmenopausal Women Than Previously Known

A survey of 3,547 women presented last fall at The Menopause Society's Annual Meeting found that postmenopausal women report dry eye disease symptoms at higher rates than perimenopausal women.

Researchers from Argentina administered the Ocular Surface Disease Index questionnaire to the cohort, whose median age was 52. Postmenopause is the final stage of menopause and lasts for the rest of a woman's life. The data confirm dry eye as a side effect of menopause that affects more women than previously understood.

The study's lead author, Buenos Aires–based gynecologist Dr. Debora Yankelevich, has argued that dry eye should be added to routine menopause screenings.

What dry eye disease is

"Dry eye disease is a relatively common diagnosis when a person's eyes don't provide enough tears or their tears evaporate too fast," says optometrist Nicola Alexander, founder and CEO of Peep Club. The condition produces a dry, gritty or burning feeling in the eyes, along with blurry vision, redness and inflammation.

One symptom carries particular weight for beauty consumers.

"One of the most disruptive symptoms is watery eyes that make it look like you're crying, which ruins makeup and leaves customers feeling like they can't wear mascara or attend big moments—weddings, work—without carrying tissues everywhere," Dr. Alexander says. "This is a protective mechanism known as reflex tearing: Your eye senses that it's irritated and responds by flooding itself with watery tears. By the time dry eye disease is chronic, it genuinely affects how people show up in their lives."

The hormonal connection

The link runs through hormones, and it starts well before menopause.

"Our eyes are very sensitive to hormonal shifts throughout our menstrual cycle, not just menopause," Dr. Alexander explains. "Estrogen is protective against inflammation, and eye tissue is very prone to inflammation, so imbalances can trigger dryness. Additionally, androgen levels, which shift more dramatically in menopause, affect the lacrimal gland's oil production directly. As such, many women also experience dry eye during pregnancy."

Androgens regulate oil production in the lacrimal gland, and those levels drop more sharply during menopause than estrogen does. The result: less stable tear film and more evaporation.

What women can do

Women at any stage of menopause who experience dry eye symptoms should see an eye doctor first to confirm the diagnosis and build a treatment plan, according to the source. Certain prescription medications can help, though the more potent options often lack insurance coverage.

The at-home market has expanded in response. Brands now sell dedicated devices and drops aimed at managing dry eye disease outside the clinic.

The Argentine data, combined with Dr. Yankelevich's screening recommendation, points toward a growing intersection of menopause care and eye health—one where beauty routines, from mascara longevity to wedding-day makeup, become part of the clinical conversation.