As women approach perimenopause and menopause, the well-known symptoms are hot flashes, mood swings, irregular cycles. But there’s another, lesser-discussed set of changes that can be just as disruptive: eye discomfort or other symptoms.
Vision changes and ocular discomfort can emerge or worsen during this hormonal transition. Understanding what to watch for and how to talk to your eye doctor about it can help you protect your sight and your sanity.
Common Eye Symptoms Associated with Menopause
Hormonal shifts — particularly decreases in estrogen and androgens — can have direct effects on your eyes. Here are the most common symptoms women may notice:
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Dry Eyes
As your hormone levels shift during perimenopause and menopause, your eyes can feel the difference. The most common symptom? Dry eyes.
That’s because hormones like estrogen and testosterone play a big role in keeping your eyes comfortable and well-lubricated. When these levels drop, your eyes can’t hold moisture as well — especially if you’re taking hormone therapy or other meds, which can sometimes make things worse.
You might notice:
- Burning or stinging
- Red, irritated eyes
- That gritty, “sand-in-your-eye” feeling
- Extra sensitivity to light
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Blurry or Fluctuating Vision
Changing hormone levels can affect the shape of the cornea and the tear film, both of which are critical for clear vision.
You may notice:
- Trouble focusing, especially during reading
- Vision that varies throughout the day
- Increased dependence on reading glasses
- Difficulty driving at dusk or at night
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Eye Fatigue
With dry or blurry eyes, you may struggle to stay focused on screens or reading.
This can lead to:- Frequent eye strain
- Headaches
- Difficulty driving at night
- Difficulty reading in the evening due to fluctuating vision
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Increased Risk of Eye Conditions
Long-term estrogen deficiency may contribute to higher risks of:- Glaucoma
- Cataracts
- Age-related macular degeneration (AMD)
How to Know If These Changes Are Hormone-Related
While not all vision issues are tied to menopause, timing is a major clue. If symptoms begin or worsen during your 40s or 50s — especially in the context of other hormonal signs — it’s worth exploring a connection.
Tracking your symptoms with a journal or app can help identify patterns that support this link.
However, many eye doctors (particularly male doctors) will not naturally associate your symptoms with your potential hormonal changes. Be an advocate for yourself and describe what is happening and when. By advocating for yourself, you may notice the doctor is more willing to begin treating your symptoms with more than simple words or plans.
In particular, offices are often equipped with advanced tools that can help alleviate your symptoms and discomfort. Ask about dry eye or ocular surface treatments for women in perimenopause.
Here are some questions that may help your doctor tune in to your concerns at your next appointment:“Could my symptoms be related to hormonal changes?” — Ask whether your current eye issues could be linked to perimenopause or menopause.
“Do I have signs of dry eye syndrome or meibomian gland dysfunction?” — These are very common in women during this life stage, and treatments are available.
“Are there preventative steps I can take?” — Inquire about nutritional supplements (like MacuHealth Omega-3), artificial tears/eye drops, or lifestyle changes.
“Do I need a new prescription, or are my vision changes temporary?” — Hormonal shifts can cause transient changes, but it’s still important to adjust your prescription as needed.
“Should I be monitored for glaucoma or other age-related conditions?” — If you have risk factors (family history, high blood pressure, etc.), earlier screening may be appropriate.
How to Know If You Have a Good Eye Doctor
You deserve a provider who listens, investigates, and understands the unique health issues that affect women — especially during life transitions.
Look for someone who:Takes time to explain what’s happening and why.
Acknowledges the role of hormones in eye health.
Asks thoughtful questions about your symptoms and lifestyle.
Keeps up with women’s health research in optometry or ophthalmology.
Offers a range of solutions, including non-pharmaceutical and preventative care - such as eyelid hygiene, Omega-3s, Intense Pulse Light Therapy or a range of other potential options.
If you feel dismissed or rushed, it might be time for a second opinion — your eyes are too important to ignore.
Don’t Overlook Your Eyes
Perimenopause and menopause are full-body experiences — and your eyes are no exception. While many symptoms are manageable, catching them early makes a big difference in long-term eye health and comfort.
Start by paying attention to what your eyes are telling you. Then, bring that awareness into the exam room. With the right support and care, you can navigate this phase with clear vision and confidence.