Why are women more susceptible to Dry Eye Disease?

Understanding the Link Between Hormones, Lifestyle and Eye Health This International Women’s Day

 

Why Focus on Women and Dry Eye Disease?

Every year on International Women’s Day, conversations around women’s health take centre stage. While topics like heart health and hormonal wellbeing are often discussed, Dry Eye Disease (DED) is rarely highlighted, despite disproportionately affecting women.[1]

Research consistently shows that women are significantly more likely than men to develop Dry Eye Disease, particularly during midlife and beyond.[1][2]

So why are women more prone to dry eyes? The answer lies in a combination of hormonal changes, autoimmune risk, lifestyle factors, and environmental exposure.

What Is Dry Eye Disease?

Dry Eye Disease occurs when:

• Your eyes do not produce enough tears, or
• Your tears evaporate too quickly, or
• The tear film becomes unstable[3]

 

Tears are made up of three essential layers:

1. Oil (lipid) layer – prevents evaporation
2. Water (aqueous) layer – hydrates the eye surface
3. Mucus layer – ensures smooth tear distribution[3]

 

When this balance is disrupted, common symptoms of dry eye include:

• Stinging or burning
• Redness
• Blurred or fluctuating vision
• Sensitivity to light
• A gritty sensation[3]

Hormones and Dry Eyes: The Key Connection

One of the biggest reasons women experience Dry Eye Disease more frequently is hormonal fluctuation.[4]

Oestrogen and androgens help regulate:

• Tear production
• Meibomian gland function (oil-producing glands in the eyelids)
• Tear film stability[4]

 

Throughout life, women experience hormonal shifts during:

• Menstrual cycles
• Pregnancy
• Use of hormonal contraception
• Perimenopause
• Menopause

Menopause and Dry Eye

Dry eye symptoms often increase after menopause due to reduced androgen levels, which are essential for maintaining the oil layer of the tear film. Without sufficient oil, tears evaporate more quickly, leading to evaporative dry eye.[2] [4]
This explains why menopause and dry eye are so strongly linked.

Autoimmune Disease and Dry Eye in Women

Women are more likely to develop autoimmune conditions that directly affect tear production, including:

• Sjögren’s syndrome
• Rheumatoid arthritis
• Systemic lupus erythematosus

In conditions such as Sjögren’s syndrome, the immune system attacks moisture-producing glands, leading to chronic dry eye symptoms.[2] For many women, persistent dry eye may be one of the first noticeable signs of an underlying autoimmune condition.

Lifestyle Factors That Increase Dry Eye Risk

Beyond biology, daily habits can contribute to dry eye symptoms.

Makeup and Eyelid Health

Applying eyeliner along the waterline or failing to remove makeup thoroughly can block the meibomian glands, reducing oil production and worsening tear evaporation.[3]

Screen Time and Dry Eyes

Extended screen use reduces blinking by up to 60%, which increases tear evaporation.[2] Many women balance professional screen use with digital downtime, compounding the effect.

Contact Lens Wear

Women are statistically more likely to wear contact lenses. Long-term lens use can destabilise the tear film and worsen dryness over time.[2]

How Dry Eye Disease Affects Quality of Life[2]

Dry Eye Disease is more than occasional irritation. It can affect:

• Workplace productivity
• Driving, especially at night
• Reading and screen use
• Confidence (red or watery eyes)
• Overall wellbeing

Chronic eye discomfort can be physically and emotionally draining, particularly when symptoms fluctuate unpredictably.

Simple Lifestyle Tips to Reduce Dry Eye Symptoms

While hormonal factors cannot be avoided, lifestyle adjustments can help manage Dry Eye Disease.

✔ Practise Daily Lid Hygiene

Remove makeup gently and completely. Consider warm compresses to support meibomian gland function.

✔ Follow the 20-20-20 Rule

Every 20 minutes, look 20 feet away for 20 seconds to encourage blinking.

✔ Improve Your Environment

Avoid direct airflow from fans or air conditioning and consider a humidifier in dry indoor spaces.

✔ Stay Hydrated

Adequate hydration supports overall tear production.

✔ Seek Professional Advice

If symptoms persist, consult an eye care professional for personalised dry eye treatment options.

 

Raising Awareness This International Women’s Day

This International Women’s Day, it’s important to recognise that Dry Eye Disease in women is common, biologically influenced, and manageable with the right support.

Understanding the connection between hormones, autoimmune risk, and lifestyle factors empowers women to:

• Recognise symptoms earlier
• Seek appropriate treatment
• Prioritise eye health as part of overall wellbeing

Clear, comfortable vision supports everything women do!

Looking for Support with Dry Eye Symptoms?

If you are experiencing symptoms of Dry Eye Disease, finding the right support can make a real difference to your daily comfort. TREHAPAN® is a versatile, all-round dry eye solution designed to support the tear film and provide lasting hydration with just two drops per day. Suitable for moderate to severe dry eye, it helps protect and stabilise the ocular surface to improve overall eye comfort.

You can find TREHAPAN® at: https://visushop.co.uk/product/trehapan/

 

References

1. Schaumberg DA, et al. Prevalence of Dry Eye Disease Among US Women. American Journal of Ophthalmology. 2003;136(2):318–326.
2. Stapleton F, et al. TFOS DEWS II Epidemiology Report. The Ocular Surface. 2017.
3. Craig JP, et al. TFOS DEWS II Definition and Classification Report. The Ocular Surface. 2017.
4. Sullivan DA, et al. Androgen deficiency, Meibomian gland dysfunction, and evaporative dry eye. Annals of the New York Academy of Sciences. 2002.

Menopause & Dry Eye: 5 Things You Need to Know

Women over the age of 50 are at a greater risk of experiencing Dry Eye Syndrome.[1] In fact, around 61% of perimenopausal and menopausal women are affected by Dry Eye Syndrome.[2] In this blog, we’ll be sharing everything you need to know about menopause and Dry Eye.

 

What are the symptoms of Dry Eye Syndrome?

Dry Eye Syndrome is a chronic condition that can have many different causes.[3] It can be moderate to severe, and can flare up due to environmental conditions and lifestyle.[4]

Dry eye symptoms include:

• Itchy eyes
• Sore eyes
• Gritty eyes
• Red eyes
• Blurry vision
• Sensitive to light
• Eyes more watery than normal
• Tears drying up (tear evaporation)
• Decreased tear production. [5]

 

 

Can menopause cause Dry Eye Dsease?

Yes! Research published in the National Library of Medicine shows that there is a link between menopause and dry eyes due to women’s decreasing hormones. This can cause itchy, sore and dry eyes.[6]

 

Why are women over 50 more likely to suffer from chronic dry eye?

Menopause is when your periods stop because of the decrease in hormone levels, which usually happens between the ages of 45 and 55. Perimenopause is when you have symptoms before your periods stop. 

Menopause can cause symptoms such as:

• Mood swings
• Brain fog
• Hot flushes [7]

Perimenopausal, Menopausal and Postmenopausal women are particularly prone to dry eyes, because sex hormones such as androgens affect tear production. Androgens are present in all genders, but females present lower levels, which then decrease after menopause.[6] This affects the balance of tear production, causing dry eyes.

 

 

Can menopause cause eye problems?

Menopause and eye problems can often go hand in hand. Menopause can alter your eyesight and even the shape of your eyes! 

Dry Eye Disease is also more common after menopause, as well as cataracts. There is also a risk of glaucoma, which can come with age. [8]

 

 

Are dry eyes a part of perimenopause?

If you have dry eyes and perimenopause, you’re not alone! Dry eyes can be linked to perimenopause, due to changing hormonal balances. Often unspoken of, Laurie G. Barber, Doctor of Medicine, said that perimenopause and Dry Eye should have more awareness and attention. [9]

 

Does low oestrogen cause Dry Eye Disease?

When women go through menopause, the body makes less oestrogen, progesterone and androgen. This can in turn cause Dry Eye Disease. [1]

Your doctor might recommend hormone therapy to restore your oestrogen levels. However, one large study found that long-term hormonal replacement therapy (HRT) can put you more at risk of Dry Eye and make symptoms worse. [10]

 

 

What other things can make Dry Eye Syndrome worse?

Dry Eye Syndrome can have many different causes. When they overlap with each other, patients can experience painful flare-ups. Here are some of the factors other than menopause that can trigger Dry Eye symptoms: 

 

Dry eyes at night

Night-time Dry Eye Disease affects many people, as your body’s metabolism slows at night, so fewer tears are produced. [11]

For people that already suffer from chronic dry eyes, this can result in irritating symptoms during the night because they already deal with problems to do with the quality and quantity of tear production.

 

Computer Vision Syndrome 

Staring at screens reduces our blink rate, causing our eyes to dry out.[12] Chronically dry, itchy eyes are one of the key symptoms of Computer Vision Syndrome, which between 50-90% of people who work at a computer screen can suffer from. [13]

 

Does Dry Eye Disease improve after menopause?

Dry eye symptoms can be improved through different changes and choices we make. Here are our top tips for dealing with dry eyes during menopause:

 

Treating dry eye and menopause

1. Eat well and stay hydrated

Drink lots of fluids to properly hydrate your body and eat a diet rich in omega-3 fatty acids and Vitamin A to encourage healthy tear production and prevent Dry Eye.[14] Experts suggest that you should drink between 8 and 10 glasses of water a day, if you have Dry Eye Disease.[15] Discover more about what vitamins are best for Dry Eye here: 6 Vitamins to Boost Eye Health

 

 

2. Use a humidifier to prevent dry eyes.

Humidifiers add moisture to the air, which can help people who suffer from Dry Eyes.[16] These can often be bought at a low cost, making them an easy solution to bring into your home or office space. For more information on lifestyle changes that you can make, visit our blog: 6 Lifestyle Tips to Help Dry Eye

 

 

3. Cut down on smoking and drinking.

Do not smoke or drink too much alcohol as this can profoundly affect your Dry Eye Disease symptoms. This is because smoking can change the composition of your tears over time and alcohol dehydrates your eyes.[17][18]

Our blog about alcohol and Dry Eye is a great resource: Is Drinking Alcohol Bad For Your Eyes?

You can also read more about the effects of smoking on dry eyes here: Smoking and Dry Eye

 

 

4. Take regular breaks from staring at screens

Taking regular breaks to rest your eyes from digital screens can prevent Computer Vision Syndrome. One technique that can help is the 20/20/20 rule: every 20 minutes, look at something 20 feet away for 20 seconds.[19] To find out more about Computer Vision Syndrome, read our blog: What is Computer Vision Syndrome?

 

 

5. Follow a three-step treatment plan

A three-step treatment plan is a great way to effectively manage your Dry Eye.

 

Step 1: If you are suffering from Evaporative Dry Eye, or Meibomian Gland Disorder, use a heated compress, such as Meibopatch®, to unblock your meibomian glands and relieve your eyes.[20]

 

Step 2: Cleanse and wipe away the melted oil blocking your glands, as well as any built-up debris with a cleanser like Naviblef ®, which is specially designed to reduce discomfort.[21]

 

Step 3: Incorporate an effective lubricant such as any drop from the VISUFamily range. Depending on your condition, you can choose an eye drop that will help ease your symptoms.

 

Best eye drops for menopause and Dry Eye Disease

Don’t let dry eye and menopause hold you back! Eye drops are a great solution for fast and effective dry eye relief. Drops, tears, gels and ointments should all be considered to help.

 

We offer a range of eye care solutions including our VisuEvo® eye drops. These drops include vitamins such as Vitamin A, which can help to reduce the effects of Dry Eye. You can browse these drops here: VisuEvo® Eye Drops

In most cases, the best way to treat dry eyes, Also known as dry eye syndrome, is to use eye gel or eye drops.

VisuXL Gel^® is a preservative-free smart gel lubricant for dry eye syndrome. It provides comfort in a bottle with it’s long-lasting lubrication properties giving 12-hour dosing with just one drop and is suitable for both day and night use.

VisuXL^® is a preservative-free eye drop lubricant for dry eye syndrome. Due to its unique ingredients, VisuXL^® will help you recover from eye surgery, an injury or persistent damaging dry eye.

VisuEvo^® is a preservative-free eye drop that prevents excessive evaporation of the tear film. Its unique formula contains omega-3 essential fatty acids, Vitamins A and D and ultra-filtered phospholipids that facilitate tear film presentation and control evaporation.

All three products are contact lens-friendly and can be used for 180 days after opening.

Shop now

References

1. Wilson, Debra Rose, ‘Menopause and Dry Eyes: What’s the link?’, Healthline, 01/04/2020. Accessed April 2022.
2. Dry Eye Center of NY & NJ, ‘What’s the Link Between Dry Eye and Menopause?’, 08/04/21. Accessed January 2023.
3. Mayo Clinic, ‘Dry Eyes. Accessed April 2022.
4. Monica Alves, Priscila Novaes, Monica de Andrade Morraye, Peter Sol Reinach, Eduardo Melani Rocha, ‘Is Dry Eye an Environmental Disease?’, Arq Bras Oftalmol, May-Jun 2014;77(3):193-200. Accessed April 2022.
5. NHS, ‘Dry eyes’. Accessed April 2022.
6. Peck, Travis, Olsakovsky, Leslie, Aggarwal Shruti, ‘Dry Eye Syndrome in Menopause and Perimenopausal Age Group’, J Midlife Health, 2017 Apr-Jun; 8(2): 51–54. Accessed April 2022.
7. NHS, ‘Menopause’. Accessed January 2023.
8. Glaucoma UK, ‘Does Menopause Play a Role in Glaucoma Development?’, Accessed September 2024.
9. Altersitz, Katrina. ‘Premenopausal women need extra dry eye care’, Ocular Surgery News, Healio, 15/12/06. Accessed January 2023.
10. AlAwlaqi, A. MBBS, MSc; Hammadeh, M. PhD. ‘Examining the relationship between hormone therapy and dry-eye syndrome in postmenopausal women: a cross-sectional comparison study’, Menopause, 23(5):550-555, 05/16. Accessed February 2022.
11. Lazarus, Russell. ‘Burning Eyes at Night’, Optometrists Network, 06/02/21. Accessed April 2022.
12. Wheeler, Regina Boyle. ‘Dry Eye and Screen Use’, WebMD, 21/06/21. Accessed April 2022.
13. Watson, Stephanie, ‘What is Computer Vision Syndrome?’, WebMD, 29/11/21. Accessed April 2022.
14. BergFeinfield Vision Correction, ‘6 Foods to Eat to Help Dry Eye’, 27/02/20. Accessed April 2022.
15. Complete Eye Care, ‘How Does Hydration Affect My Eyes?’. Accessed January 2023.
16. Wang, M. Chan, E. Ea, L. ‘Randomized Trial of Desktop Humidifier for Dry Eye Relief in Computer Users’, Optometry and Vision Science: November 2017 – Volume 94 – Issue 11 – p 1052-1057. Accessed April 2022.
17. Griffin, Morgan. ‘Smoking and Dry Eye’, WebMD, 05/05/21. Accessed April 2022.
18. You, Young-Sheng, Qu, Nai-Bin, Yu, Xiao-Ning, ‘Alcohol consumption and dry eye syndrome: a Meta-analysis’, International Journey of Opthamology, 2016; 9(10): 1487–1492. Accessed December 2021.
19. Marcin, Ashley. ‘How Does the 20-20-20 Rule Prevent Eye Strain?’, Healthline, 03/02/17. Accessed April 2022.
20. Meibopatch® Instructions for Use (IFU). Accessed April 2022.
21. Naviblef ® Instructions for Use (IFU). Accessed April 2022.