Dry eyes

Dry eye is when your eyes do not make enough tears, or the tears dry up too quickly. The NHS says it is common, not usually serious, and that there are things you can do to help.

This is a recognition page. No menopause guideline we checked, not the NHS menopause pages, NICE NG23 or the Pakistan Menopause Society's 2026 recommendations, lists dry eyes as a symptom. The link comes from eye research, described below as the researchers' findings. The nearest symptom the guidance does list is dry skin: the NHS names dry and itchy skin among the skin changes of perimenopause, so dry skin is the closest guidance-backed page. More on eyes in midlife is in eye health.

The NHS lists the signs of dry eyes as eyes that are:

• itchy, sore or gritty
• red
• blurry
• sensitive to light
• more watery than normal

That last one surprises people. Eyes that water a lot can still be dry eyes, because the tears are not doing their job.

In daily life it might be reading the Quran in small print and having to stop, or eyes stinging in an air-conditioned office, or waking with them stuck and sore. In Urdu, Roshara calls it aankhein khushk hona, the eyes going dry.

The research points to hormones, though the picture is complicated.

The TFOS DEWS II report on sex, gender and hormones, published in 2017 by an international panel of eye researchers led by David Sullivan, found that dry eye disease is more common in women than men. It says being female is a significant risk factor, and puts much of that difference down to hormones, sex hormones such as androgens and estrogen among them, along with genetic factors. That report is about women in general, not the menopause in particular.

A 2026 mini-review in Frontiers in Immunology, by Tian and colleagues, goes further. It calls the menopause a significant risk factor for dry eye disease, and reports that it is more common in perimenopausal and postmenopausal women than in men of the same age. It argues that falling and fluctuating hormones, androgens as well as estrogen, set off inflammation on the surface of the eye, rather than simply reducing tears. It also notes that estrogen therapy alone has given limited and sometimes conflicting results.

The NHS lists other things that make dry eyes more likely, and several fit midlife: being over 50, long hours at a screen without a break, air-conditioned or heated rooms, wind, dust and smoke, contact lenses, and some medicines, including some antidepressants and blood pressure medicines.

The NHS dry eyes page lists these:

• clean your eyelids every day, and take breaks when using a screen or watching TV
• keep a computer screen just below eye level
• use a humidifier so the air is less dry
• if you wear contact lenses, swap to glasses for a while to rest your eyes
• avoid smoke, dust and long spells in air-conditioned or heated rooms
• do not stop a prescribed medicine without advice, even if you think it is the cause

A pharmacist can suggest eye drops, gels or ointments, the NHS says, and tell you whether you need an optician or a GP.

The NHS says to see an optician or a GP if your eyes are still dry after a few weeks of trying these things, or if the shape of your eyelids changes.

Ask for an urgent appointment if your eye is painful and red, or red while you wear contact lenses.

Get emergency help for any sudden change to your sight such as wavy lines, flashes or loss of vision, pain when looking at light, a red eye with a severe headache and feeling sick, a very dark red eye, or an injury to the eye.

Long recitation in Ramadan, late nights, small print, a phone screen for the family group: the eyes do a lot of work in a woman's day. Resting them is not a luxury.

Notice what makes your eyes worse, the room, the screen, the time of day, and tell whoever examines them.