Perimenopause symptoms and support
Dry eye can feel gritty, burning, watery or intermittently blurred. The College of Optometrists says prevalence rises with age and is higher after menopause, while Moorfields notes that perimenopause and menopause can present with dry-eye symptoms. Contact lenses may make an unstable tear film more noticeable.
Medical disclaimer: This article provides general UK health information and is not a diagnosis or a substitute for individual medical advice. Symptoms linked online with perimenopause can also have other causes. Speak to a GP, pharmacist, dentist, optometrist or other qualified healthcare professional as appropriate. Use NHS 111 or 999 when symptoms are urgent.
How dry eye can feel
Symptoms include grittiness, burning, stinging, soreness, redness, itching, eye fatigue, sensitivity to light and blurred vision that may clear after blinking. Paradoxically, dry eyes may water because poor tear-film quality triggers reflex tearing. Contact lenses that were previously comfortable may become irritating after a few hours.
Symptoms alone cannot show whether the problem is menopause, lens wear, allergy, blepharitis, infection or another eye condition. An optometrist can examine the eyelids, tear film and eye surface and check the lens fit and care routine.
What hormones may have to do with it
The eye surface and tear-producing system respond to several hormones, and changes around menopause may affect tear quantity, evaporation and the oil-producing meibomian glands. The College of Optometrists reports that dry-eye prevalence is higher in postmenopausal women, while also calling for stronger evidence about hormonal fluctuation and eye health.
Menopause is therefore a possible contributing factor, not an explanation to apply without assessment. Age, screen use, dry environments, eyelid disease and medicines can all contribute at the same time.
Why contact lenses can become uncomfortable
Moorfields explains that contact lenses can increase risk when dry eye is present. Soft lenses interact with tears and may increase evaporation or destabilise the tear film; long wear can also irritate the eye surface. Protein, bacteria and pollen can accumulate on lenses, so discomfort may be related to lens material, replacement schedule, hygiene, allergy or overwear rather than hormone change alone.
Do not continue wearing a painful lens or use tap water on lenses. Arrange a contact-lens check rather than repeatedly adding drops without knowing whether they are compatible with lenses. An optometrist may discuss reduced wearing time, a different material or schedule, preservative-free lubricants or temporary glasses, depending on the examination.
Self-care that may be recommended
Blinking breaks during screen work, avoiding direct fan or heater airflow, wraparound glasses outdoors, adequate humidity and eyelid hygiene may help. Warm compresses can be useful when meibomian-gland dysfunction is present, but technique and suitability matter.
A pharmacist or optometrist can recommend lubricating drops. Preservative-free products may be preferred when drops are used frequently, but not every red or sore eye is dry eye. Avoid ‘get the red out’ products and do not use steroid or antibiotic eye drops without appropriate prescribing and monitoring.
When a red eye is urgent
Moorfields advises that a sudden red eye in a contact-lens wearer should be treated as a possible infection until proved otherwise. Seek same-day urgent eye care for a painful red eye, reduced vision, marked light sensitivity, discharge, injury or a suspected contact-lens infection. Remove the lens and do not reinsert it.
Sudden vision loss, a curtain or shadow, new flashing lights with many floaters, severe eye pain, chemical injury or neurological symptoms require emergency assessment. One-sided prolonged redness or symptoms not improving with conservative care should also be assessed.
Could another health condition be involved?
Dry eye can be associated with thyroid disease, diabetes, rosacea, eczema, rheumatoid arthritis, lupus and Sjögren’s syndrome. Medicines including antihistamines and some antidepressants may worsen dryness. Dry mouth, joint swelling, rashes or systemic symptoms may change the assessment.
Moorfields suggests considering systemic investigation where dry eye does not respond to usual care and the history supports anaemia, thyroid or autoimmune testing. This does not mean every person with dry eyes needs broad blood tests.
Does HRT treat dry eye?
Evidence about HRT and dry eye is not straightforward, and HRT should not be started solely from an online dry-eye article. If you have broader menopause-associated symptoms, a GP or menopause clinician can discuss treatment under NICE guidance. Eye symptoms still need eye-care assessment.
Tell both clinicians about HRT, hormonal contraception and all other medicines. If dryness changed after starting treatment, record timing and seek review rather than changing the dose yourself.
Frequently asked questions
Can perimenopause make contact lenses uncomfortable?
Hormonal transition may contribute to tear-film changes, and contact lenses can worsen irritation or evaporation. An optometrist should check the eye surface, lens fit, material and hygiene.
Why are dry eyes sometimes watery?
An unstable or poor-quality tear film can trigger reflex watering. Watery eyes do not rule out dry-eye disease, but other causes should also be considered.
Should I stop wearing lenses?
Remove lenses for pain, sudden redness, discharge, light sensitivity or reduced vision and seek urgent eye advice. For gradual discomfort, arrange a lens check and follow the practitioner’s advice.
Useful next steps
UK sources and research
We prioritised current UK clinical guidance, NHS information, professional bodies and peer-reviewed research. Social-media discussions informed the questions covered, not the medical conclusions.
About this guide
Published by The Menopause Directory editorial team for UK readers. It is designed to help you recognise questions to raise with an appropriate healthcare professional, not to tell you what condition you have or which treatment to use.
Editorial review date: 18 July 2026. Review sooner if NICE, NHS or relevant professional guidance changes.
Author: The Menopause Directory
About this guide
This guide is published by The Menopause Directory editorial team to help UK readers understand menopause symptoms, support options and services. It is for general information only and should not replace advice from a GP, pharmacist or qualified menopause specialist.
Last reviewed by The Menopause Directory editorial team.