Dry eye and hormonal changes: adolescence, pregnancy and menopause

03/09/2026

Hormonal changes can alter the balance of the ocular surface throughout life. During stages such as adolescence, pregnancy or the menopause, many people notice greater discomfort with contact lenses, fluctuating vision or a sensation of dryness that they did not previously experience. At Barraquer, we understand that these changes can raise concerns, particularly when they occur during especially sensitive stages of life.

Dry eye and hormonal changes: why can they be related?

Sex hormones, particularly androgens, oestrogens and progesterone, play a role in regulating various tissues of the ocular surface. Scientific literature describes how sex, gender and hormones influence the risk, clinical presentation and inflammatory response associated with dry eye.

This relationship is not linear. It is not simply a matter of “having more or fewer hormones”, but rather how they fluctuate, at what stage of life they do so and how each patient responds. The ocular surface functions like a very fine and precise film: if one of its layers is altered, the entire system can lose stability.

At Barraquer, the approach to dry eye should take into account the full range of personal, environmental, hormonal and eyelid-related factors that may be involved.

Adolescence: hormonal changes, oily skin and contact lenses

During adolescence, hormonal changes can affect the skin, sebaceous glands and also the Meibomian glands, located in the eyelids. These glands produce the lipid layer of the tear film, which is essential for preventing tears from evaporating too quickly.

At this stage, dry eye can go unnoticed because it is often confused with tiredness, screen use or poor tolerance of contact lenses. The most important factor is not simply identifying the usual symptoms, but recognising patterns: discomfort that worsens during intensive study, the need to remove contact lenses earlier than usual, or eyes that become more irritated during periods of greater academic stress.

Pregnancy: a stage of often temporary ocular changes

Pregnancy involves significant changes in oestrogen, progesterone and other hormone levels. These changes can affect the tear film, the cornea and tolerance of contact lenses. Different sources describe how hormonal changes can cause dryness, fluctuating vision and greater difficulty wearing contact lenses.

In many cases, these changes are temporary, but that does not mean they should simply be accepted without assessment. During pregnancy, any eye treatment should be reviewed with caution, particularly if the patient was already using eye drops, anti-inflammatory medication or other medicines.

At Barraquer, we recommend seeking advice if dryness interferes with reading, driving, rest or the use of contact lenses. The aim is to relieve discomfort with safe measures adapted to the patient’s stage of life.

Menopause: when dry eye can become more persistent

The menopause is one of the stages most closely associated with dry eye. Various studies describe how changes in oestrogen and androgen levels can affect the production of the different layers of the tear film, including the aqueous, lipid and mucin layers.

One key factor is the function of the Meibomian glands. When these glands do not secrete properly, tears evaporate more easily. It is as though the surface of the eye loses its “protective layer” and becomes more exposed to the environment.

Unlike some of the changes that occur during pregnancy, dryness during the menopause can be more chronic and may require a follow-up plan. At Barraquer, dry eye treatments may include personalised measures depending on the type of alteration detected.

When is it advisable to see an ophthalmologist?

There is no need to wait until dryness becomes severe. It is advisable to seek medical advice when symptoms appear during a particular hormonal stage, when they worsen persistently or when they limit everyday activities.

It is also important to seek advice if there is poor tolerance of contact lenses, an increasing need for artificial tears or a feeling that eye drops are becoming less effective. The aim of the consultation is not only to confirm dry eye, but also to identify the predominant underlying mechanism.

Treatment: personalise rather than generalise

Treatment for dry eye related to hormonal changes should be individualised. In some cases, adjusting habits, eyelid hygiene and ocular lubrication may be sufficient. In others, it may be necessary to address inflammation, the quality of the lipid layer or Meibomian gland dysfunction.

At Barraquer, treatment may include options such as artificial tears suited to the type of dry eye, eyelid hygiene, management of associated factors and, in selected cases, specific treatments such as intense pulsed light (IPL), particularly when there is Meibomian gland dysfunction.

Dry eye and hormonal changes are closely related, but they do not affect everyone in the same way. Adolescence, pregnancy and the menopause can alter tear quality, eyelid function and ocular tolerance. For this reason, the most important thing is not to treat dryness as an isolated discomfort, but as a condition that may have different underlying mechanisms depending on the stage of life.

At Barraquer, we understand that every patient has a different history. An ophthalmological assessment therefore makes it possible to define a realistic, safe and tailored plan.

Dr Víctor Charoenrook, ophthalmologist at the Barraquer Ophthalmology Centre