Perimenopause, or menopausal transition, marks the gradual shift in a woman’s reproductive life when hormone levels, primarily estrogen and progesterone, begin to fluctuate. It can begin early for some women in their mid-30s or 40s and lasts until menopause officially begins (defined as 12 months after the last menstrual period). During this period, women often experience symptoms like hot flashes, mood swings, irregular periods, insomnia and a less-discussed but critical change: eye discomfort and visual disturbances.
Eye health challenges during perimenopause are common, yet they are underrecognised and unspoken of, as all things around menopause, yet it can significantly impact quality of life if not addressed early. Let’s explore how perimenopause affects the eyes and what women can do nutritionally and holistically to support their ocular health.
Dry Eye Syndrome
One of the most frequent ocular symptoms in perimenopausal and menopausal women is Dry Eye Syndrome (DES). This condition occurs due to reduced tear production or increased tear evaporation. Estrogen and androgen receptors are present in the meibomian glands (oil glands in the eyelids) and lacrimal glands; these help in tear production. With the hormonal fluctuations during perimenopause, especially a decline in estrogen, it can lead to reduced tear film stability, inflammation of the tear-producing glands, grittiness, burning, and itching sensations and sensitivity to light and wind.
Blurred Vision and Fluctuating Focus
Hormonal shifts can affect the fluid balance in the cornea, subtly changing its shape and leading to fluctuating vision. Some women may notice difficulty with tasks like reading or focusing on distant objects. These changes can be temporary or may require adjustments in prescription glasses or contact lenses.
Increased Risk of Eye Conditions
The decline in estrogen and progesterone, especially after menopause, can increase the risk of more serious eye diseases, including cataracts, age-related macular degeneration (AMD) and Glaucoma. Additionally, estrogen is known to have a protective effect on the retina, so its decline may expose the retina to oxidative stress and degeneration over time.
Migraines and Visual Auras
Some women experience menstrual migraines or migraines with visual auras as part of their perimenopausal PMS. These migraines may become more frequent or severe during perimenopause due to estrogen drops.
Managing Eye Challenges in Perimenopause and Menopause
Hydration and humidification: Drink plenty of water daily to stay hydrated and use a humidifier in your room to reduce air dryness that can worsen dry eyes.
Limit screen time: Practice the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds. Use lubricating eye drops to support the tear film during extended screen use.
Quit smoking and limit alcohol: Smoking and alcohol increase oxidative stress and accelerate eye ageing. Smoking is directly linked to higher risks of cataracts and AMD.
Wear sunglasses: Protect your eyes from UV rays, which can worsen cataract formation and macular degeneration.
Get regular eye exams: Early detection of glaucoma, AMD, and cataracts is essential, especially as hormone levels decline.
Foods and Fruits That Support Eye and Hormonal Health
A nutrient-rich diet is essential for supporting both hormonal balance and eye health. Certain foods are rich in nutrients that support eye health, hormone balance, and inflammation control.
Omega-3 fatty acids, found in fatty fish like salmon, mackerel, and sardines, as well as in flaxseeds, chia seeds, and walnuts, have anti-inflammatory properties and help reduce dry eye symptoms by supporting the meibomian glands and tear film.
Vitamin A, present in carrots, sweet potatoes, pumpkin, spinach, kale, and mangoes, is essential for tear production, maintaining a healthy cornea, and aiding night vision.
Vitamin E, found in almonds, sunflower seeds, hazelnuts, and avocados, protects eye cells from free radical damage and supports the integrity of skin and eye tissues.
Vitamin C, abundant in oranges, strawberries, bell peppers, guava, and kiwi, strengthens eye tissues and blood vessels, helps prevent cataracts, and supports connective tissue in the eyes.
Lutein and Zeaxanthin, present in spinach, kale, corn, eggs, and green peas, accumulate in the retina and help protect the macula from oxidative damage and blue light exposure.
Phytoestrogens, plant-based estrogens found in soy products, flaxseeds, chickpeas, and lentils, help balance hormones, particularly during hormonal shifts, and may reduce PMS symptoms.
Zinc, found in pumpkin seeds, chickpeas, beef, and yoghurt, plays a crucial role in night vision and supports retinal health by helping transport vitamin A from the liver to the retina.
Herbal and Natural Remedies
There are several herbal and natural remedies that may support hormonal balance and eye health. However, it’s important to consult a healthcare provider before starting any herbal supplements, especially if you’re on medication or have underlying health conditions.
Some notable natural remedies include:
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Black cohosh, commonly used to relieve hot flashes, may help balance hormones and indirectly support eye health.
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Evening primrose oil, rich in gamma-linolenic acid (GLA), can be beneficial for reducing symptoms of dry eyes.
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Bilberry extract supports capillary strength in the eyes and may improve night vision.
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Turmeric, known for its powerful anti-inflammatory properties, may help reduce both systemic and ocular inflammation.
Perimenopause and menopause are natural stages in a woman’s life, but they come with a range of changes, many of which can affect the eyes. Common issues include dryness, blurry vision, an increased risk of eye disease, and migraines. By staying informed and practising good eye hygiene, as well as maintaining a diet rich in essential nutrients, women can manage many of the visual and systemic challenges associated with this hormonal transition.
Supporting hormonal health through proper nutrition, hydration, adequate rest, and regular eye checkups can significantly enhance well-being during this time. There is no need for women to suffer in silence. With the right tools and knowledge, they can navigate this phase with clarity, grace, and healthy vision.
