The Hormone Nobody Talks About, And Why It Might Be Behind Your Dry Eyes

When most people think about hormones and aging, they think estrogen. Maybe progesterone. But there's a third hormone quietly at work in your body, one that starts declining long before menopause, and one that has a surprisingly direct connection to how your eyes feel every single day.

That hormone is testosterone. And yes, women have it too.

Testosterone Isn't Just a "Male" Hormone

Here's something that surprises a lot of women: testosterone is produced in meaningful amounts by the female body, by your ovaries, your adrenal glands, and peripheral tissues. In fact, when measured in the same units, women typically have higher concentrations of testosterone than estrogen, a fact that's counterintuitive to most people.

Testosterone plays a meaningful role in how you feel across the board. It supports energy levels, mental clarity, mood stability, muscle strength, bone density, and libido. You have testosterone receptors throughout your entire body, which means when levels shift, it can affect you in a variety of ways.

When Does Testosterone Start Declining?

This is where it gets important: the decline in testosterone for women is not something that waits for menopause. Research shows that testosterone levels begin their gradual downward slide as early as the late teens and twenties, and the decline continues through to around age 58–59, at which point levels tend to plateau or modestly increase.

Importantly, newer research, including a large 2025 study published in The Lancet eBioMedicine, shows that testosterone decline in women is driven by age, not by menopause itself. Estrogen drops sharply at menopause; testosterone follows a slower, steadier path across the decades.

By the time a woman reaches menopause, she may have been experiencing this gradual testosterone decline for 20 years or more.

The drop is usually slow and subtle, which is part of why it so often goes unrecognized. There's no dramatic hormonal event like there is with estrogen, just a quiet, steady decrease that some women feel more than others, and that can contribute to changes in how they feel day to day.

Common experiences associated with declining testosterone in women include:

• Persistent fatigue
• Reduced libido or decreased sexual satisfaction
• Mood shifts or increased irritability
• Brain fog or difficulty concentrating
• Loss of muscle tone
• A decreased overall sense of well-being

So What Does This Have to Do With Your Eyes?

Your eyes depend on a protective tear film to stay comfortable, clear, and healthy. That tear film has three layers: water, mucin, and a critical outer lipid (oil) layer. The lipid layer is what prevents your tears from evaporating too quickly. Without enough of it, your eyes become dry, irritated, gritty, and sensitive, even if they're technically producing tears.

The tiny glands responsible for producing that protective oil layer are called the meibomian glands, and they're located along the edge of your eyelids. Research has consistently shown that the meibomian gland is an androgen (testosterone) target organ, meaning it responds directly to testosterone levels in the body.

Androgens stimulate the genes responsible for the production, transport, and secretion of lipids in the meibomian gland. When testosterone levels are adequate, these glands can function well, producing healthy oils that stabilize the tear film. When androgens decline, meibomian gland function can become compromised, altering lipid profiles in gland secretions, destabilizing the tear film, and contributing to evaporative dry eye.

Large-scale epidemiological studies in the United States have found that the rate of dry eye disease in women over 50 is nearly double that of men in the same age group, and researchers have consistently pointed to hormonal changes, including declining androgen levels, as a key contributing factor.

Why This Matters for Women in Their 30s and Beyond

Because testosterone begins its slow decline in young adulthood, the effects on your eyes aren't reserved for post-menopause. Women in perimenopause, and even those still years away from it, can begin noticing changes in eye comfort that seem to come out of nowhere.

Dryness, burning, light sensitivity, a gritty or foreign body sensation, or even paradoxical excessive tearing (your eyes overproducing tears to compensate for a poor-quality tear film) can all be early signals worth paying attention to.

The connection between hormones and eye health is one that many women, and even many healthcare providers, aren't fully aware of yet. But the research behind it is real and growing.

Supporting Your Eyes Through Hormonal Changes

If you're noticing more eye discomfort as you move through your thirties and beyond, there are a few things worth considering.

Talk to your doctor. Hormonal changes are complex and individual. If you suspect hormone-related dry eye, a conversation with your physician is a meaningful first step.

Be intentional about eye comfort. Warm compresses applied to closed eyelids can help support meibomian gland function and encourage healthy oil flow. This is one of the most widely recommended at-home supportive strategies for evaporative dry eye.

Try the Yoli MenoRelief Eye Mask. Designed specifically with perimenopausal and menopausal women in mind, the MenoRelief Eye Mask delivers consistent, soothing warmth & massage to the eyelid area. It's a simple, drug-free way to give your eyes meaningful relief during a time when they genuinely need extra care.

The Bottom Line

Testosterone isn't something most women think about, but the science is clear that it plays a real role in the health of your meibomian glands, and by extension, in the comfort of your eyes. And because levels begin shifting gradually across your thirties and forties, the effects can show up earlier than most people expect.

If your eyes have been feeling more uncomfortable, more irritated, or just harder to manage lately, your hormones may be part of the story, and now you know where to start.

Looking for more on how hormonal changes affect your body during perimenopause and beyond? Explore our blog for more resources, and check out the Yoli MenoRelief Eye Mask for everyday eye comfort support.