Perimenopause is often described as a hormonal rollercoaster—hot flashes, mood swings, sleep changes—but for many women, lesser-known symptoms like itchy skin and dry eyes can be surprisingly disruptive.
They’re linked to the natural decline in two key hormones—estrogen and DHEA—that help keep skin supple and eyes comfortably hydrated. Understanding the connection can help you find lasting relief.
Why Perimenopause Triggers Itchy Skin and Dry Eyes
Estrogen plays a critical role in maintaining skin hydration, elasticity, and collagen production. It also influences the tear film—the protective layer over the eye—by supporting healthy oil production in the eyelids.
When estrogen levels drop, the skin’s barrier function weakens, leading to moisture loss and increased sensitivity. Similarly, tear film quality may decline, leaving eyes dry, irritated, or gritty.
DHEA—a hormone produced by the adrenal glands—also declines with age and acts as a precursor to estrogen and testosterone. Its reduction can further impact skin hydration, thickness, and local oil production.
Mechanisms at play:
Skin: Less collagen and elastin → thinner, drier skin prone to itching.
Eyes: Reduced lipid layer in tears → faster evaporation and more irritation.
Common Triggers That Make Itchy Skin and Dry Eyes Worse
While hormonal changes are the root cause, external factors can amplify dryness and itching:
- Cold or dry climates
- Hot showers and harsh soaps
- Extended screen time (reduces blinking)
- Allergens, indoor heating, or air conditioning
How Estrogen and DHEA Can Help Perimenopause Symptoms
Because hormone decline is at the core of these changes, replenishing estrogen or DHEA can, in some cases, improve skin and eye comfort. However, responses vary and should be guided by a qualified healthcare provider.
Estrogen Therapy
Estrogen therapy—whether systemic (patches, pills) or local (creams, vaginal applications)—can improve skin hydration, support collagen production, and benefit certain tissues around the eyes.
Important nuance: Research on systemic estrogen therapy and dry eye is mixed—some studies show improvement, while others suggest no benefit or even a higher prevalence in certain women. Local estrogen therapies tend to be more targeted for genitourinary symptoms and skin benefits.
DHEA Supplementation
DHEA supports skin thickness, elasticity, and oil production by acting as a precursor to other hormones. Intravaginal DHEA (prasterone) is FDA-approved for vaginal dryness and atrophy.
Evidence for DHEA in improving skin hydration or tear production is promising but less established than its vaginal benefits. It should be considered as part of an individualized plan, not as a first-line dry-eye treatment.
Other Solutions for Relief
Even with hormone therapy, daily habits can make a big difference:
For Itchy Skin: Use fragrance-free moisturizers with ceramides; avoid overly hot showers; wear breathable fabrics.
For Dry Eyes: Apply preservative-free artificial tears; take screen breaks; use a humidifier.
Nutrition: Omega-3 fatty acids (from fish or flaxseed) may help support skin and eye hydration in some people.
When to See a Doctor
Seek medical evaluation if:
- Dryness or itching is severe or persistent
- Eyes are red, swollen, or vision changes occur
- Skin symptoms include rash, open sores, or signs of infection
Safety and Contraindications for Hormone Therapy
Both estrogen and DHEA are hormones, not just supplements, and carry potential risks.
Hormone therapy may not be safe for people with:
- History of breast, ovarian, or uterine cancer
- Active or past blood clots (DVT/PE) or stroke
- Uncontrolled cardiovascular disease
- Certain liver conditions
Only use hormone therapy under medical supervision, with regular follow-up and lab monitoring.
How Heally Can Help
Heally connects you with licensed healthcare providers who can:
- Order hormone testing – including estrogen, testosterone, and DHEA-S levels.
- Create a personalized plan – tailored hormone therapy, skincare, and eye-care strategies.
- Monitor progress – adjust treatment as needed for safety and results.
Book a telehealth consultation with Heally to start your personalized plan.
Bottom Line
Itchy skin and dry eyes in perimenopause often trace back to hormonal shifts. While lifestyle changes can help, addressing the root cause with carefully managed estrogen or DHEA therapy—plus daily care—can restore comfort and protect long-term skin and eye health.
Sources:
- National Institutes of Health (NIH): Effect of estrogens on skin aging and the potential role of SERMs
- Nature (Scientific Reports): Evaluation of the therapeutic effect of estrogen replacement therapy combined with autologous serum therapy in controlling severe dry eye
- PubMed Central: Dry Eye Syndrome in Menopause and Perimenopausal Age Group
- Indian Journal of Opthalmology: Hormones and dry eye disease
- Maturitas: Effects of topical DHEA on aging skin: a pilot study
- The Journal of Clinical Endocrinology & Metabolism (JCEM): Should Dehydroepiandrosterone Be Administered to Women?
Disclaimer
The information provided in this article is intended for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare provider before starting, changing, or stopping any hormone therapy or treatment plan.
Hormone therapy may not be suitable for everyone. Certain medical conditions, family history, or medications may affect your treatment options. Use only prescribed progesterone under professional supervision.
