I have had dry eyes since around 2004 (had to stop wearing contacts) I didn't start hormones until 2012 I think and starting in 2014 my eye issues got worse and have gotten significantly even more worse since then. I had MGD as you mention, use saline drops (the gel ones make my eyes hurt worse and feel more dry) and then I started having recurrent corneal erosion episodes. I have been trying to combat this for years and have recently had to start seeing a cornea specialist for the last 6 mos or so. He sees my medications and has never said anything about it being an issue (but now I wonder if it could be?) I use a nighttime ointment at night, saline drops during the day, have punctal plugs and use restasis (no relief as of yet!!!)