Evidence check: CYP2D6 in the context of Wechseljahre

CYP2D6 is a key drug-metabolizing enzyme responsible for processing about 25% of all medications, including many antidepressants (e.g., SSRIs like paroxetine) and tamoxifen. During menopause, such drugs are often prescribed – for hot flashes or breast cancer therapy. Genetic variants in CYP2D6 can alter metabolic rate: 'poor metabolizers' face higher drug levels and increased side effect risk, while 'ultrarapid metabolizers' may experience underdosing. However, evidence for a direct effect of CYP2D6 on the natural course of menopause or on non-drug symptoms is weak. Most studies focus on pharmacokinetics, not on menopause as a physiological condition. Therefore, CYP2D6 testing in the context of menopause is only clinically useful if drug therapy is planned or ongoing. Without medication, the genotype has no relevance for menopausal symptoms. Caution: Do not adjust any medication without medical supervision and without considering liver function and drug interactions.