How are MTHFR and Wechseljahre related?

The relationship between MTHFR variants and menopause is not clearly established. MTHFR (methylenetetrahydrofolate reductase) is a key enzyme in folate and homocysteine metabolism. Certain polymorphisms (e.g., C677T, rs1801133) can reduce enzyme activity and lead to elevated homocysteine levels. Elevated homocysteine is associated with cardiovascular risk, which increases after menopause due to estrogen decline. Some studies suggest a link between MTHFR variants and the timing of menopause or the occurrence of hot flashes, but results are inconsistent and mostly from observational studies. The evidence does not support a clinical recommendation. Lifestyle factors such as diet, exercise, and stress management are more important. A genetic test for MTHFR may provide information but should be interpreted with a healthcare provider. Self-medication with high-dose folic acid is not advisable as it may carry risks. Overall, the utility of MTHFR testing for menopause management is limited, and the evidence is rated as 'mixed'.