Myths vs facts: COMT and menopause

COMT (catechol-O-methyltransferase) degrades estrogens. The Val158Met variant (rs4680) alters enzyme activity: Met carriers have lower activity, potentially leading to higher estrogen levels. This is often linked to later menopause onset, milder hot flashes, or reduced breast cancer risk. **Myth:** A genetic test can reliably predict menopause timing or symptom severity. **Fact:** Associations are weak and inconsistent in population studies. Individual predictive value is low because many other factors (genetics, lifestyle, hormones) dominate. Clinical guidelines do not recommend routine COMT testing for menopause. DTC tests often overstate the relevance. **Bottom line:** COMT variants are a small piece of the puzzle, not a basis for hormone therapy decisions or prevention. Evidence: human-moderate (observational studies, meta-analyses).