What role does COMT play in menopause?

COMT (catechol-O-methyltransferase) breaks down catecholamines (dopamine, epinephrine) and estrogens. The common Val158Met variant (rs4680) alters enzyme activity: Met carriers have lower activity, potentially leading to higher estrogen and catecholamine levels. During menopause, this could theoretically influence symptoms like hot flashes, mood swings, and sleep quality. However, evidence is mixed – some studies find associations, others do not, and effect sizes are small. Consumer DNA tests often overclaim that COMT genotyping can guide personalized supplement stacks for menopause, but no human trials validate such combinations. COMT is just one piece of a complex hormonal and lifestyle puzzle. Testing is not clinically actionable for menopause management. Evidence: mixed. Caveat: Do not base hormone therapy or supplement decisions solely on COMT genotype.