Evidence check: MTHFR in the context of Wechseljahre

MTHFR variants (especially C677T) are often marketed in the context of menopause for hormone balance, cardiovascular risk, or bone health. However, the evidence is limited and conflicting. While reduced MTHFR activity can raise homocysteine levels—a trend also seen with estrogen decline in menopause—randomized trials do not clearly support MTHFR-guided supplementation (e.g., folate, B12) for menopausal symptoms or long-term outcomes. Most associations come from observational or mechanistic studies. Consumer DNA tests like MyBody-X can detect MTHFR variants, but clinical utility for individual menopause management is unproven. Professional guidelines do not recommend routine MTHFR testing for this purpose. Instead, direct homocysteine measurement and lifestyle interventions are more evidence-based. Evidence grade: mixed/unclear for direct clinical application.