What role does Homocystein play in Wechseljahre?

Homocysteine is a sulfur-containing amino acid; elevated levels are an independent risk factor for cardiovascular disease. During menopause, estrogen levels decline, and estrogen helps keep homocysteine levels low. Thus homocysteine may rise postmenopause, contributing to increased cardiovascular risk. There is also moderate observational evidence linking high homocysteine to bone density loss and cognitive decline. A homocysteine test can provide additional insight but should not replace standard risk markers like blood pressure or lipids. Lowering homocysteine with folate, B12, and B6 is possible, but whether this reduces clinical events remains uncertain in randomized trials. Caveat: not a standalone diagnostic; always consult a physician for interpretation and management.