How do people with "slow COMT" genetic variant navigate HRT?

[KittyK]

How do people with "slow COMT" genetic variant navigate HRT?

I'd love this to be discussed as apparently "an estimated 20-30% of Caucasians of European ancestry have a COMT gene variation which limits the body's ability to remove catechols (a specific type of molecule that includes dopamine, norepinephrine, estrogen, etc.) by 3-4 times. I have slow COMT and it seems to be expressing, which makes HRT more complicated. I need estrogen as without it I have hot flushes and bad joint pain. I also was diagnosed with full blown osteoporosis around a decade ago (am now 52 years old).

I have always been easily stressed by normal life events and it got worse when I went into perimenopause.

https://www.psychologytoday.com/nz/blog ... our-health

Thanks

[Panyanc]

Estrogen can build up faster, so I had to start low and go slow. Transdermal options (patches, gels) worked better for me than oral because they don’t spike levels as much. Also, supporting methylation helped—things like magnesium, B vitamins (especially methylfolate and B12), and managing stress made a big difference. You might also want to keep an eye on progesterone since it can counterbalance estrogen's effects.