30/04/2026
After menopause, your choline needs can increase significantly. This is not about diet. It is about a gene that relies on your estrogen to function.
The PEMT gene is responsible for producing phosphatidylcholine, a molecule your liver uses to export fat, and that every cell membrane in your body is partly built from. Phosphatidylcholine is also essential for producing bile salts, which are required to absorb fat-soluble vitamins.
Estrogen naturally activates the PEMT gene. When estrogen is present, PEMT effectively produces phosphatidylcholine, and dietary choline demand is lower.
After menopause, estrogen drops. PEMT activity drops with it. The demand for dietary choline rises sharply to compensate.
Women who had no issue pre-menopause can suddenly develop symptoms of choline deficiency: fatigue, difficulty concentrating, poor fat digestion, and, in some cases, early signs of fatty liver, not because of any dietary change, but because a hormonal signal they depended on has gone quiet.
This connection is rarely discussed in women’s health. But knowing it means you can do something about it.
The most direct way to address this is through targeted choline supplementation, alongside dietary sources such as eggs and liver.*