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Common hormonal MTHFR symptoms include: Severe PMS mood swings, breast tenderness, bloating, and irritability before periods Irregular or heavy periods unpredictable cycles or excessive menstrual bleeding Infertility and difficulty conceiving reduced egg or sperm quality or implantation issues Recurrent miscarriages often linked to elevated homocysteine and poor methylation Chronic fatigue and low energy feeling exhausted even after adequate sleep Thyroid dysfunction sluggish metabolism, weight gain, or cold sensitivity Fibrocystic breasts and ovarian cysts Endometriosis and uterine fibroids Why this happens: Poor methylation leads to oestrogen dominance (too much oestrogen relative to progesterone) because your body cant efficiently break down and eliminate used hormones