Optimizing perimenopausal mental health by integrating precision biomarkers, digital health interventions, and psychosocial care

Table 1 Highlights of perimenopausal symptoms, precision diagnosis and treatment strategies, and digital health interventions

Symptoms		Precision diagnosis and treatment	Digital health interventions
Physical symptoms	Mental and behavioural symptoms	Precision biomarkers identification	AI-driven symptom tracking apps
Vasomotor symptoms (hot flashes)	Anxiety	Genetic marker (SNPs in TACR3, SLCO1B1, ERα/ERβ)	Wearable technology (heart rate, temperature for hot flashes monitoring)
Night sweat	Brain fog	Metabolomic markers (targeted dietary intervention or supplements based on an individual’s unique metabolic profile)	Telemedicine, virtual consultations and remote monitoring
Weight gain (obesity)	Depression	Hormonal fluctuations (estrogen, neurokinin B)	Menopause education and support apps
Vaginal atrophy (vaginal dryness)	Exhaustion	Non hormonal (neurokinin 3 receptor antagonists) - fezolinetant	Personalized lifestyle and nutrition coaching
Low sex drive	Irritability	Pharmacogenomics guided treatment	Digital CBT programs
Discomfort during sexual intercourse	Poor sleep	Genotype guided personalized HRT, SSRIs, non-hormonal options	Digital medication management platforms
Palpitation	-	-	-
Irregular period	-	-	-
Urinary incontinence	-	-	-
Urinary urgency	-	-	-
Body odour	-	-	-

SNPs: Single-nucleotide polymorphisms; TACR3: Tachykinin receptor 3; SLCO1B1: Solute carrier organic anion transporter family member 1B1; ER: Estrogen receptor; AI: Artificial intelligence; CBT: Cognitive-behavioral therapy; HRT: Hormone replacement therapy; SSRIs: Selective serotonin reuptake inhibitors.

Table 2 Digital health solutions for personalized perimenopausal mental health care

Digital health technologies	Personalized benefits for perimenopausal mental health
Telemedicine and virtual counseling	Allows women with perimenopausal mental health symptoms remote access to counseling and consultations with a psychiatrist via telephone or videoconference
Wearable technology	Wearables like smartwatches or fitness bands can track sleep, heart rate, activity levels, and stress, offering data for both users and clinicians to monitor physiological symptoms associated with mental health
Digital CBT platforms	Provide access to evidence-based CBT interventions, helping women manage anxiety, depression, and mood swings associated with hormonal changes
Mental health chatbots	Artificial intelligence-driven chatbots can provide on-demand support, psychoeducation, and coping strategies for mood regulation and anxiety, offering support outside of therapy sessions
Medication management tools	Digital tools can provide reminders for HRT or other medications, track side effects, and alert users to potential adverse interactions, ensuring adherence at affordable terms regardless of location and patients insurance status
Virtual support groups	Online platforms can connect women experiencing similar perimenopausal symptoms, creating a supportive community to reduce feelings of isolation and share strategies for coping
RPM addressing behavioral health	RPM provides both continuous support through daily mood tracking, remote therapy sessions, and personalized mental health assessments. RPM also supports lifestyle adjustments, educational resources, and tailored guidance to improve mental health outcomes during this transitional phase
Sleep management apps	Sleep-tracking apps can offer insights and guidance to improve sleep hygiene and reduce stress and fatigue for many perimenopausal women experiencing sleep disturbances
Precision health platforms	Precision health platforms can suggest personalized treatments by incorporating genetic and metabolomic data

CBT: Cognitive-behavioral therapy; HRT: Hormone replacement therapy; RPM: Remote patient monitoring.