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.