Evaluating tools for assessing mental health disorders in perimenopausal women

During menopause, changing hormone levels can lead to disturbances in mood and cognitive changes. Early identification and assessment of these symptoms is critical for timely intervention and improved quality of life. Perimenopause describes the phase 4 to 8 years prior to menopause, when menstrual cycles become irregular due to the gradual decrease in hormone production by the ovaries. This process involves changing estradiol and progesterone levels, influenced by reduced inhibin B and increased follicle-stimulating hormone. Initially, women experience changes in menstrual regularity, which later progress to more noticeable issues such as hot flashes, night sweats, and genitourinary discomfort. In addition to physical signs, psychological and cognitive symptoms are recognized. Women in this phase have an increased risk of developing mood disorders, including anxiety and depression, regardless of the existence of prior psychiatric history. These symptoms tend to peak during perimenopause and typically improve after menopause. Women might also experience fluctuations in memory and ability to focus, making daily living more challenging. Recognizing cognitive and emotional changes early is essential; however, symptoms of perimenopause can easily be mistaken for other medical or mental health issues. When these symptoms are overlooked or misdiagnosed, women might face delays in receiving appropriate care, significantly affecting their well-being. This review provides an overview of tools that are currently used to assess mental and cognitive health in perimenopausal women, including general psychiatric screeners (PHQ-9 and GAD-7), menopause-specific tools (MRS, Green Climacteric Scale, and MENQOL), cognitive assessments (MoCA, MMSE, and EMQ-R), and relevant digital or biomarker-based tools. This review highlights existing gaps in the literature, including the discussion of subjective cognitive complaints and hormonally driven mood changes. This study summarizes strengths and limitations relevant to these topics and identifies areas where improved screening could better support women's mental health during the transition to menopause.