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Perimenopause is a complex, multidimensional biopsychosocial transition characterized by endocrine fluctuations that interact with psychological vulnerabilities, sleep disturbances, and physical symptoms, significantly impacting women’s health-related quality of life (HRQoL). While hormonal therapies remain a viable option, there is an increasing demand for acceptable and accessible non-pharmacological interventions. This structured narrative review synthesizes recent randomized controlled trial (RCT) evidence evaluating integrative non-pharmacological interventions for mental health and HRQoL during the menopausal transition. A structured search was performed in MEDLINE via PubMed, Web of Science Core Collection, and the Cochrane Central Register of Controlled Trials (CENTRAL) for RCTs published between 1 January 2021 and 30 June 2026. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale: Nineteen RCTs met the eligibility criteria and were categorized into five domains: (i) lifestyle and structured exercise interventions, (ii) psychological, educational, and coaching-based interventions, (iii) mind–body and meditative movement interventions, (iv) acupuncture and traditional technique-based interventions, and (v) herbal and nutraceutical interventions. Overall, physical activity, Mediterranean- or DASH-oriented dietary counseling, cognitive behavioral therapy (CBT), health coaching, mindfulness-based stress reduction (MBSR), yoga, and Tai Chi were associated with favorable findings for depressive and anxiety symptoms, perceived stress, insomnia, sexual functioning, and menopause-specific quality of life. Acupuncture, moxibustion, and specific nutraceuticals yielded positive but highly heterogeneous or formulation-specific outcomes. The breadth of reported effects appeared to vary according to comparator selection, with broader findings generally observed against inactive controls than against active or sham comparators. Current evidence supports integrating tailored non-pharmacological strategies within patient-centered perimenopausal care. However, substantial heterogeneity in perimenopause definitions, small sample sizes, high attrition in select trials, and a lack of long-term follow-up limit generalizable conclusions. Future research requires standardized staging, active comparative-effectiveness designs, and implementation evaluation within multidisciplinary healthcare settings.
Serna-Menor et al. (Wed,) studied this question.