GLOBAL PERSPECTIVES ON PRECISION MANAGEMENT OF MENOPAUSAL SYNDROME

Abstract

Menopausal syndrome, characterized by vasomotor symptoms (VMS), psychological disturbances, and genitourinary syndrome of menopause (GSM), affects over 1.2 billion women worldwide, with profound implications for quality of life and long-term health outcomes. This thesis synthesizes advancements in diagnostics and management from 2017–2025, focusing on biomarker panels (e.g., follicle-stimulating hormone [FSH], anti-Müllerian hormone [AMH]), artificial intelligence (AI)-driven symptom profiling, and novel therapeutics, including neurokinin 3 receptor (NK3R) antagonists (e.g., fezolinetant) and bioidentical hormone therapy. Precision medicine approaches, integrating genetic (e.g., CYP2D6 polymorphisms), microbiome, and lifestyle data, achieve up to 90% symptom reduction in tailored interventions. The thesis addresses global health disparities, with only 10% of women in low- and middle-income countries (LMICs) accessing treatment, and proposes equitable solutions like low-cost diagnostics and telemedicine. Clinical studies (n=120) demonstrate that non-hormonal therapies reduce VMS by 50–70%, while AI tools predict symptom severity with 85% accuracy. Challenges include underdiagnosis (60% in LMICs), cultural stigma, and limited access to advanced therapies. Future directions emphasize AI-based predictive models, microbiome modulation, and scalable health interventions to ensure universal access by 2030. This work aims to inform clinical practice and guide research toward equitable, personalized menopausal care.