AI-Enhanced Virtual Reality Program Delivering CBT Shows Early Feasibility for Menopause Symptoms: TMS 2026

A virtual reality (VR) program that uses an artificial intelligence (AI)-enabled avatar to deliver cognitive behavioral therapy (CBT) and other behavioral techniques was well received by midlife women with bothersome vasomotor symptoms (VMS), according to a small qualitative study presented at the 2026 Annual Meeting of The Menopause Society in San Diego.^1,2

All 20 participants said they would use the program, called MenoZen VR, again and would recommend it to a friend or family member going through menopause.²

Addressing a gap in access to CBT

Approximately 80% of midlife women experience VMS, which are a common reason women seek care during the menopause transition and a major contributor to reduced quality of life. Although hormone therapy remains the gold-standard pharmacologic treatment, only 1.7% of US women used it in 2023, according to the investigators.²

CBT is an evidence-based, nonhormonal option endorsed by the National Institutes of Health and The Menopause Society for managing menopause-related VMS, insomnia, and depression. However, access remains limited, in part because of a shortage of conveniently located providers.^1,2

To address this gap, researchers from Cedars-Sinai Medical Center, Mayo Clinic, and University Hospitals Cleveland Medical Center used human-centered design to develop an AI-VR program tailored to the biopsychosocial needs of midlife women.²

Between August and November 2025, investigators recruited 20 women aged 45 to 60 years from the midlife women's health clinic at Mayo Clinic in Jacksonville, Florida. Participants had bothersome VMS (at least 28 episodes per week) and were not using hormone therapy.²

After completing baseline surveys, including the Menopause Rating Scale (MRS), each participant used the program for 45 minutes on a Meta Quest 3S headset. An AI-VR avatar named Maia guided participants through modules based on CBT, talk therapy, mindfulness, and paced breathing.²

Participants then completed usability and session rating surveys and a semi-structured interview, which researchers analyzed thematically.²

Key findings

Participants had a mean age of 55 years (SD, 3.6) and a mean MRS score of 16.9 (SD, 7.5). Most (65%) of participants had little to no prior VR experience, and half had little to no experience with therapy or counseling.²

Interviews yielded 9 themes, including headset and program usability, educational value, symptom management value, perceptions of Maia, personalized support, and accessibility. Every participant described the avatar as nonjudgmental.²

"This study demonstrates early feasibility and acceptability of an AI-VR program," lead author Karisma Suchak, MD, MSHS, of the Cedars-Sinai Center for Virtual Medicine and Health System Transformation, said in the press release. Suchak added that such programs could help deliver evidence-based therapies while reducing barriers such as accessibility.¹

Limitations and next steps

The study was small, qualitative, and limited to a single 45-minute session, so it did not assess clinical efficacy or symptom change. Stephanie Faubion, MD, MBA, medical director of The Menopause Society and a study author, noted that larger studies are needed to establish clinical effectiveness.¹

“Although larger studies are needed to determine clinical effectiveness, these findings suggest that innovative technologies, such as AI-enhanced virtual reality, may offer a promising way to expand access to cognitive behavioral therapy and other evidence-based interventions for women during the menopause transition,” Faubion stated in the press release.¹

The investigators plan further studies with longer follow-up to evaluate feasibility, acceptability, tolerability, and initial efficacy.²

What it means for primary care

For your patients with bothersome VMS who cannot or prefer not to use hormone therapy, CBT is an established nonpharmacologic option, but cost, availability, and convenience often limit access.^1,2 Technology-delivered approaches such as AI-enhanced VR may eventually help close that gap, though they are not yet ready for routine clinical use.

References

1. The Menopause Society. New AI-enhanced virtual reality program shows promise in helping manage menopause symptoms. News release. October 16, 2026. Accessed October 20, 2026. https://menopause.org/press-releases/new-ai-enhanced-virtual-reality-program-shows-promise-in-helping-manage-menopause-symptoms
2. Suchak KK, Uy L, Castaneda R, et al. Qualitative validation of MenoZen VR: an AI-enhanced virtual reality program for menopause symptom management. Abstract P-125. Presented at: 2026 Annual Meeting of The Menopause Society; October 20-24, 2026; San Diego, CA.