The relationship between proactive health management, perceived social support, and symptoms in perimenopausal women: a latent profile and mediation analysis

Background Perimenopausal women experience various physical and psychological symptoms. Proactive health management and perceived social support are considered important factors in alleviating these symptoms. However, previous studies have largely overlooked the heterogeneity of proactive health management among individuals. This study aims to identify latent profiles of proactive health management in perimenopausal women and to explore the mediating role of perceived social support between different levels of proactive health management and perimenopausal symptoms. Methods Between February 2025 and August 2025, a total of 491 perimenopausal women were recruited from four tertiary hospitals in Sichuan Province. Data were collected using the perimenopausal women’s proactive health management scale, the Perceived Social Support Scale, and the Menopause Rating Scale. Latent profile analysis and mediation analysis were performed. Results Three latent profiles of proactive health management in perimenopausal women were identified through latent profile analysis (LPA): the low-level passive health group (39.5%), the low-ability high-driven group (24.6%), and the high-level proactive health group (35.9%). Significant differences in perceived social support and perimenopausal symptoms were found between the low-level passive health group and the other groups. Mediation analysis revealed that the indirect association of perceived social support between the high-level proactive health group and perimenopausal symptoms was significant compared with the low-level passive management group ( β = −1.389, SE = 0.451, 95% CI [−2.286, −0.504]), with a mediation proportion of 83.62%. In contrast, the indirect association for the low-ability high-drive group was not significant ( β = −0.838, SE = 0.516, 95% CI [−1.822, 0.231]). Conclusion There is heterogeneity in the level of proactive health management among perimenopausal women. Perceived social support shows a significant mediating association between the high-level proactive health management and perimenopausal symptoms. This mediating association was not observed in the low-ability high-driven group. It is recommended that community-based healthcare service systems and families pay attention to individual differences in health management among perimenopausal women. Beyond improving health literacy and self-management skills, health promotion programs should also leverage family and community support networks. Stratified and precise health promotion and intervention strategies should be developed for different subgroups to alleviate perimenopausal symptoms, thereby helping women transition through the perimenopausal period more smoothly and successfully.