uses ToolsApi, Menus;
{....}
var
item: TMenuItem;
begin
{get reference to delphi's mainmenu. You can handle it like a common TMainMenu}
with (BorlandIDEServices as INTAServices).GetMainMenu do
begin
item := TMenuItem.Create(nil);
item.Caption := 'A Mewn caption';
Items.Add(item);
end;
end;