Menopause signifies a crucial biological shift in a woman’s life, generally occurring between the ages of 45 and 55, characterized by a reduction in estrogen and progesterone levels. These hormonal alterations significantly impact mental health, including mood control, cognition, and emotional stability. This chapter examines the mental aspects of menopause, emphasizing the heightened incidence of sadness, anxiety, bipolar disorder, cognitive deficits, and sleep difficulties during this phase. Disruptions in neurotransmitter systems, including serotonin, dopamine, and GABA, lead to mood instability, irritability, and cognitive impairments. Depression impacts over 50% of menopausal women, but anxiety problems affect up to 40%. Hormonal variations may exacerbate bipolar symptoms, complicating treatment approaches. Cognitive difficulties, such as memory deficits and “brain fog,” are prevalent, while sleep disorders including insomnia and restless legs syndrome exacerbate emotional health. The interaction between neuroendocrine alterations and psychosocial stressors highlights the necessity for prompt identification and comprehensive care. Effective management encompasses psychotherapy, pharmaceutical treatments, lifestyle modifications, and, when applicable, hormone therapy. A complete understanding of these mental health effects is crucial for delivering effective care and enhancing the quality of life for women experiencing menopause.