Major depressive disorder is a chronic condition that significantly impairs patients’ quality of life and impairs their ability to effectively cope with daily activities. The incidence of depression in women is 1.5 to 3 times higher than in men. Observations have shown that the tendency to develop this condition increases in the period around adolescence, when the balance of sex hormones is being built, which determines the importance of hormonal changes. In the context of menopause, however, some hypotheses suggest that a key role in the genesis of depression is the lowering of estrogen levels. Mood swings are the result of the disturbance in the balance of sex hormones. Estrogen affects the levels and metabolism of many neurotransmitters in the brain. These are dopamine, norepinephrine, beta-endorphin and serotonin. All of these are key to emotional balance. In addition, the decrease in serum estrogen concentrations leads to the appearance of somatic complaints – for example, night sweats and hot flashes. They are the cause of disturbances in the quality and duration of sleep, which leads to an emotional imbalance before the day. In the period before menopause – premenopause, mood changes are related and exacerbated during the luteal phase of the menstrual cycle, which emphasizes the importance of hormonal changes for these processes. During the transition to menopause – perimenopause, hormonal changes are not limited to the luteal phase of the menstrual cycle, which leads to a lack of cyclicity in the manifestation of depressive episodes and emotional imbalance. As menopause progresses, depression is associated with the natural changes in cognitive capacity that occur as a result of the aging process. This leads to cognitive decline. The age at which menopause occurs also has an impact on stress levels and the onset of depressive episodes in female patients. During the transition from premenopause to menopause, insomnia, weight gain and palpitations are observed. Other hypotheses point to changes in physical capacity and decreased ability to cope with stress as a leading risk factor for depression around menopause. From the first menstruation – menarche until the onset of menopause, there are regular monthly changes in the levels of the hormones estrogen and progesterone, which have a neuromodulating effect. During the transition to menopause, these hormonal changes acquire an irregular rhythm of manifestation and are characterized by increasingly long periods in which estrogen levels drop dramatically. Violation of the neuromodulatory effect of hormones increases the sensitivity and predisposition of patients to mood changes, anxiety and depressive episodes. The transition to menopause begins with changes in the function of the hypothalamic-pituitary-ovarian axis, which coincides with disturbances in the regularity of the menstrual cycle. However,hormonal imbalance may not lead to irregular periods for a long time. This explains why, in some cases, mood swings and the risk of depression are significant even before menstrual disturbances. Other characteristic symptoms are muscle pain and increased fatigue. Menopause also affects sexual desire and can lead to decreased libido, irritability, pain during intercourse and vaginal dryness.