The menopausal period is considered a sensitive transitional phase in women’s lives, characterized by multidimensional changes in biological, psychological, and social domains. During this period, mental health problems such as depression, anxiety, sleep disturbances, and mood fluctuations are commonly observed, primarily due to declines in estrogen and progesterone levels. However, the severity of menopausal psychological symptoms cannot be explained solely by hormonal changes; they are also significantly influenced by psychosocial factors including individual differences, lifestyle, sociocultural context, level of social support, and health perceptions. Recent evidence highlights the importance of evidence-based and individualized approaches in the management of psychological symptoms during menopause. In this context, hormone replacement therapy, cognitive behavioral therapy, mindfulness-based interventions, and pharmacological treatments such as selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) represent key therapeutic options that should be tailored to the individual’s symptom profile and risk factors. Effective management should not be limited to pharmacological interventions but should instead adopt a holistic care model that incorporates lifestyle modifications, psychological support, and the strengthening of social resources. In conclusion, the preservation and promotion of mental health during menopause require a multidisciplinary, personalized approach grounded in current scientific evidence.