Menopausal depression is an important entity in the lives of many women. The authors review current thinking concerning-this condition. In contradistinction to the male, female psychology is seen as being dependent upon biology. Youth, attractiveness, sex, and motherhood are viewed as the important roles for women. Menopause is seen as a time of mortification, with service to the species over. This thinking has influenced the therapy offered for menopausal symptoms. Physiologic symptoms have been treated psychologically, and psychologic symptoms, physiologically. Frequently psychotherapy has been superficial or designed to gain acceptance of the biologic loss. Mature emotions and cognition have been given little emphasis. The authors suggest that rethinking current notions may aid in treating and preventing menopausal depression.