When clients present with distressful emotional states, such as anxiety or depression, clinicians are faced with the challenge of distinguishing psychological disorders from normative psychological reactions, including those states occurring within the context of developmental transitions such as menopause. While there is debate about menopause being an inevitable cause of psychological distress, there is no debate that some women do experience distress during this stage of life. This dissertation synthesizes the clinically relevant literature about psychological distress during the natural menopausal transition. This synthesis informs clinicians about the experiences women may encounter during the menopausal transition. This includes experiences of depressed and/or anxious mood and alterations in cognitive abilities associated with menopause. Although depression, anxiety, and cognitive decline that meet full diagnostic criteria are not normative experiences during menopause, milder symptoms are common. The physiology, psychological concomitants, and sociocultural perspective of the menopause are discussed. The theories that have been posited as possible causes of this distress are examined, including: (a) the biochemical hypothesis, (b) the domino hypothesis, (c) the social circumstance perspective, (d) the effects of beliefs and attitudes, (e) the timing of menopause hypothesis, and (f) multiple causes hypothesis. The assessment measures that are currently being used to assess symptoms during menopause and current treatments are discussed. Finally, the suggestions for the clinical assessment of psychological distress during the menopause, which were developed from this review, are provided.