Sex hormones have a significant impact on the physical, as well as the mental state of women. During their whole reproductive life, starting ftom the menarche up until reaching menopause, women experience intense changes of progesterone and estrogen concentrations. Well described effects of these hormones on their peripheral target tissues are acompanied with their effects upon the central nervous system where they regulate multiple different processes. Sex hormones influence the brain's adaptation capabilities during pivotal hormonal transitions such as pregnancy or menopause, however their effects during monthly fluctuations within the menstrual cycle can not be neglected. For instance, the most apparent structural changes during the menstrual cycle happen in the hippocampus, amygdala, temporal and parietal regions of the brain with changes in gray matter volume. In addition to the structural aspect, functional changes include alterations of multiple neurotransmission systems with emphasis on the monoamine system. Thic could potentially be related to the risk of developing mental disorders. Estrogen is considered to have a neuroprotective role with beneficial effects of elevating the levels of serotonine and dopamine. A sudden drop in estrogen levels is associated with negative mood disorders and decreasing cognitive cpabilities during menopause. Progesterone also has a modulatory role in the central nervous system, mainly through its active metabolite allopregnanolone which exerts a positive effect on mood regulation via positive modulation of GABA – A receptors. An abrupt decrease in progesterone or allopregnanolone in the laste phase of the luteal period is associated with intensifying negative mood symptoms in women with PMS or PMDD. Exogenous hormones, such as combined estrogen and progesterone medications used for contraceptive purposes or for reducing menopausal symptoms demonstrate different effects on women's mental health and behaviour.While in adolescents the use of hormonal preparations increased the risk of depression, in menopausal women the use of combined hormones is associated with positive effects on mood and cognitive function, however the evidence is not unanimous. Even though changes in sex hormones during the menstrual cycle affect multiple organ systems, their contribution is largely dismissed during psychopharmacological therapy, in large due to lacking data and no clear evidence based guidelines. So far, the most data has been collected regarding sex hormone fluctuations and the use of selective serotonine reuptake inhibitors as well as benzodiazepines. Further research is needed in order to provide patient tailored therapy, taking hormonal status into account.