Objectives. To study correlations between symptoms of hypertensive encephalopathy (HE), structural MRI changes of the brain and affective disorders in the perimenopausal period. Materials and methods. A study included 150 women who have been through natural menopause (group 1) and 100 women in the premenopausal (group 2). Somatic and neurological examination, MRI and psychometric scales for anxiety and depression were used. Results and Conclusions. Women with hypertensive encephalopathy in the postmenopausal period had signs of persistent psycho-emotional disorders (higher anxiety, depression of different severity) combined with structural changes in the brain, with their severity increasing with the progression of HE.