Background: It has been suggested that hormonal changes and environmental alterations during the climacteric period are important in the development of psychological symptoms. Objective: To evaluate the role of biological and psycho-social factors in the prevalence of climacteric symptoms. Design: Open, cross-sectional, observational and descriptive study. Material and methods: A total of 300 women between 40 and 59 years of age were evaluated using Greene scale for climacteric symptoms, Cooper questionnaire for psychosomatic symptoms of stress, Smilkstein family apgar for family dysfunction, Duke-UNC questionnaire for social support and Israel scale for vital events. All these tests have been previously validated in Spanish. Results: Postmenopausal women do not have higher prevalence of psychological symptoms, they only have more vasomotor symptoms. Premenopausal women with vasomotor symptoms have more psychological and somatic symptoms and stress, independently of the vital events, family dysfunction or poor social support. Vasomotor symptoms in the premenopause are associated with increased risk of anxiety (OR: 3.7, IC: 1.4–9.7; P<0.008), depression (OR: 8.1, IC: 2.5–26.4; P<0.0005), somatic symptoms (OR: 14.9, IC: 3.4–65.3; P<0.0003), sexual dysfunction (OR: 7.2, IC: 2.5–20.6; P<0.0002) and stress (OR: 7.5, IC: 3.5–15.9; P<0.0001). Negative vital events and family dysfunction increase in minor intensity the risk of anxiety, depression and stress. Conclusion: In conclusion, psychological symptoms are frequent in the premenopause and are associated to vasomotor symptoms. This observation links psychological symptoms with menopausal transition and might suggest an organic base in their origin. The negative psycho-social environment is a factor that favours the development of these symptoms.