This study investigated the relative importance of psychosocial factors as opposed to menopausal status in relation to so-called 'menopausal symptoms' among a large sample of premenopausal, perimenopausal and (naturally and surgically) postmenopausal women (n = 4308) in The Netherlands. The incidence of psychological, somatic, vasomotor and sexual symptoms was assessed and related to menopausal status and to measures relating to coping behaviors, (body- and self-) esteem and quality of life. Among the findings were that vasomotor symptoms in particular, and loss of interest in sex to a lesser extent, were relatively strongly associated with menopausal status. Psychological and somatic symptoms, however, were found to be more closely associated with psychosocial factors (although perimenopausal women as a group were found to suffer them most). Findings are discussed and interpreted as further evidence that only vasomotor symptoms may rightly be called 'menopausal'.