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Abstract: Background: Muscle and joint aches (MJA) are frequently observed among menopausal women. They impair quality of life and are a burden to the healthcare system. Objective: To analyze the relation between MJA and several variables related to the menopause. Methods: In this cross-sectional study, 8373 healthy women aged 40–59 years, accompanying patients to healthcare centers in 18 cities of 12 Latin American countries, were asked to fill out the Menopause Rating Scale (MRS) and a questionnaire containing personal data. Results: Mean age of the whole sample was 49.1±5.7 years, 48.6% were postmenopausal and 14.7% used hormone therapy (HT). A 63.0% of them presented MJA, with a 15.6% being scored as severe to very severe according to the MRS (scores 3 or 4). Logistic regression model determined that vasomotor symptoms (OR: 6.16; 95% CI, 5.25–7.24), premature menopause (OR: 1.58; 95% CI, 1.02–2.45), postmenopausal status (OR: 1.43; 95% CI, 1.20–1.69), psychiatric consultation (OR: 1.93; 95% CI, 1.60–2.32) and the use of psychotropic drugs (OR: 1.35; 95% CI, 1.08–1.69) were significantly related to the presence of severe-very severe MJA. Other significant variables included: age, tobacco consumption and lower education. Self perception of healthiness (OR: 0.49; 95% CI, 0.41–0.59), private healthcare access (OR: 0.77; 95% CI, 0.67–0.88) and HT use (OR: 0.75; 95% CI, 0.62–0.91) were significantly related to a lower risk for the presence of severe-very severe MJA. Conclusion: In this large mid-aged sample the prevalence of MJA was high, which was significantly associated to menopausal variables, especially vasomotor symptoms. This association may suggest a potential role of mid-life female hormonal changes in the pathogenesis of MJA. [Copyright &y& Elsevier]