PURPOSE: This study is to provide basic data for the development of climacteric adaptation programs by identifying relevant factors based on the degree of climacteric adaptation and perceived stress, marital closeness and mental health in middle-aged women. METHODS: The data were collected from 191 middle-aged women aged 45 to 60 living in the B metropolitan city during July to September 2018. The data were analyzed using the SPSS/WIN 21.0 Statistical Program by descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson's correlation coefficient, and multiple linear regression. RESULTS: The relevant variables that affect the adaptation of middle-aged women to climacteric were founded as somatization (β=-.29, t=−3.99, p<.001), depression(β=−.24, t=−3.03, p=.003), perceived stress (β=−.19; t=−2.50; p=.013), and spouse's job status (β=.16; t=2.77, p=.006). Overall, approximately 37.8% of the variability in climacteric adaptation was explained by the 4 variables in this study (R2=.378, F=24.12, p<.001). CONCLUSION: Since the middle-aged women in menopause show maladjustment due to negative emotions, it is important for them to control negative emotions and stress. Therefore, it will be necessary to develop a support system through spouse's careful attention and self-help meetings as well as a program of self-awareness of their symptoms for middle-aged climacteric adaptation.