Objetivo: Identificar el sintoma menopausico severo mas prevalente en mujeres indige- nas en etapa de climaterio. Metodologia: Se estudiaron mujeres zenues del resguardo indigena de San Andres de Sotavento, departamento de Cordoba, en el Caribe colombiano, en diferentes estados me- nopausicos y entre 40-59 anos de edad. Valoradas con Menopause Rating Scale (MRS). Resultados: En el estudio se incluyeron 693 mujeres, 295 premenopausicas y 398 en posmenopausia. Edad promedio de ultima menstruacion: 49.4±3.0. El dominio mas dete- riorado en las indigenas premenopausicas fue el somatico-vegetativo (2.9±1.6), influen- ciado por molestias musculo-articulares. En las posmenopausicas, el mas deteriorado fue el domino urogenital (5.5±3.0), por la alta prevalencia de problemas severos de vejiga. La manifestacion severa mas prevalente entre premenopausicas fue la sequedad vaginal, junto a molestias musculo-articulares (10.8%), y en posmenopausicas, los problemas de vejiga (60.3%). Tiene mala calidad de vida el 5.4% de las premenopausicas y el 52.0% de las postmenopausicas. Conclusiones: Las indigenas zenues tienen elevada prevalencia de los sintomas que ha- cen parte del dominio urogenital, y son los que mas influyen para deteriorar la calidad de vida. Las mujeres posmenopausicas tienen peor calidad de vida y mas prevalencia de problemas de vejiga. Palabras clave: Climaterio, posmenopausia, calidad de vida, urogenital, indigenas Abstract Objective: To identify the most prevalent severe menopausal symptoms among indig- enous women in menopause stage. Methodology: Women Zenues in the indigenous reserve of San Andres de Sotavento, Department of Cordoba, in the Colombian Caribbean, in different stages of menopause. Ages 40-59 years old were studied. Rated with Menopause Rating Scale (MRS). Results: 693 women were included in the study, 295 premenopausal and 398 postmeno- pausal. Average age of last menstrual period: 49.4 ± 3.0. The domain more impaired in premenopausal indigenous somatic-vegetative was (2.9 ± 1.6), influenced by muscle-joint discomfort. In postmenopausal women the most impaired domain was urogenital (5.5 ± 3.0), the high prevalence of severe bladder problems. The severe occurrence was more prevalent among pre-menopausal vaginal dryness with muscle joint pains (10.8%) and postmenopausal bladder problems (60.3%). 5.4% of premenopausal and 52.0% of post- menopausal women 52.0% have a poor quality of life. Conclusions: Zenues indigenous women have high prevalence of symptoms that are part of the urogenital domain and have the most influence to impair the quality of life. Post- menopausal women have worse quality of life and prevalence of bladder problems. Keywords: Climacteric, post menopause, quality of life, urogenital, indians.