Objective: To investigate the influence of a supervised multicomponent exercise training program on menopause-related symptoms, particularly vasomotor symptoms (VMS), in middle-aged women.Methods: A total of 112 middle-aged women (mean age 52 AE 4 y old, age range 45-60 y) from the FLAMENCO project (exercise [n ¼ 59] and counseling [n ¼ 53] groups) participated in this randomized controlled trial (perprotocol basis). The exercise group followed a multicomponent exercise program composed of 60-minute sessions 3 days per week for 16 weeks. The 15-item Cervantes Menopause and Health Subscale was used to assess the frequency of menopause-related symptoms.Results: After adjusting for body mass index and Mediterranean diet adherence, the subscales measuring menopause-related symptoms and VMSs decreased 4.6 more in the exercise group compared to the counseling group (between-group differences [B]: 95% CI: -8.8 to -0.2; P ¼ 0.040). The exercise group also showed significant improvements in the subscales of couple relationships (between-group differences [B]: -1.87: 95% CI: -3.29 to -0.45; P ¼ 0.010), psychological state (between-group differences [B]: -2.3: 95% CI: -5 to -0.2; P ¼ 0.035), and VMSs (between-group differences [B]: -4.5: 95% CI: -8.8 to -0.2; p ¼ 0.040) in the Cervantes Menopause and Health Subscale compared with the counseling group.Conclusions: A 16-week multicomponent physical exercise program showed a positive effect on menopauserelated symptoms especially in couple relationships, psychological state, and VMS, among 45 to 60 year old women.