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These symptoms can substantially impair quality of life (QoL), particularly in the context of an aging global population. This study aimed to evaluate the QoL among perimenopausal women and identify factors influencing it.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This cross-sectional study was conducted at the Second Hospital of Shandong University from January 2022 to December 2023. A total of 387 perimenopausal women were selected by convenience sampling. Data were collected using MENQOL, PSQI, IPAQ-L, SAS, and SDS scales. Statistical analyses included Pearson correlation, one-way ANOVA, rank-sum tests, and stepwise multivariate linear regression (P\u2009&lt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The mean MENQOL score was 51.59\u2009\u00b1\u200930.15, indicating moderate overall quality-of-life impairment. The mean PSQI score was 9.97\u2009\u00b1\u20095.89; 70.54% of participants had poor sleep quality. Anxiety symptoms were present in 58.9% of participants, and depressive symptoms in 68.7%. Leisure-time physical activity was low (median: 396 MET-min\/week), while sedentary behavior was high (mean: 1598\u2009\u00b1\u2009903\u00a0min\/week). Correlation analysis showed total MENQOL scores to be positively associated with PSQI (r\u2009=\u20090.579, P\u2009&lt;\u20090.01), SAS (r\u2009=\u20090.096, P\u2009&gt;\u20090.05), and SDS scores (r\u2009=\u20090.059, P\u2009&gt;\u20090.05), and negatively associated with sleep duration (r\u2009=\u2009\u2212\u00a00.380, P\u2009&lt;\u20090.01). Work-related physical activity was also positively associated with MENQOL scores (r\u2009=\u20090.144, P\u2009&lt;\u20090.01). Multivariate regression identified the following independent predictors of poorer quality of life: poorer sleep quality, shorter sleep duration, higher work-related physical activity, presence of anxiety or depression, older age, and comorbid conditions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The QoL of perimenopausal women is affected by a multifactorial interplay of lifestyle behaviors, psychological status, and chronic health conditions, highlighting the importance of early screening and tailored interventions, particularly those addressing sleep disturbances, mental health, and appropriate physical activity.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00404-025-08116-1","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T12:56:38Z","timestamp":1753275398000},"page":"1253-1265","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Investigation of the quality of life and influencing factors among perimenopausal women"],"prefix":"10.1007","volume":"312","author":[{"given":"Xiangrong","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiumin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianhui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,23]]},"reference":[{"key":"8116_CR1","volume-title":"Menopause: endocrinology and clinical","author":"S Zhang","year":"2014","unstructured":"Zhang S (2014) Menopause: endocrinology and clinical, 2nd edn. 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