OBJECTIVE: The aim of this study was to explore factors associated with "resilience" and "vulnerability" to hot flushes and night sweats. METHODS: A total of 4,407 women aged 45 to 54 years who were recruited from family practices in northeast Scotland responded to a postal questionnaire. Among respondents reporting high-frequency hot flushes (n = 628) or night sweats (n = 628), we compared those with low levels of bother ("resilient") with the rest. Similarly, among women reporting low-frequency hot flushes (n = 459) or night sweats (n = 459), those with high bother ("vulnerable") were compared with the rest. Forward stepwise logistic regression examined social, psychological, and physical factors associated with resilience or vulnerability to each symptom. RESULTS: Women resilient to hot flushes were those who had previously not been bothered by their menstrual periods; were not experiencing somatic symptoms or night sweats; and perceived their symptoms as having low consequences on their lives. Those vulnerable to hot flushes had children; had a high body mass index; reported night sweats; and perceived their symptoms as having high life consequences. Women resilient to night sweats were nonsmokers; were not experiencing sleep difficulties; were not using psychological symptom management strategies; and perceived their menopausal symptoms as having low life consequences. Those vulnerable to night sweats had low educational attainment; had previously been bothered by their menstrual periods; had below-average physical health; reported musculoskeletal symptoms and hot flushes; and perceived their menopausal symptoms as having high life consequences. CONCLUSIONS: Factors associated with resilience or vulnerability differ by symptom studied, although relationships with illness perceptions exist in all models. Our results suggest that a single approach to managing these symptoms is likely to be unsuccessful.