Objective. We analyzed the cytological picture of the vagina and its relation to morphologic changes of the endometrium in women with vegetative-vascular manifestations of climacteric syndrome. Methods. 140 women aged 45-52 y.o. were examined: 40 conditionally healthy with a normal rhythm of menstruation, 60 women with vegetative-vascular manifestations of climacteric syndrome with the episodes of menstrual disorders, and 40 women with the climacteric syndrome without menstruation during a year. In the blood serum, the content of follicle-stimulating (FSH) and luteinizing (LH) hormones as well as estradiol, progesterone and testosterone was determined. Colpositologic examination, needle-biopsy and scrapings of the endometrium were performed. Results. It was found that the type of vaginal smear was influenced not only by the level of the hormones of the ovaries, but by the ratio of LH and FSH. This is most clearly seen in menstruating women with climacteric syndrome. Attention was drawn to the connection of non-atypical endometrial hyperplasia in healthy women and the proliferative type of vaginal smear. Conclusions. With the help of the colpocytological study in women with climacteric syndrome, pathological proliferation of the vaginal epithelium can be revealed, which can indirectly indicate endometrial hyperplasia. The most informative in the sense of the onset of proliferative processes in the female genital organs can be called a cytological picture of the vagina, the level of estrogens and the ratio of gonadotropic hormones - LH / FSH.