Background: Pattern identification is a unique diagnostic method of traditional Oriental medicine that has recently been the target of questionnaire-based research. Sasang (four-types) constitutional medicine (SCM) is a practice in traditional Korean medicine that seeks to promote objectivity in diagnostics. This paper attempts to illuminate the relationship between constitutions and the pathogenic factors of pattern identification through questionnaires completed by menopausal women about their symptoms. Methods: From March to October 2012, we examined 291 women from the general population, with ages ranging from 40 to 60 years, applying the Kupperman index, the Menopause-Specific Quality of Life Questionnaire (MENQOL), pattern identification based on the Diagnosis System of Oriental Medicine (DSOM), and SCM. We then analyzed the relationship between constitutional type and pathogenic factors. Results: No significant differences were found in the scores of either the Kupperman index or MENQOL questionnaire in relation to constitutional type. However, in a statistical analysis correlating the DSOM pathogenic factor scores (PFS) with the scores of the Kupperman index and MENQOL vasomotor subscale, heat showed a significant positive correlation with SoYang type (SY) and TaeEum type (TE), but not SoEum type (SE), while insufficiency of yin and insufficiency of yang, as well as blood deficiency, showed a significant positive correlation with the TE and SE types. Conclusion: The pathogenic factors in the menopausal symptoms of middle-aged women, specifically the prominent menopausal symptom of facial flushing, differed significantly according to constitutional type.