<![CDATA[Background: Hormonal fluctuations during the perimenopausal phase due to decreased ovarian function are influenced by various factors, including nutrient intake and sleep quality, which are thought to play a role in hormonal regulation. Objective: This study aimed to evaluate the relationships between macronutrient and micronutrient intake, sleep quality, and serum FSH levels in Indonesian perimenopausal women. Methods: This study used an analytical observational design with a cross-sectional approach involving 120 perimenopausal women in Gondanglegi, Malang, from September to November 2025. The sample was selected by cluster random sampling. Nutrient intake data were collected with multiple 24-hour food recalls, sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and serum follicle-stimulating hormone (FSH) levels were assessed with ELISA. Data analysis was performed using the Spearman correlation test and multiple linear regression (α = 0.05). Results: The mean serum FSH level was 16.73 ± 18.48 IU/L. Bivariate analysis showed a significant correlation between fat intake (r=-0.348; p<0.001), protein (r=0.304; p=0.001), iron (r=0.298; p=0.001), zinc (r=0.297; p=0.001), sleep quality (r=-0.304; p=0.001) and serum FSH levels. Meanwhile, carbohydrate intake was not significant (p=0.535). Multiple linear regression analysis showed that all independent variables accounted for 22.2% of the variation in FSH levels (R²=0.222; p<0.001), with fat intake, carbohydrate intake, iron intake, and sleep quality as predictors. Conclusion: Fat, carbohydrate, and iron intake, along with sleep quality, were independently associated with serum FSH levels in perimenopausal women, highlighting their role in hormonal variation during the menopausal transition.]]>
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