BACKGROUND: Menopause leads to rapid bone loss, mainly as a result of estrogen deficiency and peri and postmenopausal symptoms are related with estrogen deficiency. We investigated the relationship between peri and postmenopausal symptoms and vertebral bone mineral density(BMD). METHODS: Study subjects were women aged above 40 years underwent a vertebral bone density measurement with dual energy x-ray absorptiometry(DEXA). We examined the relationship between the menopausal symptoms by Kupperman index including vasomotor symptom and vertebral BMD in 74 perimenopausal and 205 postmenopausal women. RESULTS: On the basis of vertebral fracture threshold, 169 subjects were osteoporotic group and the others were nonosteoporotic group. Menopausal index was significantly high in osteoporotic group. And the osteoporotic one also complained of vasomotor symptom more severely. These findings were more definite during perimenopausal and early postmenopausal periods than late period. CONCLUSIONS: The results suggest that menopausal symptoms of peri and early menopausal period are significantly related with vertebral bone loss and helpful in predicting the vertebral osteoporosis.