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Vasomotor symptoms (VMS) are common, but whether VMS are associated with fracture incidence or bone mineral density (BMD) levels is unknown. The following data are derived from the Women’s Health Initiative Clinical Trial participants ([i]n[/i] = 23,573) aged 50–79 years not using menopausal hormone therapy, and 4867 participants of the BMD sub-study [1]. This was a prospective observational study with mean (standard deviation) follow-up of 8.2 (1.7) years (1993–2005). Baseline VMS, incident adjudicated fractures, and BMD (baseline, annual visits 1, 3, 6, and 9) were measured. The mean age of those with moderate/severe VMS was 60 years, and mean body mass index (BMI) was 30.7 kg/m[+]2[/+]. After adjustment for baseline age, BMI, race/ethnicity, smoking, and education, the hazard ratio for hip fracture among women with baseline moderate/severe VMS (vs. no VMS) was 1.78 (95% confidence interval, CI 1.20–2.64; [i]p[/i] = 0.01). There was no association between VMS and vertebral fracture. VMS severity was inversely associated with BMD during follow-up ([i]p[/i] = 0.004 for femoral neck, [i]p[/i] = 0.045 for lumbar spine). In repeated measures models, compared with women who reported no VMS, women with moderate/severe VMS had 0.015 g/cm[+]2[/+] lower femoral neck BMD (95% CI -0.025 to -0.005) and 0.016 g/cm[+]2[/+] lower lumbar spine BMD (95% CI -0.032 to -0.004).


  • Amos Pines
    Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel


  1. Crandall CJ, Aragaki A, Cauley JA, et al. Associations of menopausal vasomotor symptoms with fracture incidence. J Clin Endocrinol Metab 2014 Dec 18. Epub ahead of print
  2. Gast GC, Grobbee DE, Pop VJ, et al. Vasomotor symptoms are associated with a lower bone mineral density. Menopause 2009;16:231-8
  3. Gast GC, Pop VJ, Samsioe GN, et al. Vasomotor menopausal symptoms are associated with increased risk of coronary heart disease. Menopause 2011;18:146-51
  4. Szmuilowicz ED, Manson JE, Rossouw JE, et al. Vasomotor symptoms and cardiovascular events in postmenopausal women. Menopause 2011;18:603-10
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