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Premenopausal women with systemic lupus erythematosus (SLE) taking prednisone to suppress inflammatory reactions may be more likely to develop osteoporosis. Seventy-four premenopausal SLE patients had X-ray absorptiometry of the lumbar spine and the thigh bone to determine bone mineral density. Results were compared with bone mineral density in a group of 50 healthy premenopausal women volunteering for a screening program for age-related bone loss. Bone mineral density was reduced in both locations in SLE patients. Twelve percent of SLE patients versus no control women had bone mineral densities low enough to be considered osteoporotic. The adverse effect on bone mineral density may be due to the effects of prednisone, lack of menstrual cycles in SLE patients, overactivity of the parathyroid resulting from kidney failure, conscious avoidance of sunshine, or lack of physical activity as a result of painful joints.