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Objective: To study the possible association between menopausal hot flushes and bone mineral density., Design: Observational study., Setting: University clinic., Population: Healthy women (n = 143) with or without hot flushes, 6-36 months postmenopausal after participating in a 6-month hormone therapy trial., Methods: The women prospectively recorded the number and severity of hot flushes for 2 weeks. Bone mineral density in lumbar and hip bones was measured with dual-energy X-ray absorptiometry at recruitment and reassessed in 114 women approximately 6.2 years later., Main Outcome Measures: Hot flushes and bone mineral density., Results: At recruitment, hot flushes were absent in 22 women, mild in 32, moderate in 28, and severe in 61. Lumbar bone mineral densities in non-flushing women (1.130 ± 0.022 g/cm(2) ; mean ± SEM), and in those with mild (1.088 ± 0.024 g/cm(2) ), moderate (1.082 ± 0.030 g/cm(2) ) or severe (1.102 ± 0.019 g/cm(2) ) hot flushes did not differ, nor were there differences in hip bone mineral densities between the four study groups. During the follow-up, lumbar bone mineral density decreased by a mean of 0.4 ± 0.1% a year in women not using hormone therapy, and increased by 0.1 ± 0.2% a year in hormone therapy users (p = 0.019). The respective non-significant changes in left and right total hip bone mineral densities were - -0.6 ± 0.01 and -1.0 ± 0.1 for the non-users, and -0.4 ± 0.1 and -0.6 ± 0.2 for hormone therapy users. These changes in bone mineral density bore no relation to the hot flush status at baseline., Conclusion: In recently menopausal women, hot flushes do not appear to determine bone mass density., (© 2014 Nordic Federation of Societies of Obstetrics and Gynecology.)