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to find out the association between the severity of different menopausal symptoms with the occurrence of osteoporotic fractures. case-control study of 159 patients who suffered from osteoporotic fractures and 169 controls. Data collected using a pre-validated questionnaire of the Arabic version of Menopause rating scale, in addition to other sociodemographics. all menopausal symptoms were more severe in women in the control group, the highest scores were reported for joint pain followed by hot flashes. Conclusion severe menopausal symptom