A total of 63 healthy young women with primary amenorrhea, 37 control women at the same age with normal ovarian function and 118 postmenopausal women underwent bone mineral density (BMD) measurements at the lumbar spine (L2-L4) by dual photon absorptiometry. Mean +/- SE BMD value in the primary amenorrheic patients (0.878 +/- 0.015 g/cm2) was significantly lower than in both the control ovulatory women (1.069 +/- 0.026 g/cm2) and the postmenopausal patients (0.967 +/- 0.013 g/cm2) (p < 0.05). When hormonal parameters were compared between primary amenorrheic and ovulatory control cases, only the prolactin mean levels were found to be significantly lower in the first group (8.74 +/- 0.86 vs. 16.31 +/- 1.05 ng/ml; p < 0.001). Serum total alkaline phosphatase activity and LDL-cholesterol were negatively correlated with bone mineral density. Total cholesterol and lipid levels were significantly higher in women with primary amenorrhea when compared with the eumenorrheic control group (p < 0.001).