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The aim of the present study was to investigate the association between grip strength change and bone health according to menopausal status. A random sample of 971 pre- to postmenopausal women from the Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study cohort was measured with dual X-ray absorptiometry in the lumbar spine (LS) and femoral neck (FN) and grip strength with pneumatic squeeze dynamometer at baseline (1989–1991), 5 years (1994–1997), and 10 years (1999–2001). Fractures were recorded based on self-reports and validated from medical records. Women were divided into two groups according to change in grip strength quartile from baseline to 5-year follow-up: not improved (n = 735) and improved (n = 236). In the total population, the greatest bone loss was observed in perimenopausal (beginning of menopause during follow-up, n = 311) women [P < 0.001 vs …