Background:Menopause is a period of high risk for osteoporosis in women due to reduced estrogen. Fractures will be susceptible because of bone loss due to osteoporosis, so prevention of fracture is an important thing to do, which is by early detection. This study aims to determine the relation between early detection of osteoporosis and the incidence of pathological fractures in menopausal women and to determine the diagnostic test results of each early detection. Methods: This study was an observational analytic epidemiological study with a cross sectional retrospective design. Data was collected from medical records of 40 menopausal women which included BMD value, osteocalcin levels, PTH levels, and OSTA Score (age and weight), then analyzed by Chi-Square test to determine the relation and diagnostic test values. Result: Early detection of BMD and PTH has a significant relation to fracture incidence. Menopausal women with osteoporosis BMD values at risk of fracture 8 times greater than normal BMD values and menopausal women with high PTH levels are at risk of fracture 4 times greater than normal PTH levels. The BMD diagnostic test is as follows; sensitivity value 83.33%, specificity 62.50%, Positive Predictive Value 76.90%, and Negative Predictive Value 71.42% (OR 8.333; 95% CI, 1.906 - 36.440; p 0.003). PTH diagnostic tests are as follows sensitivity values 66.67%, specificity 68.75%, Positive Predictive Value 76.19%, and Negative Predictive Value 57.89% (OR 4.400; 95% CI, 1.134 - 17.069; p 0.028). Conclusion: Early detection of BMD and PTH is related to the incidence of pathological fractures in menopausal women.