Despite the substantial psychosocial impact of osteoporosis, little research has evolved in this area. Early reports conceptualized these nonskeletal problems as psychosocial in nature, but more recent investigations focus on health-related quality of life (HRQOL). Multiple HRQOL instruments have been designed to measure this construct in people with osteoporosis, and each has its strengths and weaknesses. Unfortunately, so much investigative energy has been spent on psychometric testing that these instruments have not been put to work efficiently to identify problem areas in HRQOL. It is from such results that interventions to improve HRQOL will occur.