Osteoporosis and osteoporotic bone fractures becomes a serious life threat for women after menopause. Estrogens, mainly through alpha type receptor, act on immunological cells, osteoblasts and osteoclasts, causing increase of bone mineral density and decline of risk of fractures. Conventional hormonal replacement therapy (in peculiarity its estrogens) is effective regimen, applied in prevention and treatment of osteoporosis. Observational studies carried out in past revealed its beneficial influence on cardiovascular disease. However, randomized clinical trials and newer observational studies neglected those conclusions. It was shown that hormonal replacement therapy has adverse effects on: risk of heart disease among older women, thromboemolic disease, stroke and breast cancer among some groups of women. On the other hand, hormonal therapy is effective for menopause symptoms, risk of death and in some clinical cases it might be used in osteoporosis treatment. On base of precise scientific data, particular group of patients may be selected, for which use of hormonal replacement therapy will be especially valuable.