Osteoporosis in both men and women is associated with reduced sex hormone secretion, so it is logical to treat these patients with sex hormones. There is a great difference between men and women in the occurrence of fractures in elderly osteoporosis, and the rate is even four times higher in women than in men, so we mainly discuss hormone replacement therapy for women. Estrogen has the effect of reducing bone conversion to maintain bone mass. Osteoporosis in postmenopausal women is characterized by increased bone calcium mobilization and decreased intestinal calcium absorption, independent of the age of menopause, but directly related to estrogen. Studies have found that estrogen receptors are present in the intestines, kidneys and on osteoblasts and osteoclasts, so postmenopausal treatment with estrogen can restore intestinal calcium absorption and increase urinary calcium reabsorption, resulting in a decrease in blood calcium and a decrease in urinary calcium excretion to correct the negative calcium balance, thus promoting bone formation and inhibiting bone resorption. Although estrogen therapy is more effective and was proposed as early as the 1930s, the fatal drawback is that its carcinogenic effects on the target organs, the uterus and the breast, are still somewhat controversial. Henrieh (10) reviewed 24 original articles, 3 comprehensive analyses, and 5 studies with minimal bias, and Crandy (11) summarized 39 epidemiological surveys and 4227 specimens from breast biopsies performed by Depont on 3303 women showed that estrogen does not increase the risk of breast cancer. However, many studies have shown that long-term estrogen use can lead to endometrial hyperplasia, functional uterine bleeding, and even the risk of endometrial and hepatocellular carcinoma. Some statistics show that the incidence of endometrial cancer is 390/100,000 with estrogen alone, 245/100,000 without estrogen, and 45/100,000 with combined estrogen and progestin. However, due to the short duration of progestin application, further observation is needed. Vaginal ultrasound should be performed regularly during application, and its sensitivity for endometrial lesions reaches 98.2% (13). At present, in addition to ethinyl estradiol, ethylene estradiol, nil estrol, combined estrogen with methyl progesterone (Angioprogesterone) and methoprogesterone (gynecological tablets), synthetic drugs such as gynecomastia capsules and Levitra have also been developed in clinical practice. Lu Biao et al. conducted animal tests and proposed that tetracycline-estrone makes full use of the properties of tetracycline and calcium chelation to precisely aggregate estrone to the specific target site, the bone rebuilding site, increase the frequency of bone activation, promote bone formation, and deposit calcium in the mineralized frontier between mineralized bone and bone-like material, while maximizing minimizes the side effects produced by estrogen. As for male hormones, Jiao Shuhua proposed that methyltestosterone can both promote bone production and inhibit osteolysis, and nandrolone phenylpropionate promotes bone matrix formation, so it can be used by both men and women.