Context. Against the backdrop of estrogen deficiency in postmenopausal women, the processes of resorption predominate over the processes of bone formation, which leads to the development of osteoporosis. The main pathogenetic method of treatment of osteopenia associated with hypoestrogenemia is the use of estrogens. However, in some women, hormone replacement therapy does not have the expected effect. Combined use of calcium and calciferol preparations slows the rate of decrease in bone mineral density. Currently, factors that increase the effectiveness of estrogen-progestational therapy for osteopenia in postmenopausal women are being actively investigated. Objective. To determine the effectiveness of estrogen-progestogen drugs in the therapy of osteopenia in postmenopausal women Patients. 23 postmenopausal women, which used hormone replacement therapy with sex steroids and a calcium preparation and vitamin D3 Methods.The MPC was determined by the method of dual-energy X-ray osteodensitometry (DXA) using a Lunar apparatus (USA).Biochemical markers of bone metabolism in blood serum were determined Results.Significant changes already in the first 3 months of therapy: the level of osteocalcin increased, the content of ß cross-laps decreased. Throughout the period of treatment, the BMD increased in all parts of the skeleton - in the I group: in the lumbar spine - by 5.7 + 0.6%, in the proximal part of the thigh - by 4.0 + 0.5%, in the distal forearm - by 2.9 + 0.6%; The marker of osteorheal resection decreased (by 48.3 + 0.9%) and the osteosynthesis marker increased (by 15.7 + 0.7%). In group II, the BMD increased to a lesser extent than in group I: in the lumbar spine - by 3.4 + 0.6%, in the proximal part of the thigh - by 2.3 + 1.1%, in the distal forearm - by 1.8 + 0.4%; the index of osteorecorrection decreased by 41.3 + 0.7%, the osteosynthesis index increased by 11.2 + 0.7% compared to the initial one. Conclusions. A greater efficacy in the treatment of osteopenic syndrome with estrogen-containing drugs with the use of calcium and vitamin D in women of postmenopausal age, depending on the level of vitamin D in the blood serum, has been revealed.