The way I understand it is that the human body constantly has bone resorption and building going on. That's part of bone physio. In women, part of that is due to estrogen production which stimulates both arms of that process. In osteoporosis, you're taking away some of the stimulus for bone production, ultimately leading to bone loss. HRT attempts to correct this, though there are cardiovascular side effects that may lead to contraindications. Importantly for boards though, all lab values in osteoporosis are normal. Hope this helps.