AIM. To study the formation of and trends in risk factors (RFs) for cardiovascular disease (CVD), their influence on the occurrence of early (preclinical) atherosclerotic lesions, a combination of these changes with osteoporosis (OP) in women following bilateral oophorectomy depending on whether hormone replacement therapy (HRT) is performed. MATERIALS AND METHODS. The investigation enrolled 50 women with surgical menopause after bilateral oophorectomy in combination with hysterectomy who received estrogen monotherapy (a study group) and 37 patients who underwent the same operation, but had no HRT (a control group). The study group patients were examined twice (before and 10 years after HRT); the comparison group was examined once in the same period postsurgery. The investigators conducted Doppler study of the great arteries of the head and neck and measured pulse wave velocity, as well as they made dual-energy X-ray densitometry to estimate bone mineral density and a detailed analysis of the most common RFs for CVD. RESULTS. There was an increase in the prevalence of RFs for CVD and a change in their structure, which were particularly marked in the women who received no HRT, their impact on the development of early atherosclerotic changes naturally progressing with the number of RFs. The similar trend was observed for bone tissue changes: a higher incidence of osteopenia and OP during the follow-up. CONCLUSION. The high percentage of a concurrence of osteoporosis and atherosclerosis argues for that there are common pathogenic mechanisms.