Declined anabolic and gonadal steroid hormones with age affect the development of age-related musculoskeletal disorders, including osteoporosis and sarcopenia. Exercises could have an influence on hormones affecting bone and muscle metabolism. Studies have shown that a combination of physical exercise and hormone replacement therapy (HRT) has a significantly better effect on bone and muscle than either of these interventions alone. Recent studies provide possible mechanisms for HRT effects in augmenting skeletal muscle repair and retention of muscle mass in older woman. Vitamin D improves musculoskeletal functions and prevents falls. However, it is not known whether exercise and bisphosphonates are able to interact in improving musculoskeletal functions.