Mechanism of action of estrogen agonists and antagonists.

The relationship between estrogen agonists and antagonists and the nuclear binding of the estrogen receptor was investigated in the immature rat uterus. Estriol (and other short acting estrogens) are antagonistic when administered as a single injection due to the inability of the receptor-estriol complex to be retained by uterine nuclei for a critical period necessary to stimulate true uterine growth. This failure of the receptor-estriol complex to be retained appears to be due to rapid clearance of estriol from uterine tissue following a single injection of the hormone. When estriol is present in a chronic fashion, it acts as an agonist because receptor estriol complex is retained at nuclear sites for long periods of time. Nonsteroid estrogen antagonists, such as Nafoxidine, also cause long term nuclear retention of the estrogen receptor and act as estrogen agonists after a single injection. However, after multiple injections these drugs are antagonistic and this effect is correlated with decrease availability of cytoplasmic estrogen receptors. In addition, these compounds appear to specifically stimulate the growth of uterine epithelial cells while minimally affecting other cell types which results in hyperestrogenization of the epithelium.