Differences in reproductive toxicity between ERα antagonists and agonists: From basic research to environmental health risks

Estrogen receptor α (ERα) is a critical nuclear receptor that regulates the development and function of the female reproductive system. Both its agonists and antagonists can disrupt reproductive health through distinct mechanisms. This article systematically reviews the reproductive toxicity and molecular mechanisms of ERα agonists (such as the environmental pollutant bisphenol A) and antagonists (such as the clinical drug tamoxifen), with a focus on the toxic effects of low-dose environmental exposure, sexual dimorphism, and transgenerational inheritance risks. These conclusions can provide a theoretical basis for environmental health risk assessment and clinical drug use strategies.