Background-Estrogens stimulate growth of breast or uterine cells but have the opposite effect on vascular smooth muscle cells. in which they protect against coronary artery disease with ur without concomitant administration of progesterone. A possible cause of differences in hormone action is variable tissue-specific expression of hormone receptor. Therefore, we analyzed the structure of estrogen receptors (ERs) and progesterone receptors (PRs) in human vascular smooth muscle. Methods and Results-RNA was isolated from human vascular smooth muscle, and the functional domains of ER-alpha and PR were characterized by reverse transcriptase and polymerase chain reaction, Interestingly, in addition to wild-type ER-alpha and PR, 5 variant ER-alpha and 2 variant PR transcripts were found. These variants contained precise deletions of exons encoding regions of the hormone-binding domain. The PR transcripts lacked exon 4 (PR Delta 4) and exon 6 (PR Delta 6). The ER-alpha transcripts were missing exon 4 (ER Delta 4), exon 5 (ER Delta 5), exon 6 (ER Delta 6), exon 7 (ER Delta 7), and exons 6 and 7, (ER Delta 6,7). ER-beta variants were also detected. The PR variants were functionally characterized, and PR Delta 6 was found to be a dominant-negative transcription inhibitor of wild-type receptors. Variant PR was present in premenopausal women but absent in postmenopausal women. Conclusions-Variant PR and ER transcripts are extensively expressed in human vascular smooth muscle, The complex tissue-specific effects of sex hormones may be mediated by the expression of heterogeneous fr,rms of their cognate receptors. The presence of variant ERs and PRs may be of importance in altering the physiological effects of estrogens or progestins in vascular smooth muscle.