Female ROP Os/؉ mice are partially protected by endogenous estrogens against progressive glomerulosclerosis (GS) during their reproductive period; however, ovariectomy accelerates GS progression. We examined the effects of continuous and intermittent 17-estradiol (E 2 ) replacement and tamoxifen therapy on the development of GS in ovariectomized (Ovx) ROP Os/؉ mice. Continuous E 2 replacement (CE 2 ) throughout 9 months prevented microalbuminuria and excess extracellular matrix accumulation in Ovx ROP Os/؉, not only compared to placebo-treated Ovx mice but also in comparison to intact female ROP Os/؉. Tamoxifen had a similar effect, but of lesser magnitude. Intermittent 3-month on-off-on E 2 did not reduce the kidney changes. Mesangial cells (MCs) from CE 2 mice maintained their estrogen responsiveness. E 2 in vitro prevented transforming growth factor-1 stimulation of a Smad-responsive reporter construct and increased MMP-2 expression and activity in MCs isolated from CE 2 mice. MCs from mice on either placebo or intermittent E 2 treatment did not respond to added E 2 , consistent with a stable alteration of their estrogen responsiveness. Tamoxifen protection against GS was less pronounced in ROP Os/؉ mice. Thus, prolonged estrogen deficiency promotes GS and renders MCs insensitive to subsequent estrogen treatment. This underscores the importance of continuous estrogen exposure for maintaining glomerular function and structure in females susceptible to progressive GS. The glomerulus is a direct estrogen target tissue that predominantly expresses the estrogen receptor (ER) subtype ␣.1 Estrogens regulate genes involved in extracellular matrix (ECM) turnover in a manner leading to the prevention of the accumulation of ECM in the mesangium in mouse strains that do not develop glomerulosclerosis (GS) in response to renal injuries such as nephron reduction or experimentally induced diabetes (sclerosis-resistant mouse models). [1][2][3][4][5] In comparison, the level of glomerular ER expression is inversely correlated with the susceptibility to GS among different mouse strains.3 Furthermore, in other rodent models estrogen replacement therapy has also been shown to decrease glomerular damage in uninephrectomized, spontaneously hypertensive rats, to attenuate GS in aging Dahl salt-sensitive rats, and to normalize the decreased renal functional reserve in ovariectomized (Ovx) Wistar rats. 6 -8 Female ROP Os/ϩ mice develop GS during their reproductive period of life and are, therefore, considered sclerosis-prone. 9 However, estrogen deficiency, induced by ovariectomy, accelerates glomerular dysfunction and scarring in young ROP Os/ϩ mice. 9 This suggests that endogenous estrogens only partially protect this mouse strain from the development of GS. Thus, female ROP Os/ϩ mice represent a model of progressive GS that specifically resembles those women who develop chronic kidney disease (CKD) in midlife with rapidly deteriorating kidney function after the onset of menopause.To address the question of the efficacy of est...