Diethylstilbestrol (DES) is a synthetic estrogen prescribed to millions of pregnant women around the world from the 1930s through to the 1980s, and may still be administered to women today in some developing countries. In other areas of the world, DES is currently used to treat prostate cancer. However, this drug has been linked with serious health problems, including cancer and structural changes to reproductive organs, issues found not only in women who took the hormone supplement while pregnant, but their sons and daughters as well.

Why Use DES?
DES was prescribed to women because it was believed to prevent pregnancy complications as well as miscarriages. Because of this, DES was prescribed to women around the world, including the United States, Australia and several European nations. In the United States alone, four million women were given the drug between 1938 and 1971.

In 1971, the United States Food and Drug Administration issued a warning about using DES while pregnant. In studies, the agency had found a link found between the estrogen drug and clear cell adenocarcinoma of the vagina and cervix, which was found in young women whose mothers had used DES while they were pregnant. The study also found that the drug didn�t prevent complications during pregnancy. In fact, the study showed that when the drug was administered in the first five months of pregnancy, it negatively affected the fetus�s reproductive system. After the results were made public, use of DES was halted, although it was still administered in other nations into the early 1980s.

How It�s Affecting Women and Men Today
Although no longer in use in developed countries, DES is still affecting people around the world. Some five to ten million people were unknowingly exposed to DES in the United States because their mothers took the drug while pregnant with them. The women themselves that took DES have a 30% greater chance of developing breast cancer. Unfortunately, the effects of the drug don�t stop there.

Daughters of DES (women whose mothers took DES) are at a higher risk of developing cancer of the vagina or cervix. They are also susceptible to pregnancy complications, including miscarriage, ectopic pregnancy and preterm delivery. Irregular periods are also common and infertility may be a problem for some. Daughters of DES can also have a lowered level of production and protein content in their breast milk.

Reproductive structural abnormalities are also found in DES daughters, such as a T-shaped uterus. DES daughters require special obstetric care and early confirmation of pregnancy.

Sons of DES (men whose mothers took the drug) also experience health problems related to the estrogen drug. These men are at a higher risk of testicular cancer, genital structural abnormalities and sperm and semen abnormalities.

Long-Term Effects: Spanning Generations
While little research has yet be done to assess the impact of DES use on grandchildren of women who took the drug, one 2002 study found no changes to reproductive structures. Whether or not DES granddaughters will have a higher risk of breast cancer is still not clear.

However a study conducted in the Netherlands found a high rate of hypospadias, a male birth defect that results in structural abnormalities in the penis.

How To Assess Your Risk Level
Men and women who think they might have been exposed to the drug either directly or indirectly are advised to learn about their medical and family history.

Regular exams are also strongly advised. DES daughters are encouraged to get yearly Pap tests and pelvic exams to check for abnormalities, and to have regular mammograms. Colonoscopies are also advised. DES sons are encouraged to have regular prostate exams because of the risk of prostate cancer.


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