Diethylstilbestrol (DES)

What is diethylstilbestrol (DES)?

Diethylstilbestrol (DES) is a synthetic (man-made) estrogen that was used in the past:

• To try to help prevent miscarriages.
• To treat underdeveloped ovaries.
• To treat the symptoms of menopause such as hot flashes, sweating, and dryness of the vagina.
• To treat problems with menstruation.
• To stop milk production in mothers who did not want to nurse.
• As an after-sex contraceptive.

For about 30 years until 1971, millions of pregnant women were given DES because it was thought that DES would help prevent miscarriages or other problems. However, women and the children of women who took DES are at risk for certain health problems. As a result, in 1971 the Federal Drug Administration (FDA) issued a warning that DES should not be given to pregnant women.

What are the risks of exposure to DES?

Some of the problems caused by this drug in daughters of women who took DES during pregnancy are:

• a rare type of vaginal or cervical cancer in young women in their teens and twenties
• changes in the shape of the cervix and uterus, which may cause increased miscarriages, abnormal pregnancies, and premature labor
• increased risk of tubal (ectopic) pregnancies
• increased risk of problems getting pregnant (infertility)
• a problem with keeping the cervix closed during pregnancy. This is called an incompetent cervix

Sons of women who took DES may have changes in their reproductive system and may have problems conceiving (infertility). Researchers are doing studies to find out if men who were exposed to DES have a higher risk of cancer in the testicles.

Women who took DES have a somewhat higher risk of breast cancer.

How can I take care of myself?

If you think your mother was given DES while she was pregnant, tell your healthcare provider.

• You will have a pelvic exam.
• Your provider will carefully look at and feel your vagina and cervix for any physical differences.
• A Pap test will be taken with extra attention focused on the vaginal area.
• Your provider may paint your vagina and cervix with iodine to check for abnormal tissue.
• You may have a special exam called a colposcopy to check your vagina and cervix.
• You may have other tests of the uterus and kidney systems.
• You should have regular checkups according to your provider's recommendations.