DES Mothers and Children

1
DES Mothers and Children

• Group Members
• Amanda McMonagle
• Cassi Mahder
• Stacey Wegener
• Emily Deremo
• Julie Reinemann

2
What is DES?

• DES (diethylstilbestrol) is a synthetic form of
  estrogen, a female hormone.
• It was prescribed between 1940 and 1971 to help
  women with certain complications of pregnancy.
• It has been estimated that 5 to 10 million people
  were exposed to DES during pregnancy.

3

• Use of DES declined in the 1960s after studies
  showed that it is not effective in preventing
  pregnancy complications.
• When given during the first 5 months of
  pregnancy, DES can interfere with the development
  of the reproductive system in the fetus.
• DES and other estrogens may be prescribed for
  some other medical reasons, it is no longer used
  during pregnancy.

4
What health problems might DES-exposed daughters
have?

• In 1971, DES was linked to an uncommon cancer
  called, clear cell adenocarcinoma, in daughters
  of women who had used DES during pregnancy.
• It is a cancer of the vagina or cervix that
  occurs after the age of 14.
• The risk of an exposed daughter to develop this
  cancer is 0.1 percent.

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• There is also an increased risk of developing
  abnormal cells in the tissue of the cervix and
  vagina.
• These abnormal cells resemble cancer cells in
  appearance but they do not invade nearby healthy
  tissue.
• And these cells may lead to cancer if they are
  left untreated.

6
Precautions of the DES-daughters

• They should have a yearly Pap test and pelvic
  exam to check for abnormal cells.
• May have structural changes in the vagina,
  uterus, or cervix.
• May have irregular menstration.
• Also, they may have increased risk of
  miscarriage, tubal pregnancy, infertility, and
  premature births.

7
What health problems might DES-sons have?

• There is some evidence that DES-exposed sons may
  have testicular abnormalities.
• Such as undescended testicles or abnormally small
  testicles.
• The risk for testicular or prostate cancer is
  unclear.

8
What health problems might DES-mothers have?

• Women who use DES may have an increased risk of
  breast cancer, 30 higher than the risk of women
  who havent been exposed to the drug.

9
What should DES-exposed daughters do?

• Pelvic Examination- A physical examination of the
  reproductive organ and an examination of the
  rectum should be done.
• Palpation- As part of the pelvic examination, the
  doctor feels the vagina, uterus, cervix, and
  ovaries for any lumps. Often palpation provides
  the only evidence that an abnormal growth is
  present.

10

• Pap Test- A routine cervical Pap test is not
  adequate for DES-exposed daughters.
• Iodine staining of the cervix and vagina- An
  iodine solution is used to temporarily stain the
  linings of the cervix and vagina to detect
  adenosis (a noncancerous but abnormal growth of
  the glandular tissue).
• Colposcopy- A magnifying instrument is used to
  view the vagina and cervix and used to check for
  abnormal tissue.

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• Biopsy- small samples of any tissue that appears
  abnormal on colposcopy are removed and examined
  under a microscope to see whether cancer cells
  are present.
• Breast examinations- DES-exposed daughters have
  not been shown to have an increased risk for
  breast cancer, but they should follow through
  their routine check up.

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What should DES-exposed mothers do?

• First she should inform her doctor.
• She should try to remember the dosage, when it
  was started and how often it was used.
• Inform her children if they were exposed to it so
  they can keep it in their medical records.
• Should have regular breast cancer screening and
  yearly medical checkups that include pelvic
  examination and a Pap test.

13
What should DES-exposed sons do?

• Inform their physician of their exposure and be
  examined periodically.
• Males with undescended testicles or unusually
  small testicles have an increased risk of
  developing testicular cancer, and they should get
  a regular check up for that as well.

14
Do DES-exposed daughters have unusual problems
with fertility and pregnancy?

• A study in 1980 found that an increased risk of
  premature births, miscarriages, and ectopic
  pregnancy is associated with DES exposure.
• Another study in 2001 found that DES-exposed
  daughters have a higher risk of infertility and
  it is mainly due to uterine or tubal problems.

15
What is the current research?

• Researchers continue to study DES-exposed
  daughters as they move into the menopausal years.
• The cancer risks for exposed daughters and sons
  are being further studied.
• Researchers are also studying possible health
  defects on the grandchildren of mothers who were
  exposed to DES during pregnancy.