Abstract
Since the 1940s, diaethylstilbestrol (DES) has been used by millions of pregnant women to prevent miscarriages and many other disorders in pregnancy. In 1971, it became clear that this apparently innocent treatment proved to be a time bomb for the infants exposed to DES during the first trimester of pregnancy. DES is now associated with an increased risk of breast cancer, clear cell adenocarcinoma (CCAC) of the vagina and cervix, and reproductive anomalies. This article summarises the potential long-term health implications of DES on the mother, DES daughters and DES sons, and the possible side effects on the third generation. Health care professionals have to know the history of DES to prevent future disasters with drugs prescribed.
Similar content being viewed by others
References
RM Giusti K Iwamoto EE. Hatch (1995) ArticleTitleDiethylstilbestrol revisited: a review of the long-term health effects Ann Intern Med 122 IssueID10 778–88 Occurrence Handle7717601
OW Smith GS. Smith (1949) ArticleTitleThe influence of diethylstilbestrol on the progress and outcome of pregnancy as based on a comparison of treated with untreated primigravidas Am J Obstet Gynecol 58 994–1009 Occurrence Handle15392965
K Kruse D Lauver K. Hanson (2003) ArticleTitleClinical implications of DES Nurse Pract 28 IssueID7 26–35 Occurrence Handle10.1097/00006205-200307000-00005
WJ Dieckmann ME Davis LM Rynkiewicz RE. Pottinger (1953) ArticleTitleDoes the administration of diethylstilbestrol during pregnancy have therapeutic value? Am J Obstet Gynecol 66 1062–81 Occurrence Handle13104505
JH. Ferguson (1953) ArticleTitleEffect of stilbestrol on pregnancy compared to the effect of a placebo Am J Obstet Gynecol 65 592–601 Occurrence Handle13030591
AL Herbst H Ulfelder DC. Poskanzer (1971) ArticleTitleAssociation of maternal stilbestrol therapy with tumor appearance in young women N Engl J Med 284 878–81 Occurrence Handle5549830
M Bibbo WM Haenszel GL Wied M Hubby AL. Herbst (1978) ArticleTitleA twenty-five-year follow-up study of women exposed to diethylstilbestrol during pregnancy N Engl J Med 298 763–7 Occurrence Handle628409
V Beral L. Colwell (1980) Randomised trial of high doses of stilbestrol and ethisterone in pregnancy: long-term follow-up of mothers, Br Med J 281 1098–1201
MP Vessey DVI Fairweather B Norman-Smith J. Buckley (1983) ArticleTitleA randomised double-blind controlled trial of the value of stilboestrol therapy in pregnancy: long-term follow-up of mothers and their offspring Br J Obstet Gynecol 90 1007–17
ER Greenberg AB Barnes L Resseguie JA Barrett S Burnside LL Lanza et al. (1984) ArticleTitleBreast cancer in mothers given diethylstilbestrol in pregnancy N Engl J Med 311 1393–8 Occurrence Handle6493300
OC Hadjimichael JW Miegs FW Falcier WD Thompson JT. Flannery (1984) ArticleTitleCancer risk among women exposed to exogenous estrogens during pregnancy J Natl Cancer Inst 73 831–4 Occurrence Handle6592380
CMF Antunes PD Stolley NB Rosenshein JL Davies JA Tonascia C Brown et al. (1979) ArticleTitleEndometrial cancer and estrogen use. Report of a large case-control study N Engl J Med 300 9–13 Occurrence Handle213722
L Titus-Ernstoff EE Hatch RN Hoover J Palmer ER Greenberg W. Ricker (2001) ArticleTitleLong-term cancer risk in women given diethylstilbestrol (DES) during pregnancy Br J Cancer 84 IssueID1 126–33 Occurrence Handle10.1054/bjoc.2000.1521 Occurrence Handle11139327
AL. Herbst (2000) ArticleTitleBehavior of estrogen-associated female genital tract cancer and its relation to neoplasia following intrauterine exposure to diethylstilbestrol (DES) Gynecol Oncol 76 147–56 Occurrence Handle10.1006/gyno.1999.5471 Occurrence Handle10637063
S Melnick P Cole D Anderson AL. Herbst (1987) ArticleTitleRates and risks of diethylstilbestrol-related clear-cell adenocarcinoma of the vagina and cervix N Engl J Med 316 514–6 Occurrence Handle3807995
AL Herbst RJ Kurman RE. Scully (1972) ArticleTitleVaginal and cervical abnormalities after exposure to stilbestrol in utero Obstet Gynecol 40 287–98 Occurrence Handle5054957
JM Goldberg T. Falcone (1999) ArticleTitleEffect of diethylstilbestrol on reproductive function Fertil Steril 72 1–7 Occurrence Handle10.1016/S0015-0282(99)00153-3 Occurrence Handle10428139
JG Stolk GP Vooijs EJ Asrtsen AP. Heintz (1982) ArticleTitleHet teratogene effect van diethylstilbestrol in de zwangerschap; de omvang van het DES-probleem in Nederland Ned T Geneesk 126 1350–8 Occurrence Handle7133167
K Block A Kardana P Igarashi HS. Taylor (2000) ArticleTitleIn utero diethylstilbestrol (DES) exposure alters Hox gene expression in the developing müllerian system FASEB J 14 IssueID9 1101–8 Occurrence Handle10834931
RH Kaufman E Adam EE Hatch K Noller AL Herbst JR. Palmer (2000) ArticleTitleContinued follow-up of pregnancy outcomes in diethylstilbestrol-exposed offspring Obstet Gynecol 96 IssueID4 483–9 Occurrence Handle10.1016/S0029-7844(00)00959-5 Occurrence Handle11004345
JR Palmer EE Hatch SR Rao RH Kaufman AL Herbst KL. Noller (2001) ArticleTitleInfertility among women exposed prenatally to diethylstilbestrol Am J Epidemiol 154 316–21 Occurrence Handle10.1093/aje/154.4.316 Occurrence Handle11495854
RR Newbold BC Bullock JA. McLachlan (1987) ArticleTitleTesticular tumors in mice exposed in utero to diethylstilbestrol J Urol 138 1446–50 Occurrence Handle3682076
WB Gill GFB Schumacher M Bibbo FH Straus HW. Schoenberg (1979) ArticleTitleAssociation of diethylstilbestrol exposure in utero with cryptorchidism, testicular hypoplasia and semen abnormalities J Urol 122 36–9 Occurrence Handle37351
RH Depue MC Pike BE. Henderson (1983) ArticleTitleEstrogen exposure during gestation and risk of testicular cancer J Natl Cancer Inst 71 1151–5 Occurrence Handle6140323
AR Moss D Osmond P Bacchetti FM Torti V. Gurgin (1986) ArticleTitleHormonal risk factors in testicular cancer, a case-control study Am J Epidemiol 124 39–52 Occurrence Handle2872797
ST Gershman PD. Stolley (1988) ArticleTitleA case-control study of testicular cancer using Connecticut tumour registry data Int J Epidemiol 17 738–42 Occurrence Handle3225080
ED Whitehead E. Leiter (1981) ArticleTitleGenital abnormalities and abnormal semen analyses in male patients exposed to diethylstilbestrol in utero J Urol 125 47–50 Occurrence Handle7463583
MA Stenchever RA Williamson J Leonard LE Karp B Ley K. Shy (1981) ArticleTitlePossible relationship between in utero diethylstilbestrol exposure and male fertility Am J Obstet Gynecol 140 186–91 Occurrence Handle7234914
AJ Wilcox DD Baird CR Weinberg PP Hornsby AL. Herbst (1995) ArticleTitleFertility in men exposed prenatally to diethylstilbestrol N Engl J Med 332 IssueID21 1411–6 Occurrence Handle10.1056/NEJM199505253322104 Occurrence Handle7723797
JA Visser A McLuskey M Verhoef-Post P Kramer JA Grootegoed APN. Themmen (1998) ArticleTitleEffect of prenatal exposure to diethylstilbestrol on Müllerian duct development in fetal male mice Endocrinology 139 4244–51 Occurrence Handle10.1210/en.139.10.4244 Occurrence Handle9751506
RR Newbold RB Hanson WN Jefferson BC Bullock J Haseman JA. McLachlan (2000) ArticleTitleProliverative lesions and reproductive tract tumors in male descendants of mice exposed developmentally to diethylstilbestrol Carcinogenesis 21 IssueID7 1355–63 Occurrence Handle10.1093/carcin/21.7.1355 Occurrence Handle10874014
BE. Walker (1984) ArticleTitleTumors of female offspring of mice exposed prenatally to diethylstilbestrol J Natl Cancer Inst 73 133–40 Occurrence Handle6588221
RH Kaufman E. Adam (2002) ArticleTitleFindings in female offspring of women exposed in utero to diethylstilbestrol Obstet Gynecol 99 197–200 Occurrence Handle10.1016/S0029-7844(01)01682-9 Occurrence Handle11814496
AJ Wilcox DM Umbach PP Hornsby AL. Herbst (1995) ArticleTitleAge at menarche among diethylstilbestrol granddaughters Am J Obstet Gynecol 173 835–6 Occurrence Handle10.1016/0002-9378(95)90350-X Occurrence Handle7573253
H Klip J Verloop JD Gool Particlevan META Koster CW Burger FE. Leeuwen Particlevan (2002) ArticleTitleHypospadias in sons of women exposed to diethylstilbestrol in utero: a cohort study Lancet 359 1102–7 Occurrence Handle10.1016/S0140-6736(02)08152-7 Occurrence Handle11943257
CJ Whittington T Kendall P Fonagy D Cottrell A Cotgrove E. Boddington (2004) ArticleTitleSelective serotonin reuptake inhibitors in childhood depression: systemic review of published versus unpublished data Lancet 363 1341–5 Occurrence Handle10.1016/S0140-6736(04)16043-1 Occurrence Handle15110490
HC Shah JA. McLachlan (1976) ArticleTitleThe fate of diethylstilbestrol in the pregnant mouse J Pharmacol Exp Ther 197 687–96 Occurrence Handle819646
Goodman Gilman A, Rall TW, Nies AS, Taylor P. The farmalogical basis of therapeutics, eight edition, 58; 1390–1
M Marselos L. Tomatis (1992) ArticleTitleDiethylstilbestrol: I, Pharmacology, Toxicology and Carcinogenicity in Human Eur J Cancer 28A 1182–9 Occurrence Handle10.1016/0959-8049(92)90482-H Occurrence Handle1627392
R Maydl RR Newbold M Metzler JA. McLachlan (1983) ArticleTitleDiethylbestrol metabolism by the fetal genital tract Endocrinology 113 146–51 Occurrence Handle6861692
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Veurink, M., Koster, M. & Berg, L.T.d.Jv. The History of DES, Lessons to be Learned. Pharm World Sci 27, 139–143 (2005). https://doi.org/10.1007/s11096-005-3663-z
Issue Date:
DOI: https://doi.org/10.1007/s11096-005-3663-z