Few human studies have been conducted to determine if DES-related health effects occur in the Third Generation (offspring of DES Daughters and Sons). However, animal studies have shown that Third Generation mice suffer from increased health risks as they age. As a result it is important to identify patients whose parents were exposed to DES in utero.
In the United States, DES was prescribed primarily to prevent spontaneous
abortion and premature delivery between 1938 and 1971 (12). Never
patented, it was prescribed under more than 200 brand
names under a variety of dosage regimens, including in combination
with vitamins (290). DES was shown to lack efficacy for prevention
of pregnancy complications in 1953 (291). However, it was still
widely prescribed until it was demonstrated, in the early 1970s,
that women exposed to DES in utero (DES Daughters) developed clear
cell adenocarcinoma (CCA) of the vagina and cervix at a rate significantly
higher than the general population (132,157).
Although public education campaigns were taken, not all DES-exposed
men and women know about their exposure. DES was prescribed to pregnant
women outside the United States after 1971, and is still available
in oral form for human use in some countries today (296). Some persons
may be aware that their grandmother was prescribed DES while pregnant.
Others may identify that their mother suffered from reproductive
tract structural differences typical for DES, that their father
had genitourinary abnormalities suspected to be related to DES exposure,
or that their mother had CCA. Such persons should be considered
as possibly transgenerationally exposed to DES. For more information
on the drug DES, including details of current usage, refer to DES:
For a complete list of the numbered citations
on this page see DES References.
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