DES (Diethylstilbestrol) EXPOSURE |
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DESCRIPTIONBetween 1946 and 1971, Diethylstilbestrol (DES), a synthetic form of estrogen, was prescribed for many pregnant women whose doctors hoped it would prevent repeated miscarriages, stillbirths, and premature births. It was also prescribed for women with diabetes and for some women who experienced abnormal bleeding during pregnancy. Beginning about 1968, physicians began discovering a benign form of tumor and a few rare instances of cancer (clear-cell carcinoma) in the vagina and cervix of daughters born of mothers who took DES during pregnancy. Sons of mothers who took DES may also have inherited abnormalities.
Appropriate health care includes:
Physician's history and physical examination.
Office treatments after diagnosis has been established.
SIGNS & SYMPTOMS
Girls: Abnormal vaginal discharge or bleeding (sometimes) beginning at about age 14 or at the start of menstruation.
Boys: Narrowed urethra, hypospadias (urethra opens on the underside of the penis), abnormally small penis, cysts in the testicles, undescended testicles, varicoceles, fewer sperm than normal, less than normal activity of sperm, and decreased volume of semen.
CAUSES
Taking DES during pregnancy.
RISK FACTORS
None other than the reasons DES was commonly prescribed for during 1946-1971.
PREVENTING COMPLICATIONS OR RECURRENCE
Don't take estrogen or any other drug (if possible) during pregnancy.
Daughters of DES mothers should not use estrogen for any purpose.
Daughters of DES mothers should have pelvic exams performed annually or more frequently.
BASIC INFORMATION
MEDICAL TESTS
Obtain a record of mother's pregnancy.
Your daughter should get pelvic exams on a regular basis beginning at age 14.
Colposcopy (vaginal walls are spread with a speculum and tissue is viewed with a binocular microscope).
Biopsy of abnormal tissue.
POSSIBLE COMPLICATIONS
Difficulty in becoming pregnant.
Higher risk of miscarriages, stillbirth, and prematurity.
Vaginal cancer.
PROBABLE OUTCOME
Condition is simply and successfully treated. A very small percentage of girls with DES exposure will have cancerous changes that require additional treatment.
TREATMENT
HOME CARENone, unless prescribed by your doctor.
MEDICATION
Local treatment in doctor's office.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITY
No restrictions.
DIET & FLUIDS
No restrictions.
OK TO GO TO SCHOOL?Yes.
CALL YOUR DOCTOR IF
Your daughter or son develops any of the symptoms of DES exposure.
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