Physical and psychological problems associated with exposure to diethylstilbestrol

Psychiatric disorders among DES-exposed persons, 1988

image of the-lightner
Psychiatric disorders among DES-exposed persons are reportedly twice as common as for nonexposed persons, with anger, anxiety, low self-worth, identity confusion, and guilt the most frequent symptoms. the lightner.

1988 Study Abstract

The synthetic hormone diethylstilbestrol (DES) was widely prescribed between 1943 and 1971 to minimize pregnancy complications.

It has caused serious physical and psychological damage to the women who took it and to their offspring. DES-exposed mothers may suffer a higher incidence of breast cancer, their exposed daughters are at risk for reproductive tract cancers and infertility, and their exposed sons are more likely to have genital abnormalities and reproductive dysfunction.

Psychiatric disorders among DES-exposed persons are reportedly twice as common as for nonexposed persons, with anger, anxiety, low self-worth, identity confusion, and guilt the most frequent symptoms. The author describes therapeutic interventions designed to alleviate these problems.

Sources and more information
  • Physical and psychological problems associated with exposure to diethylstilbestrol (DES), Hospital & community psychiatry, NCBI PMID: 3276594, 1988 Jan.
  • Full study psychiatryonline, Volume 39 Issue 1, January 1988, pp. 73-77.
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Identification and management of DES-exposed women

Emphasis has been placed on screening for clear cell adenocarcinoma rather than squamous cell carcinoma and reproductive alterations

identification-lab image
Greater effort must be made by practitioners to identify and screen for DES exposure in their practices, as well as to educate the public regarding the health risks posed by DES exposure so that affected women may be reached and receive care.

1988 Study Abstract

Diethylstilbestrol (DES), a synthetic estrogen compound, was prescribed to many women with history of miscarriage between the years 1940 and 1971.

As a result of prolonged use of DES in gynecological practice, an estimated 1 million to 1.5 million women were exposed prenatally, resulting in multiple upper and lower genital tract abnormalities. These anomalies may affect reproductive function and place women at greater risk for developing clear cell adenocarcinoma (peak incidence at age 19) and squamous cell carcinoma of the vagina and cervix (peak incidence at ages 35 to 40).

Emphasis has been placed on screening for clear cell adenocarcinoma rather than squamous cell carcinoma and reproductive alterations. Despite the previous emphasis during the 1970s and a subsequent decline in public and practitioner awareness, women are at risk for the known effects of DES exposure until the year 2010. Greater effort must be made by practitioners to identify and screen for DES exposure in their practices, as well as to educate the public regarding the health risks posed by DES exposure so that affected women may be reached and receive care.

Sources and more information
  • Identification and management of DES-exposed women, The Nurse practitioner, 1988 Nov;13(11):15-6, 19-20, 22 passim, NCBI PMID: 3231355.
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Cervical and vaginal cancer detection at a regional DES screening clinic

Utility of DES screening specialized clinics discussed, 1988

The utility of DES screening specialized clinics is discussed in this 1988 study.

1988 Study Abstract

From 1979 to 1986, 500 women were enrolled in a New York State regional diethylstilbestrol (DES) clinic for the early detection of DES-associated adenocarcinoma of the cervix or vagina. Only 66 DES-exposed females were seen at Roswell Park Memorial Institute in the 6-year period prior to the establishment of the DES screening clinic. Most (40%) learned of the DES screening clinic through television public service announcements. Documentation by physician, pharmacy, or hospital records of intrauterine DES exposure was possible in only 15.2% of the cases. Because of a mean age of 24 years of the DES-exposed patients, most physician, pharmacy, and hospital records were not readily available from that time period. In 5.2% of the patients enrolled in the DES clinic, review documented that the mother had not taken DES or other synthetic estrogen analogs. Among the 474 evaluable DES patients, gross vaginal or cervical abnormalities were present in 13.5% and DES-associated adenosis was seen in 16.0%. Sixteen (3.4%) developed squamous dysplasia, one developed squamous in situ carcinoma of the cervix, and one developed invasive squamous cell carcinoma of the cervix. During the 6-year period of the DES screening clinic, no patient developed DES-associated adenocarcinoma of the cervix or vagina. The utility of such specialized clinics is discussed..

Sources and more information
  • Cervical and vaginal cancer detection at a regional diethylstilbestrol (DES) screening clinic, Cancer Detect Prev. 1988;11(3-6):197-202, NCBI PMID: 3390844.
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Clear cell adenocarcinoma of the vagina and cervix: incidence, undetected disease, and DES

DES usage review buttress the need for adequate and rigorous research into the use of drugs in pregnancy and ensure that they do more good than harm before being introduced for consumption

Cervical-cancer
The finding of stable (or rising) incidence rates for clear cell adenocarcinoma occurring nearly 30 years after the marked decrease in diethylstilbestrol sales emphasizes the need for continued clinical and epidemiologic studies of the etiology and clinical course of CCAC.

1988 Study Abstract

We conducted an incidence study to determine the occurrence rates of clear cell adenocarcinoma (CCAC) of the vagina and cervix in young women (born in 1940 and thereafter), and a case-series analysis, focusing on the maternal history of pregnancy and delivery and in-utero exposure to diethylstilbestrol (DES).

Overall, 10 cases of CCAC had been listed in the files of the Connecticut State Tumor Registry prior to the study, and each of the 10 cases were confirmed as valid. In addition, another 10 cases, all previously undetected, were found after the tissue slides of young women listed as having other cancers of the vagina and cervix were reviewed by expert pathologists, suggesting that prior estimates of the incidence rate for CCAC must be misleading unless special efforts are taken to identify undetected cases. The incidence rates of vaginal CCAC (11 cases total) were highest in 1975-1979, and decreased slightly during 1980-1982. In the cervix (nine cases total), the rate increased consistently since 1970. History of in-utero exposure to diethylstilbestrol was obtained for five of eight vaginal cases and four of eight cervical cases of CCAC. In all nine cases, exposure to diethylstilbestrol was associated with a history of bleeding during the pregnancy or prior miscarriage.

We conclude that the finding of stable (or rising) incidence rates for CCAC occurring nearly 30 years after the marked decrease in diethylstilbestrol sales emphasizes the need for continued clinical and epidemiologic studies of the etiology and clinical course of CCAC.

Sources and more information
  • Clear cell adenocarcinoma of the vagina and cervix: incidence, undetected disease, and diethylstilbestrol, NCBI PMID: 3385459, J Clin Epidemiol. 1988;41(6):593-7.
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Distilbene et grossesse à risque… Vidéo d’archives 1988

Et si votre mère avait eu une grossesse à risque et pris le médicament #Distilbène? Vidéo d’archives 1988

Et si votre mère avait eu une grossesse à risque et pris le médicament Distilbène?

  • Vidéo par Ina Sciences, 2 Jul 2012.
  • Archives 11 novembre 1988

    • Retour à l’actualité du Distilbène, à l’occasion d’un congrès de gynécologie qui se tient à Paris. Ce médicament, indiqué dans les cas de grossesse difficile, provoque des malformations génitales chez les enfants des mères traitées.
    • Photo de comprimés de Distilbène.
    • Mère poussant landau dans jardin public.
    • Interview Mme Lascar, son bébé dans les bras, au sujet de sa grossesse difficile.
    • Reportage dans une famille dont les 4 enfants souffrent de malformations dues au Distilbène ; scène de famille ; interview de l’une des filles au sujet de ses craintes pour faire un enfant.
    • Entretien entre une gynéco et une patiente ; interview gynéco, Anne CABAU, au sujet des risques de malformations dus au Distilbène et de l’importance du dialogue mère-fille.
    • Brochure médicale éditée par le ministère au sujet de ce médicament.
    • Enfant dans jardin public.

Le Distilbène DES, en savoir plus:

Distilbène témoignages émouvants… Vidéo d’archives 1988

#Distilbène témoignages émouvants… Vidéo d’archives 1988. Interview du Professeur Michel Tournaire, gynéologue à l’Hôpital Saint Vincent de Paul, sur l’importance d’informer les médecins.

Témoignages émouvants d’Astrid, Béatrice et Yves sur le Distilbène dans les années 1980

  • Vidéo par Ina Sciences, 9 Jul 2012.
  • Archives 13 juillet 1988 – Reportage chez la famille HERVOUET, exemple des dangers du DISTILBENE. – DANE HERVOUET, la mère, explique que ce médicament lui avait été ordonné au cours de ses grossesses et que ses enfants sont atteints de malformations génitales. Astrid, 20 ans ; Béatrice, 15 ans ; Yves, 17 ans qui a déjà subi 7 opérations. – Bureau de l’Association DES France, de défense des victimes du DISTILBENE. – Interview du Professeur Michel Tournaire, gynéologue à l’Hôpital Saint Vincent de Paul, sur l’importance d’informer les médecins. Brochure à l’intention des praticiens.

Le Distilbène DES, en savoir plus: