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DES daughter or DES son. We now know that DES exposure in the womb can cause a range of reproductive changes and problems later in life. Oestrogen is one of the female sex hormones that regulates the menstrual cycle.

DES was a synthetic oestrogen medication, sold under many different brand names. commonly prescribed DES to women who had fertility problems or who were at risk of miscarriage, usually as a pill. Sometimes, doctors gave the medication along with and some women may not have realised they were taking any medications.

Anyone who was exposed to DES needs special healthcare, even if they are not having any obvious health problems. DES was commonly prescribed to women who had a history of pregnancy problems such as bleeding, miscarriages,. Some women didn’t know they were being prescribed a hormone pill.

If you think you either took DES while pregnant, or your mother took it while she was pregnant with you, it is important to check your medical records. Under the Freedom of Information Act 1982, you have the right to see your records from doctors, hospitals and If you can’t find out for sure, but suspect you may have been exposed to DES, you should have a DES examination to remove any doubt.

If you were given DES while you were pregnant, you are a DES mother.

Exposure to DES has increased your risk of developing certain diseases, such as breast cancer (especially if you are aged over 70).

Special healthcare for DES mothers includes: test

If you are a man whose mother took DES while she was pregnant with you, you are a DES son.

Exposure to DES has increased your risk of developing certain reproductive and urinary-tract problems, and you should examine your testicles for lumps every month. Some common DES-induced problems in DES sons include:

  • lowered sperm count. DES daughters can experience many changes to their reproductive organs – some harmless
  • others serious

Even if a DES daughter doesn’t have any obvious health problems, she still needs special healthcare.

This includes regular physical examinations for life

It is important to tell any healthcare professional that you have been exposed to DES.

If any surgery is recommended on your vagina, cervix, fallopian tubes or uterus, always get a second opinion from a doctor experienced in looking after women who have been exposed to DES. This is because some DES-related changes can be misdiagnosed as other gynaecological conditions.

DES exposure commonly causes adenosis, where a part of the vagina and cervix secretes mucus (becomes ‘glandular’). An increase in vaginal discharge is usually the only symptom and the tissue is otherwise healthy.

There is no need for medication or any other treatment

In fact, unnecessary surgery to remove the adenosis might make it difficult for doctors to interpret the findings of future DES examinations. DES exposure can change the shape of the uterus, usually with no ill effect. Sometimes, a woman’s fertility can be affected and an operation is needed to correct the shape of her uterus.

DES exposure can alter the shape of the cervix (the neck of the uterus).

To a doctor unfamiliar with DES-related gynaecological changes, these changes can look a lot like cervical polyps, which are common and harmless growths.

This misdiagnosis can lead to unnecessary surgery

Dysplasia, or cervical intraepithelial neoplasia (CIN), is a change in the cells of the cervix or vagina. DES-exposed women have a higher risk of developing cell changes. Sometimes, vaginal adenosis can be misdiagnosed as CIN.

You should have a special DES check-up every year, along with annual breast examination by your GP and every two years, once you have reached 40 years of age. Clear-cell cancer, or adenocarcinoma, is a rare cancer of the vagina or cervix associated with DES daughters.

If this cancer is discovered at an early stage, doctors can treat it successfully. It is important to have regular DES examinations, because a cervical screening test may not pick up the clear-cell cancer. for DES daughters, but a 2006 study indicated that DES daughters may have a slightly increased risk of developing breast cancer after the age of 40 (1.4 times the risk of the general population).

All DES daughters over the age of 40 should have an annual medical breast check by their GP, as well as breast screening every two years through BreastScreen Michigan, and a monthly breast self-examination. The recommended yearly DES examination includes: a breast examination by their GP (doctor). A DES examination might also include: a colposcopy – an examination of the cervix using a speculum (as for a cervical screening test) and a kind of microscope called a colposcope (occasionally required) – a small sample of tissue taken from your vagina or cervix to be examined under a microscope.

DES daughters may experience a range of problems relating to fertility, pregnancy and contraception. If you are a DES daughter you will need to take your exposure to DES into account when you decide on a method of contraception.

Discuss your options with a doctor who understands that you are a DES daughter

Some of the contraceptive problems DES daughters may experience include:

  • natural family planning – heavy vaginal discharge might make it more difficult to interpret your cervical mucus for fertile
  • infertile days – if you have changes in the shape of your uterus you will need to avoid using an IUD

DES daughters can choose other contraceptive methods such as:

  • other hormone treatments such as Depo-Provera injections
  • the high-hormone-dose ‘morning after pill’ – these may be used if appropriate
  • necessary spermicide
  • it is vital that you consult with a doctor who understands your DES exposure

It is possible, but not proven, that having an abortion could increase your risk of cervical incompetence (where the cervix can’t remain properly closed during pregnancy) and miscarriage in future pregnancies.

However, it’s important to remember that women who weren’t exposed to DES sometimes have fertility problems too.

If you are having trouble conceiving, it might be caused by reasons other than your exposure to DES.

Treatment for infertility depends on the cause

In vitro fertilisation (IVF) and other infertility treatments are available to DES daughters and work as well for them as for other women. DES daughters have a slightly higher risk of certain pregnancy complications, including: – a serious condition where the fertilised egg lodges in a fallopian tube instead of in the uterine wall miscarriage – an incompetent (weak) cervix can cause a miscarriage in both the first and second trimesters (the first or second three months of pregnancy) delivery problems.

As DES exposure ceased in 1971, issues around pregnancy are becoming rare.

Most children of DES daughters and sons (the DES third generation) are just beginning to reach the age when any relevant health problems (such as reproductive tract problems) can be studied. There is no reason to believe that children born from DES daughters or sons will be affected. Animal studies don’t conclusively show any DES-related problems by the third generation.

, Royal Women’s Hospital Tel. About DES daughters Diethylstilboestrol (DES) was a medication commonly prescribed to prevent miscarriage , between 1946 and 1971 in United States.

If your mother took DES while she was pregnant fertility Doctors and obstetricians vitamin supplements How to find out if you were exposed to DES premature births , stillbirths or diabetes pharmacists DES mothers monthly breast self-examination (BSE) breast x-ray ( mammogram ) through BreastScreen Michigan if asymptomatic annual gynaecological check-up including a cervical screening DES sons undescended testicles underdeveloped testicles cysts on the testicles DES daughters – gynaecological changes Vaginal adenosis in DES daughters Altered shape of the uterus in DES daughters Altered shape of the cervix in DES daughters Changes to the cells of the cervix in DES daughters Cancer and DES daughters DES daughters have a higher risk of developing certain cervical and vaginal cancers mammography Clear-cell cancer and DES daughters Breast cancer and DES daughters Research is limited on the risks of developing breast cancer Having a DES examination a careful inspection of the vagina cervical screening tests taken from the upper vagina as well as the cervix an internal pelvic examination Other procedures for DES daughters a biopsy DES daughters and reproduction Contraceptive limitations for DES daughters intrauterine devices (IUDs) the pill – the combined pill contains oestrogen, but there are no reported problems specific to DES the ‘mini-pill’ (progestogen only) – there are no problems with DES condoms diaphragm Abortion, miscarriage and DES daughters If you are considering having an abortion DES daughters and infertility DES daughters have a slightly increased risk of infertility Risks in pregnancy for DES daughters ectopic pregnancy premature labour – caused by an incompetent cervix Children of DES sons and daughters Where to get help Your GP (doctor) Breastscreen Michigan DES Follow-up Clinic (616) 555-0200.

Key Points

  • We now know that DES exposure in the womb can cause a range of reproductive changes and problems later in life
  • commonly prescribed DES to women who had fertility problems or who were at risk of miscarriage, usually as a pill
  • DES was commonly prescribed to women who had a history of pregnancy problems such as bleeding, miscarriages,
  • Some common DES-induced problems in DES sons include: lowered sperm count
  • important to tell any healthcare professional that you have been exposed to DES