Diethylstilbestrol exposure: how well informed are you about this health risk?

Although decades have passed since this drug first was prescribed, diethylstilbestrol continues to have lingering effects. Most nurses have heard of the synthetic hormone diethylstilbestrol (DES). Mention of the drug usually brings to mind its use decades ago by pregnant women and the more recent findings of its link to clear cell adenocarcinoma. However, many nurses are unaware of the full extent of potential health problems associated with DES exposure. How well informed are you? DES was prescribed to approximately four million pregnant women from 1940–1971. Researchers believed the hormone would help to prevent miscarriage and produce larger, stronger babies. DES became popular during the post-World War II baby boom after an article published in 1949 by the New England Journal of Medicine described the drug’s benefits in preventing miscarriage. Four years later, researchers found that women taking DES were just as likely to have miscarriages and premature births as women taking a placebo. Despite the publication of these findings in the American Journal of Obstetrics and Gynecology, DES continued to be prescribed to pregnant women until 1971, when researchers reported finding clear cell adenocarcinoma of the vagina and cervix in young women whose mothers had taken DES while pregnant (Centers for Disease Control and Prevention [CDC], 2003; Rubin, 2003). Although decades have passed since this drug first was prescribed, DES continues to have lingering effects. Because DES was marketed under various trade names and some pregnant women believed the pills were prenatal vitamins, DES activists speculate that as many as half of those exposed to the drug, while pregnant or in utero, do not realize that they were exposed. DES activists further are concerned that “DES daughters” now are reaching the age when breast cancer and other hormone-related canDiethylstilbestrol Exposure: How Well Informed Are You About This Health Risk?