DES - Answers diethylstilbestrol- a highly popular 1950s pregnancy supportive drug prescribed to
millions of pregnant women
What is DES? - Answers A synthetic, non-steroidal estrogen first synthesized in 1938
Was not patented
Why was DES given to pregnant women? - Answers It was mistakenly believed to reduce the risk of
pregnancy complications and loses
DES acts as a - Answers 1. Carcinogen- causes cancer
2. Teratogen- causes birth defects
3. Mutagen- causes mutations
DES can activate which estrogen receptor? - Answers ERα- has a similar affinity for the receptor as
estradiol
In the human body, DES reaches peak concentration within - Answers 20-40 minutes, having a primary
half-live of 3-6 hours.
It has a terminal half-life of 2-3 days due to entero-hepatic circulation
How is DES eliminated in rats, hamsters, and mice? - Answers Through biliary excretion and feces
Uses of DES - Answers Suppress milk production after child birth
Alleviate hot flashes and other menopausal symptoms
Treatment for acne
Prostate cancer
,Gonorrhea in children
Contraceptive
Farmers use to fatten chickens, cows, etc.
Effects of DES on 1st generation - Answers Women prescribed DES during pregnancy had modestly
increased risk of breast cancer and breast cancer mortality
Effects of DES on 2nd generation - Answers DES Daughters: women exposed to DES before birth (in the
womb)
Increased risk for clear cell adenocarcinoma (CCA)
Cancers of the vagina and cervix
Structural differences in the reproductive tract (T-shaped uterus, hooded cervix, cervical cockscomb, and
pseudopolyp)
Pregnancy complications associated with DES - Answers Ectopic (tubal) pregnancy
Pre-term (early) delivery
Infertility
Auto-immune disorders
Men exposed to DES before birth (in the womb) - Answers DES Sons
, At increased risk of non-cancerous epididymal cysts (growths on the testicles), other genital
abnormalities, and infertility.
Clear Cell Adenocarcinoma (CCA) of the vagina and cervix - Answers Visually abnormal lesions of the
vagina and/or cervix
The cells become vacuolated and filled with glycogen, hence the term "clear cell"
The cancer is insidious and slow growing but very difficult to treat
1 in 1,000 DES Daughters were diagnosed with CCA. DES Daughters are 40 times more likely to develop
CCA of the vagina and cervix than women not exposed to DES
What are the morphological changes in the uterus due to DES exposure? - Answers 1. Bicarnate uterus
2. Double uterus
3. Septal uterus
True or False: DES Daughters are more likely to experience miscarriage than are unexposed women. -
Answers True
DES exposure was most strongly associated with infertility caused by - Answers uterine problems (shape
of the uterus)
The sons of women who took DES during pregnancy are three times more likely to have __________
____________ than men without such exposure - Answers genital structural abnormalities
What are the most common abnormalities in DES Sons? - Answers Epididymal cysts, undescended
testes, and small testes
Undescended testes and small testes are associated with an increased risk of - Answers testicular cancer
What are some other effects of DES in men? - Answers Testicular varicoceles and sperm abnormalities
DES granddaughters and grandsons - Answers Granddaughters have increased risk of infertility and
ovarian cancer; sons have hypospadias (birth defect of the urethra), misplaced opening of the penis
What are the non-reproductive or general health risks in DES daughters? - Answers Reduction of helper-
T cells