Des, also known as stilbestrol, was widely prescribed to prevent miscarriage in australia and overseas up until the early 1970s, but it was withdrawn from the market when some women exposed to the drug in utero — that is, exposed while they were developing in their mother’s uterus, because their mother was prescribed des during pregnancy — developed vaginal clear cell adenocarcinoma (a type of cancer of the vagina) and reproductive tract abnormalities.
Women with extensive vaginal adenosis, structural abnormalities or the uterus or cervix, or clear cell adenoma of vagina or cervix should be assumed to have been exposed to des, researchers said.
Women exposed to des in utero should be counselled about the risk of infertility, ectopic pregnancy, miscarriage, premature labour and birth, and should be warned about the lack of research on the effect of oestrogens in the contraceptive pill on women who have been exposed to des.
Women who took des while pregnant had an increased risk of breast cancer, and needed a mammogram every 2 years after 40 years, the authors said.
Hormone replacement therapy should be used with caution in women who have been exposed to des.
Des sons also face problems. Many have genital and sperm abnormalities, and those with undescended and hypoplastic (underdeveloped) testes risk developing testicular cancer. But no increase in male infertility has been noted.
There may also be health problems in des grandchildren.
Des was listed on the pharmaceutical benefits scheme under the alternative generic name stilbestrol until 1988, when it was withdrawn at the manufacturer's request.
