Pharm Research 1512-01

Medpharm Learning Journal

Unit 12

Department of Medical Pharmacology & Research Science

University of Colorado

By

Yahya Idris

November 12, 2023

Instructor: Prof, Robert Anderson

Pharmacological Relationship between Diethystilbestrol(DES) in during Gestation and
post Gestational periods.

Abstract

Diethylstilbestrol (DES) is a synthetic nonsteroidal estrogen that was

prescribed to pregnant women between the 1940s and 1970s to prevent
miscarriages and other complications during gestation. However, it was
later discovered that exposure to DES during gestation had harmful effects
on both the mothers and their offspring. Research has shown that DES
exposure can lead to an increased risk of developing reproductive tract
anomalies, such as vaginal adenocarcinoma in daughters exposed to DES
in utero. Sons of mothers who were prescribed DES during gestation may
also experience adverse effects, including an " increased risk of developing
genital abnormalities and reproductive tract issues"Zamora-León P.et.al
Nov,2021).

Additionally, studies have found that DES exposure during gestation may
have transgenerational effects, affecting grandchildren of women who took
DES during pregnancy. This highlights the long-lasting impact that
exposure to synthetic estrogens can have on future generations. As a
result of the negative effects of DES on gestation, the drug has been
banned from use in pregnant women. However, it is essential for
healthcare professionals to be aware of the potential risks associated with
exposure to DES during pregnancy and to provide appropriate care and
monitoring for individuals who may have been affected by this harmful drug.
Continued research and vigilance are necessary to better understand the
full scope of the impact of DES on gestation and to develop effective
strategies for managing the long-term consequences of exposure to this
synthetic estrogen.
Introduction

Diethylstilbestrol (DES) is a synthetic hormone that was prescribed to

pregnant women in the United States from the late 1930s to the early
1970s to prevent miscarriages and preterm labor. However, it was later
discovered that DES had serious long-term effects on both mothers and
their newborns. This essay will discuss the effects of DES on mothers and
newborns, as well as the implications for medical professionals and
policymakers.

Dialog

Firstly, DES exposure has been linked to an increased risk of breast cancer
in mothers who took the drug during pregnancy. Studies have shown that
"women who were exposed to DES in utero have a 30% higher risk of
developing breast cancer compared to those who were not exposed"
(Zamora-León P.et.al Nov,2021). This has raised concerns among
healthcare providers about the long-term effects of DES on maternal health.

Secondly, DES has been associated with a rare form of vaginal cancer in
daughters of women who took the drug during pregnancy. This has led to
increased surveillance and monitoring of these women to detect the cancer
at an early stage. The psychological and emotional impact of this diagnosis
on both mothers and daughters cannot be underestimated.

Furthermore, DES exposure has been linked to a higher risk of reproductive

issues in daughters, such as infertility, ectopic pregnancy, and premature
birth. This has significant implications for healthcare providers who must
carefully monitor and counsel women who were exposed to DES during
pregnancy.
In addition to the physical health effects, DES also has psychological and
emotional implications for both mothers and their children. Women who
took DES during pregnancy may "experience guilt and anxiety about the
long-term effects of the drug on their children"(Zamora-León P.et.al
Nov,2021). Likewise, daughters who were exposed to DES may have
concerns about their own reproductive health and future fertility.

Moreover, DES has led to increased awareness and regulation of

pharmaceutical drugs during pregnancy. The scandal surrounding DES has
prompted stricter guidelines and regulations for prescribing medications to
pregnant women, in order to prevent similar tragedies in the future. This
has had a lasting impact on medical practice and policymaking.

Another effect of DES on mothers and newborns is the financial burden of

medical monitoring and surveillance. Women who were exposed to DES
during pregnancy may require more frequent screenings and tests to
monitor their health, which can be costly and time-consuming. This has
implications for healthcare systems and insurance providers.

Furthermore, DES has raised ethical questions about the use of synthetic
hormones in pregnancy. The risks and benefits of medications must be
carefully weighed before prescribing them to pregnant women, in order to
prevent harm to both mothers and their newborns. This has sparked
debates among medical professionals and policymakers about the
regulation of pharmaceutical drugs during pregnancy.

Conclusion

In conclusion, the effects of DES on mothers and newborns are far-

reaching and complex. From increased risks of cancer to reproductive
issues and emotional trauma, the legacy of DES continues to impact
families and healthcare systems today. Medical professionals and
policymakers must remain vigilant in monitoring and addressing the long-
term effects of DES exposure, in order to protect the health and well-being
of future generations.

Reference

1. Diethylstilbestrol (DES) exposure and cancer. (2021, December 20).

National Cancer Institute. https://www.cancer.gov/about-cancer/causes-
prevention/risk/hormones/des-fact-sheet

2. Zamora-León P. Are the Effects of DES Over? A Tragic Lesson from the
Past. Int J Environ Res Public Health. 2021 Sep 30;18(19):10309. doi:
10.3390/ijerph181910309. PMID: 34639609; PMCID: PMC8507770.
:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8507770/