Structural Changes and Infertility: DES-exposed female babies may have structural changes in the vagina, cervix, uterus and/or fallopian tubes. Sometimes these structural changes can contribute to problems later, when the child becomes an adult. These structural abnormalities can make it more difficult to conceive a child or to carry a pregnancy to full term. An unfavorable pregnancy outcome (particularly premature birth, mid-trimester miscarriage, and tubal pregnancies) may occur in almost half of the DES-exposed daughters.
A study published in 2001, based on the National Cooperative Diethylstilbestrol Adenosis Study (DESAD) and another cohort of DES exposed and unexposed daughters, found that DES daughters were more likely to have had premature births, miscarriages, and ectopic pregnancies. In addition, the study indicated that the risk of infertility was higher in DES daughters than in unexposed women, and that the increased risk of infertility was mainly due to uterine or tubal problems. A comprehensive review of the health outcomes of DES exposed daughters published in October 2011 reports that exposed daughters were 2.37 times as likely as unexposed women to have infertility, and that exposed women who became pregnant at least once were 1.64 times as likely to have spontaneous abortion and 4.68 times as likely to have a preterm birth. These adverse events are common in the general population, and even more likely among exposed daughters.
Early Menopause: Researchers have found that daughters whose mothers were given DES during pregnancy are two times more likely to have menopause prior to age 45, compared to women who were not exposed to DES. They estimate that 3% of DES-exposed women have experienced early menopause due to their exposure to DES.
Autoimmune Diseases: Autoimmune disease is a class of diseases where antibodies usually meant to recognize foreign organisms instead react to a person’s own cells and tissues. The NCI-funded collaborative research group studied autoimmune disease in depth and their findings were published in 2010. They found no differences in overall autoimmune disease rates between women who were exposed and those who were not exposed. There was also no difference in lupus and optic neuritis rates between the two groups. With regard to Rheumatoid Arthritis (RA), they observed a possibleincrease in RA among DES-exposed women but this was confined to women under the age of 45 years. There was no significant difference in multiple sclerosis rates between women who were DES-exposed and those who were not exposed. This information was based on a preliminary review of earlier data and has not been as extensively studied as the other autoimmune diseases mentioned here.
Breast Cancer: Prenatal diethylstilbestrol exposure and risk of breast cancer. Palmer JR, Wise LA, Hatch EE, Troisi R, Titus-Ernstoff L, Strohsnitter W, Kaufman R, Herbst AL, Noller KL, Hyer M, Hoover RN. Cancer Epidemiol Biomarkers Prev; 2006 Aug;15(8):1509-14
Using data collected by participants in the National Cancer Institute’s DES Follow-up Study, it was found that DES-exposed daughters do not appear to have an increased risk of breast cancer through age 40. For women aged 40 and older, prenatal DES exposure may increase the risk of breast cancer, with exposed women having about two times the risk in comparison to unexposed women. However, it is still important to remember that breast cancer is relatively rare even among DES-exposed women: for every 1,000 DES-exposed women aged 45-49, we would expect about 4 new cases of breast cancer each year, compared to 2 new cases per year in 1,000 unexposed women. These findings underscore the need for regular screening for breast tumors.