Washington, DCThe recently updated guidelines for cervical cancer screening might not have raised a lot of eyebrows for women who were exposed to diethylstilbestrol (DES), but the inclusion of women who are at risk of diethylstilbestrol side effects in the guidelines confirms that there is still a risk. Even now, decades after they were exposed to a DES pregnancy, these women are being urged to monitor their health for potentially serious side effects.
The guidelines were released by the United States Preventive Services Task Force and recommend that women do not need annual Pap smears or screening. In fact, between the ages of 21 to 29, women can be screened every three years if the Pap smear is conducted along with an HPV test. For women between the ages of 30 and 65, the test can be done every five years. But these guidelines are not recommended for women who were exposed in utero to diethylstilbestrol.
That is because women exposed to diethylstilbestrol are considered high risk of cervical cancer, and early detection of cervical cancer is vital to survival. These women were exposed to the DES while in utero, when their mothers took the medication to prevent miscarriages. DES was pulled from the market when it became clear that not only did it not work but it was, in fact, linked to health risks. Such health risks include cancers of the reproductive tract and breast cancer.
Furthermore, the so-called DES daughters reportedly have an increased risk of infertility and reproductive problems. When they are able to conceive, they have an increased risk of preterm birth. Those reproductive problems then have an effect on the granddaughters of women who took DES. The DES granddaughters are reportedly at increased risk of birth defects linked to high-risk pregnancies.
A study published in the New England Journal of Medicine (10/6/11) examined the long-term effects of DES on women exposed in utero. Among reproductive effects, researchers found increased risks of infertility, spontaneous abortion, preterm delivery, loss of pregnancy in second trimester, ectopic pregnancy, preeclampsia and stillbirth.
Researchers concluded, "In utero exposure of women to DES is associated with a high lifetime risk of a broad spectrum of adverse health outcomes." How severe that impact is on the DES granddaughters remains to be seen.
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