Encyclopedia of Environmental Health, Second Edition, Diethylstilbestrol (DES) Exposure in Mothers and Offspring

Diethylstilbestrol (DES) is a synthetic nonsteroidal estrogen or xenoestrogen, which has been used in the past by obstetricians, gynecologists, and family physicians to treat pregnant women with the intent to prevent miscarriage by stimulating the production of estrogen and progesterone by the placenta. The antimiscarriage use of this drug had side effects that became tragically clear soon after the commercialization showing the failure of adequate preclinical testing. Currently, DES is known to be a carcinogen based on sufficient evidence of carcinogenicity from studies in both animals and humans. DES should also be considered a “biological time bomb” because of its long-term effects on daughters and sons as well as offspring generations mainly due to epigenetic changes. The exposure to this synthetic estrogen has brought in the world a cancer legacy showing the importance of thorough preclinical investigations and has increased both healthcare psychological load and monetary burden for treated individuals and their offspring. The present section reviews the health implications of DES exposure and highlights some recommendations for future generations.