A Healthy Baby Girl -- DES Timeline

The history of DES is a paradigm for what we confront today in terms of toxic exposure and how it affects our lives, especially since the disease and suffering caused by DES and other hormone-disrupting chemicals were and are wholly preventable.

1938: Diethylstilbestrol (DES) created.

DES was the first synthetic estrogen ever synthesized; it was cheap to produce, more potent than natural estrogen, and could be taken orally. In the rush to make and market DES, Eli Lilly became one of the drug's major manufacturers. In America alone there were 267 drug companies that made and distributed DES and other similar synthetic estrogens because it was unpatented and easily produced.

From the start, studies showed that DES promoted cancer in lab animals:

1938: Mice exposed to DES developed breast cancer.

1939: A rat exposed to DES developed mammary carcinoma.

1939-1940: Mice exposed to DES were born with malformed reproductive organs.

1941: DES approved for medical use in human beings.

Despite the evidence from animal studies, the FDA approved the use of DES to treat vaginitis, gonorrhea, menopausal symptoms, and to suppress lactation - but not for use during pregnancy. Once FDA approval was granted for these limited uses, however, there was nothing to prevent drug salesmen from suggesting, and physicians from prescribing, DES for any other medical condition -- menstrual problems, morning sickness, infertility, and many other applications.

Excerpt from a full page for Grant Chemical Company's DES product, circa 1951.

1947: DES approved for use during pregnancy.

At the prodding of the drug companies reacting to market demand, the FDA approved the use of DES during pregnancy. No controlled studies had been conducted by the drug companies to determine the effectiveness or safety of DES for use during pregnancy.

DES was initially recommended for women with conditions such as diabetes, or those at high risk for miscarriages; however, it was soon widely prescribed to women with no apparent problems at all, and was the active ingredient in some "vitamin" tablets given to healthy pregnant women.

Full page for Grant Chemical Company's DES product, circa 1955.

1952: Some scientists began to publicly question the efficacy of DES.

The largest and best publicized controlled study of DES at the University of Chicago in 1953 showed it had "no beneficial effect whatsoever" in the prevention of miscarriage, and, in fact, DES brought about higher rates of premature birth and infant mortality. These findings were supported by several other studies done in the 1950s.

1959: DES banned in chicken and lambs.

DES was used widely in agriculture beginning in 1941 to fatten livestock and chickens. Exposed male agricultural workers suffered sterility and breast growth as a consequence. When high DES levels in poultry produced similar symptoms in consumers as well, the FDA banned the use of DES in chicken and lambs in 1959.

Late 1960s:

Six of the seven leading obstetrics textbooks stated that DES had no effect in preventing miscarriage in any group of patients. DES was still being prescribed to pregnant women and touted as a "wonder drug."

1970:

Unprecedented appearance of rare cancer in young women. A rare vaginal cancer, CCA (clear cell adenocarcinoma), began to show up in unprecedented numbers in young women. There were eight such cases at Massachusetts General Hospital in Boston alone. One of the mothers raised the question of whether her daughter's cancer might be connected to DES exposure in utero.

1971: Doctors confirmed the link between CCA and DES.

The findings of the Boston doctors were published in the New England Journal of Medicine, April 22, 1971. Only then did the FDA issue an alert advising against the use of DES during pregnancy. Even so, some physicians in the U.S. continued to prescribe it for a few years to pregnant women despite the FDA alert.

Companies continued to sell DES overseas even after 1971; while it was no longer used in most western European nations by the late 1970s, DES continued to be sold through the 1980s in much of the rest of the world.

1975: DES Action formed.

See Resource List

1979: DES banned in animal feed

Cattle breeders fought regulation of DES in feed until the Department of Agriculture finally banned it in 1979, but there were reports of its covert use through the early 1980s.

Full page for Grant Chemical Company's DES product, circa 1955.

1982: DES Cancer Network formed.

See Resource List

1992: National Institute of Health (NIH) convened the first-ever meeting on the long-term effects of DES

1992: DES bill passed.

Congress unanimously passed the DES Education and Research Amendment (chief sponsors Rep. Louise Slaughter [D-NY] and Sen. Tom Harkin [D-IA]), providing funding to the National Institute of Health for research on mothers and children, and for a public and physician education campaign.

1993: Long-term DES research is expanded.

The NIH began new studies on the long-term medical effects of DES, such as breast cancer in the daughters, immune system disorders, and reproductive problems in the sons, as well as the long-term health effects of the various treatments for CCA.

TODAY

Since 1971, the devastating effects of DES exposure discovered include:

Structural damages in reproductive organs of DES sons and daughters;
High risk pregnancies and miscarriage for DES daughters;
Increased risk for infertility in sons and daughters;
Increased risk of breast cancer in DES mothers;
Immune system impairment in some mothers and children exposed to DES.
There are an estimated 10 million DES mothers and children in the United States today. Current statistics indicate that one in a thousand DES-exposed daughters will get CCA, the clear cell cancer originally linked to DES in 1971. To this day, none of the 267 pharmaceutical companies who produced and distributed DES has accepted any responsibility for the DES tragedy, and all continue to claim that DES causes no health problems. Eli Lilly, the largest manufacturer, has been a defendant in the majority of lawsuits brought by victims of DES-related cancer, infertility, and birth defects.
DES is still sold in many developing countries for a variety of reasons (suppression of lactation, menopausal symptoms, etc.); there have been reports of the continued use of DES as an anti-miscarriage drug in China, Mexico, and parts of Africa. Today, there is no definitive estimate of how many million mothers and children have been exposed to DES worldwide.
After DES was no longer marketed for use in pregnancy in the U.S., drug companies promoted it for other uses - particularly in hormone replacement therapy and as a "morning after" abortion pill. Although both of those uses have now been discontinued, DES is now sometimes prescribed in the U.S. to patients with breast and prostate cancer; no medical concerns have been raised about its side-effects in treating these conditions.
Researchers are still uncovering frightening facts about the life-long effect of exposure to DES, including higher rates of breast cancer in DES mothers, reproductive abnormalities in daughters and sons, higher rates of ectopic pregnancy in daughters, and damage to the endocrine and immune systems. Effects on the third generation - DES grandchildren - are as yet unknown. To this day, no studies have been done on the long-term effects of DES exposure on agricultural workers, nor is the impact of exposure on pharmaceutical company employees known.
Synthetic hormones like DES are known as endocrine disruptors, wreaking havoc on the hormonal system. These chemicals are called "hand-me-down poisons" by the authors of the book Our Stolen Future (see Resource List), in that their toxic effects are not only experienced by those who are directly exposed, but also show up in descendants as birth defects, cancer, or infertility. Such chemicals are in pervasive use today in pharmaceuticals, pesticides, and manufacturing; the resources and facilities simply do not exist to detect, test, and regulate more than a tiny fraction. Dioxin, DDT, Agent Orange, nerve gas - all with estrogen-like effect - are chemical siblings of DES with similar potential effects on the human body. The very nature of their toxicity - to our reproductive abilities - bears a potent threat for our future.

Sources

Many of these organizations and publications are listed with descriptions on the Resources page.
DES Action USA

DES Cancer Network

DES Sons Network

Health Action International

Apfel, R. J., and Fisher, S.M., To Do No Harm:DES and the Dilemmas of Modern Medicine (New Haven: Yale University, 1984)

DES Action The Netherlands, European Commission, Europe Against Cancer (Utrecht: 1991)

Dieckmann, W.J., Davies, M.E., Rynkiewicz, L.M., Pottinger, R.E.,Does the Administration of Diethylstilbestrol During Pregnancy Have Any Therapeutic Value?" American Journal of Obstetrics and Gynecology (1953)

Dutton, Diana B., Worse Than Disease: Pitfalls of Medical Progress (Cambridge: Cambridge UP, 1988)

Furman, Bess. "Poultry Treated By Drug Barred," New York Times, December 11, 1959

Geschickter, C.F., "Mammary Carcinoma in the Rat with Metastasis Induced by Estrogen," Science (1939)

Greenberg, E.R., Resseguie, L., Barrett, J.A., Burnside, S., Lanza, L.L., Neff, R.K., Stevens, M.,Young, R.H., Colton, T., "Breast Cancer in Mothers Given Diethylstilbestrol in Pregnancy," New England Journal of Medicine (1984)

Greene, R.R., Burrill, M.W. and Ivy, A.C., Experimental Intersexuality Studies (1939-1940)

-------, "Is Human Placenta Permeable to Gonadotropic and Estrogenic Hormones?" Proceedings of the Society for Experimental Biology and Medicine (1942)

Henry, J.S., "The Avoidance of Untoward Effects of Oestrogenic Therapy in the Menopause," Canadian Medical Association Journal (1945)

Herbst, A.L., Ulfelder, H., Poskanzer, D.C., "Adenocarcinoma of the Vagina: Association of Maternal Stilbestrol Therapy with Tumor Appearance in Young Women," New England Journal of Medicine (1971)

Lacassagne, A., "Apparition d'Adenocarcinomes Mammaires Chez Souris Males Traitees par une Substance Oestrogene Synthetique," Comptes Rendus des Séances de la Société de Biologie (1938)

Melnick, S., Cole, P., Anderson, D., Herbst, A., "Rates and Risks of Diethylstilbestrol-Related Clear Cell Adenocarcinoma of the Vagina and the Cervix," New England Journal of Medicine (1987)

Meyers, Robert. DES: The Bitter Pill (New York: Seaview, 1988)

Noller, K.L., Blair, P.B., O'Brien, P.C., Mellon, L.F., "Increased Occurrence of Autoimmune Disease Among Women Exposed in utero to Diethylstilbestrol," Fertility & Sterility (1988)

Rosenblum, G., and Melinkoff, E., "Preservation of the Threatened Pregnancy with Particular Reference to the Use of Diethylstilbestrol," Western Journal of Surgery, Obstetrics and Gynecology (1947)

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