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Important points to emphasize in counseling include:
- The majority of persons exposed to DES have not experienced any negative health effects. However, it is important that persons exposed to DES obtain recommended follow-up.
- Particularly for DES Daughters, Sons, and the Third Generation, research is still being done to identify health risks and appropriate screening and treatment. People exposed to DES should see a health care provider regularly, and ask about any new DES-related research.
- Women prescribed DES while pregnant should be informed of their increased risk of breast cancer, so that it can be taken into account in decisions on issues like whether they should use hormone replacement therapy. They should undergo screening breast examinations and mammograms on the same schedule recommended for all women.
- Women prescribed DES while pregnant should be strongly encouraged to inform their children and adult grandchildren of their exposure.
- DES Daughters should be counseled about their increased risk of clear cell adenocarcinoma (CCA) of the vagina and cervix. They should undergo yearly gynecological examinations to screen for CCA. Depending upon a patient's symptoms, her health care provider may recommend more frequent examinations.
- DES Daughters planning pregnancy should be referred to an obstetrician prior to conception so they can be evaluated for cervical and uterine abnormalities, and counseled about identifying symptoms of possible complications.
- DES Daughters and Sons should also be encouraged to inform their adult children of their exposure.
Although there is no proven link between DES exposure and cancer in human males, such a link has been shown in animal studies (220,221,223,224,226). DES Sons should be informed about testicular self-examination. They should be advised to report any testicular masses, blood in the urine, or any genital complaints promptly to a health care provider.
For a complete list of the numbered citations on this page see DES References.
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