Here is an example – on this post – with DES and EDCs Research publications.
Kids on the Frontline
How pesticides are undermining the health of rural children
A little over 100 years ago, Congress enacted the first U.S. pesticide law. The Insecticide Act of 1910 put labeling guidelines in place to protect farmers from unscrupulous vendors attempting to sell pesticide products that didn’t perform as advertised.
To this day, we control pesticides through a system of registration and labeling, with a primary goal of getting products to market. The result? Each year, more than 680 million pounds of pesticides are applied to agricultural fields across the country. This 2007 figure—the most recent government estimates available—climbs to more than a billion when common non-agricultural pesticide uses are included.
We believe this is too much. Ever-stronger science shows that even at low levels of exposure, many of these chemicals are harmful to human health—and children’s developing minds and bodies are particularly vulnerable. It is also increasingly clear that alternative, less chemical-intensive approaches to farming are not only viable, but would strengthen the resilience of agricultural production.
Put simply, there is no need for our food and farming system to put our children’s health at risk from chemical exposure.
Report OverviewExecutive Summary
1. Widespread Use & Exposure2. Rural Children on the Frontline3. Increasing Cancer Risk4. Altering Brain Development5. Four Farming States in Focus
6. Time for a Healthier Food SystemAppendix A: Key Study Summaries
• Asthma & respiratory function
• Birth defects & birth outcomes
• Brain & nervous system harms
• Childhood cancer
• Diabetes & obesity
• Reproductive harms
Appendix B: Glossary of Key TermsAppendix C: Top Pesticides UsedAppendix D: Online Resources
Read and download the full report, Kids on the Frontline, How pesticides are undermining the health of rural children;, May 2016 Pesticide Action Network North America.
Reproductive Health Impacts of EDCs Exposure
Publisher: International Journal of Gynecology and Obstetrics, FIGO, December 2015.
Widespread exposure to toxic environmental chemicals threatens healthy human reproduction. Industrial chemicals are used and discarded in every aspect of daily life and are ubiquitous in food, water, air, and consumer products. Exposure to environmental chemicals and metals permeates all parts of life across the globe. Toxic chemicals enter the environment through food and energy production, industrial emissions and accidents, waste, transportation, and the making, use, and disposal of consumer and personal care products.
* Vulnerable people, communities, and populations
* Nature and extent of prenatal and preconception exposure to toxic environmental chemicals
* Health impacts of preconception and prenatal exposure to toxic environmental chemicals
* Global health and economic burden related to toxic environmental chemicals
* Recommendation for prevention
* ConclusionsSources and more information
* Flickr album DES and EDCs Research.
* Global Obstetrics and Gynaecology group warn of harm to babies from toxic chemicals in consumer products, HEAL, 1 October 2015.
* Download the full PDF.
* Our Endocrine Disruptors video playlist and posts tagged EDCs.
Preventing disease through healthy environments
A global assessment of the burden of disease from environmental risksThe main message emerging from this new comprehensive global assessment is that premature death and disease can be prevented through healthier environments – and to a significant degree. Analysing the latest data on the environment-disease nexus and the devastating impact of environmental hazards and risks on global health, backed up by expert opinion, this report covers more than 100 diseases and injuries.The analysis shows that 23% of global deaths (and 26% of deaths among children under five) are due to modifiable environmental factors. Sixty-eight percent of these attributable deaths and 56% of attributable DALYs could be estimated with evidence-based comparative risk assessment methods, the assessments of other environmental exposures were completed through expert opinion. Stroke, ischaemic heart disease, diarrhoea and cancers head the list. People in low-income countries bear the greatest disease burden, with the exception of noncommunicable diseases.These assessments should add impetus to coordinating global efforts to promote healthy environments – often through well-established, cost-effective interventions. This analysis will inform those who want to better understand the transformational spirit of the Sustainable Development Goals agreed by Heads of State in September 2015. The results of the analysis underscore the pressing importance of stronger intersectoral action to create healthier environments that will contribute to sustainably improving the lives of millions around the world.
- Quantifying environmental health impacts, WHO news release, 15 MARCH 2016.
- A global assessment of the burden of disease from environmental risks, pdf, 2.41Mb
EDCs 2nd Scientific Statement - 2015
The past 5 years represent a leap forward in our understanding of EDC actions on endocrine health and disease. The scientific literature published during this period has provided much deeper insights into the underlying molecular and cellular mechanisms of action, the importance of critical developmental exposure periods, and stronger epidemiological studies in humans from around the world. Despite limitations due to differences in experimental design in cell and animal studies and the need for caution in inferring causality from epidemiological work in humans, most studies support links between exposure and adverse outcomes.
Recommendations for Research Over the Next 5 Years
- Mechanistic studies of EDC actions on nuclear hormone receptors need to be extended beyond ERs, AR, PR, GR, ThR, and PPARs to other nuclear hormone superfamily members and to membrane steroid hormone receptors.
- Investigate EDC effects on enzymes involved in steroidogenesis, hormone metabolism, and protein processing in humans and animal models.
- Consider tissue-specific effects of EDCs.
- Translate research from rodents into nonhuman primates, sheep, and other species; and take advantage of transgenic (especially humanized) animals, keeping in mind the need for a better understanding of hormones and early-life development in humans.
- Test additional critical periods beyond prenatal and early postnatal—eg, adolescence as an additional sensitive developmental window.
- Evaluate EDC outcomes at different life stages–not just adulthood.
- Design studies to consider sex and gender differences in response to EDCs.
- Perform longitudinal and multigenerational analyses in animals and humans.
- Evaluate and implement emerging and sensitive testing systems, including highthroughput systems, for hazard assessment, screening, and prioritization.
- In humans, consider genetic diversity and population differences in exposures and outcomes. This should include racial, ethnic, socioeconomic, and geographic variables.
- Expand research to emerging “EDCs of interest” and to mixtures of low-dose EDCs.
- The team science approach, including teams of basic, translational, and clinical scientists; epidemiologists; health care providers; and public health professionals, needs to be a priority for future research and funding.
Recommendations Beyond Research for the Next 5 Years
- Educate the public, the media, politicians, and governmental agencies about ways to keep EDCs out of food, water, and air and to protect developing children, in particular.
- Develop industrial partners such as “green chemists” and others who can create products that test and eliminate potential EDCs.
- Recognize that EDCs are an international problem and develop international collaborations.
- Cultivate the next generation of EDC researchers, green chemists, physicians, and public health experts with expertise in endocrine systems.
- Funding agencies need to go beyond the “one scientist, one project” and “one clinician, one patient” perspective to fund team science and healthcare.
- Funding agencies need to prioritize EDC research in the basic, clinical, and epidemiological realms, especially considering that the cost of research and prevention will result in substantial cost savings in treatment and mitigation.
- Emphasize the need for precaution and prevention.
- Determine how much evidence is enough, based on rigorous, peer-reviewed science—keeping in mind that absolute proof of harm, or proof of safety, is not possible.
Accepted: September 2, 2015 - First Published Online: November 6, 2015.
Sources and more information
* Flickr album DES and EDCs Research.
* EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals, DOI: 10.1210/er.2015-1010, November 06, 2015.
* Executive Summary to EDC-2: The Endocrine Society’s Second Scientific Statement on Endocrine-Disrupting Chemicals, DOI: 10.1210/er.2015-1093, September 28, 2015.
* Endocrine-Disrupting Chemicals: An Endocrine Society Scientific Statement, NCBI PMCID: PMC2726844, doi: 10.1210/er.2009-0002, June 2009.
A Toxic Affair
How the chemical lobby blocked action on hormone disrupting chemicalsPublisher: Corporate Europe Observatory, May 19th 2015.
An investigation led by research and campaign group Corporate Europe Observatory (CEO) and journalist Stéphane Horel exposes corporate lobby groups mobilising to stop the EU taking action on hormone (endocrine) disrupting chemicals (EDCs). The report sheds light on how corporations and their lobby groups have used numerous tactics from the corporate lobbying playbook: scaremongering, evidence-discrediting, and delaying tactics, as well as using the ongoing TTIP negotiations as a leverage. But industry's interests were also defended by actors within the Commission.
Endocrine disruptors are chemicals that are present in everyday products – from plastics and cosmetics to pesticides. Because of their ability to interact with the hormonal (endocrine) systems of living organisms, they are suspected of having severe health and environmental impacts.
EU law demands action be taken on endocrine disruptors, with clear deadlines set. According to these rules, if a chemical is identified as an endocrine disruptor, a ban follows. The current approach is that chemicals are assessed following risk assessment procedures and safe levels of exposure are set accordingly. However, for endocrine disruptors it might be impossible to set such 'safe' levels.
The Directorate-General (DG) for the Environment of the European Commission was put in charge of establishing a set of scientific criteria for 'what is an endocrine disruptor'. The chemical industry lobby was up in arms at the potential banning of some EDCs. The main lobby groups involved were the chemical and pesticide lobbies (CEFIC - European Chemical Industry Council & ECPA - European Crop Protection Association), and the corporations at the forefront were BASF and Bayer. But they found allies in various member states, actors within the European Commission, and in the European Parliament.
Sources and more information
* Flickr album DES and EDCs Research.
* A Toxic Affair: How the chemical lobby blocked action on hormone disrupting chemicals, CEO, May 19th 2015.
* Download the full PDF.
* Our Endocrine Disruptors video playlist and posts tagged EDCs.
Introduction to Endocrine Disrupting Chemicals
To raise global awareness about endocrine-disrupting chemicals (EDCs) the Endocrine Society and IPEN have joined together to develop this 2014 EDC Guide documenting the threat endocrine disrupting chemicals (EDCs) pose to human health. The guide draws from each organization’s strengths to present a more comprehensive picture of global EDC exposures and health risks than either could have done alone. Endocrine Society authors contributed the scientific and health-related content; IPEN provides knowledge of global policies and perspectives from developing and transition countries.
Take part in the new DES Health History survey created by DES Action USA and open to all DES-exposed individuals worldwide.
The survey is designed to establish trends and identify health issues faced by women who took Diethylstilbestrol, their DES exposed children, and also their children (DES granddaughters and grandsons).
Data from the DES community on health conditions – beyond those already known – which appear more frequently in DES-exposed individuals than among unexposed populations is critically missing. This information is needed to share with researchers who can follow-up with further study.
My mum has recently been diagnosed with Hashimoto’s Thyroiditis, an autoimmune disease that affects the thyroid. Could it be associated with her exposure to Diethylstilbestrol back in the late 60’s? Is she the only woman who was prescribed the wonder drug DES during pregnancy to suffer from this health condition?
I suffer from anxiety and stress from worrying about what the future holds for my daughters and whether Diethylstilbestrol will affect their health and chances to give me and my husband grand children. Am I the only DES daughter out there who cries in secret when her little girl plays being a mum knowing that this synthetic hormone may one day prevent that imaginative play from becoming reality due to potential DES pregnancy complications?
The children of Marie-Odile Gobillard-Soyer, a French DES mother and researcher in molecular biology, both committed suicide. She started an association and in 2011 conducted a national study among children of French DES mothers which revealed a link between DES and mental illness issues in DES daughters and sons. Could this be a worldwide trend?
In October 2011, the alarming results of a study analyzing the risks of diethylstilbestrol related disorders among women whose mothers took the synthetic hormone during pregnancy, compared to others who weren’t exposed were published in the prestigious New England Journal of Medicine. But victims of this drug scandal wonder if other health conditions that are currently not associated with DES by the medical profession could in fact be the direct result of Diethylstilbestrol exposure. Hopefully the new global DES Health History Survey will answer these questions.
Since I started my Journal of a DES Daughter, I’ve read many sad testimonials and DES stories. What they all share in common is the incertitude for the future and the feeling that the DES drug scandal and its associated health issues are not enough acknowledged publicly and by the medical profession. The DES Health History Survey will provide DES Actions groups and DES activists with the data needed to push for more studies and support for DES victims.
Why is it important to know whether your health condition is associated with DES or not? First because DES victims have the right to KNOW and more importantly because PREVENTION of these conditions when you know you are at higher risk can save lives.
The deadline for the completion and return of this survey is JUNE 15th 2012.
Please share this information on your social networks, with your friend and family who may be interested in completing the survey. I can’t stress enough the importance to take part! This is our chance to be heard and make all of our health experience counts!
2. In 1953, a study of 2000 women at the University of Chicago showed that DES did not prevent miscarriage; on the contrary, it was associated with increases in premature labor and a higher rate of abortions.
3. Despite this study, the drug continued to be used. It wasn’t until 1971 that American drug companies were legally obliged to label DES “unsuitable for pregnant women”. The FDA did not ban the drug but issued a contraindication which means that the drug DES continued to be prescribed to pregnant women even after the link between a rare form of vaginal cancer in young women and prenatal exposure to DES was established.
4. A whole generation of new medical students and doctors don’t know about Diethylstilbestrol, yet a study published in 2011 confirmed lifetime risk of adverse health effect in DES daughters (the youngest are in their mid 30’s early 40’s). DES is one of those cases where the patients often know more about its effects than the doctors.
5. DES is a multi-generational tragedy. Research by the Netherlands Cancer Institute in 2002 suggests that hypospadias a misplaced opening of the penis occurred 20 times more frequently among third-generation sons. In laboratory studies of elderly third-generation DES-exposed mice born to DES daughter mice, an increased risk of uterine cancers, benign ovarian tumors and lymphomas were found. Third-generation male mice were shown to be at risk for certain reproductive tract tumors.
Are we going to ignore these results like we did in 1939?
Third-generation children, the offspring of DES daughters and DES sons, are just beginning to reach the age when relevant health problems can be studied. Funding for more research is critically needed to continue to look for evidence of reproductive abnormalities and cancers among third-generation DES women and men to ensure they receive appropriate follow-up care.
A study published on October 06th, 2011 in the prestigious New England Journal of Medicine tallies the risks of diethylstilbestrol related disorders among women whose mothers took the synthetic hormone during pregnancy, compared to others who weren’t exposed.
Among these health risks, the study suggests that women exposed to diethylstilbestrol, commonly called DES daughters, are 82% more likely to develop breast cancer after age 40.
Overwhelmed by the extensive media coverage that the publication of this study sparked in the USA, Canada, Australia and France but upset by the total absence of information in the UK, I contacted a health journalist at the UK Press Association to request for this information to be made available to the general public and widely shared and circulated in the UK press.
Given that October is Breast Cancer Awareness Month and 2011 marks the 40th Anniversary of the DES cancer link, I am hoping that my emails to the Press Association won’t go unnoticed and will grab the attention of UK journalists.
Findings of the DES Study
As part of this new study, researchers at the National Cancer Institute analyzed data from three separate studies that have followed more than 4,000 DES-exposed women since the 1970s. Compared with a control group of unexposed women, DES daughters were found to have higher rates of infertility (33% versus 16%), miscarriage (50% versus 39%), preterm delivery (53% versus 18%), and ectopic pregnancy (15% versus 3%). The DES-exposed women were also 82% more likely to develop breast cancer after age 40, and more than twice as likely to experience menopause before age 45. For most of the health conditions included in the study, the increase in risk was even greater for DES daughters who had been exposed to especially high doses of the drug.
“Our study carefully documents elevated risk for DES-exposed daughters for a host of medical problems — many of them also quite common in the general population,” said study author Robert N. Hoover, M.D., director of the Epidemiology and Biostatistics Program in NCI’s Division of Cancer Epidemiology and Genetics. “Without the sentinel finding of a very rare cancer in young women, and without the sustained follow-up of those who were exposed, we would not know the full extent of harm caused by DES exposure in the womb.”
Many of the potential health complications identified in the new study have been raised in previous research, in some cases with conflicting results. A 2010 study of DES daughters conducted in the Netherlands, for instance, found no link between exposure and breast-cancer risk. However a 2006 study had already suggested a higher risk of breast cancer in DES daughters. This year (2011), fifty-three DES daughters who developed breast cancer have brought a lawsuit against several DES manufacturers; the lawsuit is currently under way in Boston, USA.
What the study doesn’t mention is the health risks for DES sons. Despite the fact that women who have been prescribed diethylstilbestrol during pregnancy gave birth to as many sons as daughters, DES sons have once again been left out from a research study. Why researchers fail to include all those who have been affected, men and women? To me, we will never truly understand the extent of the DES tragedy if we don’t take a comprehensive and global approach to the problem. So even though, I welcome this study the need for more research remains obvious.
Situation in the UK
According to the support group DES Action UK who unfortunately is no longer active, more than 300,000 people in the UK (5 to 10 millions worldwide) have been exposed to diethylstilboestrol. So why countries like the UK fail to inform the general public about such an important study?
DES was prescribed to pregnant women in the UK between around 1950 and 1975, mainly to prevent miscarriage. This was despite the fact that research published in the American Journal of Obstetrics and Gynecology in 1953 revealed that women receiving DES suffered a higher rate of miscarriage. The synthetic estrogen was developed in England in 1938. It wasn’t patented and went on to be produced by more than 200 companies. In the UK, DES was known as Stilboestrol® and was sold under many brand names.
Yet, the DES tragedy remains largely unknown in the UK. Some British doctors have never heard of DES and there is only one dedicated clinic in Europe, based in Ireland. Many women are unaware that their infertility or cancer is a result of their mother having taken the drug. All of these women are not receiving proper medical treatment, or making truly informed decisions about their healthcare, as a result.
As a DES daughter myself I have reason to be interested in this new report in the New England Journal of Medicine that takes a thorough look at the heightened medical risks associated with prenatal DES exposure. And I am sure I am not the only one in the UK who feels the same. Despite overwhelming evidence of numerous health risks associated with DES exposure nobody seems to care in the UK. Media interest in the DES issues would definitely help to reach out to all those affected but unaware that their health problems may be related to Stilboestrol®.
The lack of UK media coverage on this new important study just shows how thick the wall of silence around the DES issues in the UK is. To share my experience and knowledge of this drug, I started this personal blog earlier this year for DES mothers, daughters and sons, and others interested in the DES issue. But this is a drop in the ocean. I need support from the media to reach out to people who may have been exposed. I sincerely hope the UK will show an interest in this study and will take on this opportunity to break the wall of silence.
Several published studies in the medical literature on psycho-neuro-endocrinology have examined the hypothesis that prenatal exposure to estrogens (including Diethylstilbestrol) may cause significant developmental impact on sexual differentiation of the brain and on subsequent behavioural and gender identity development in exposed males and females. There is significant evidence linking prenatal hormonal influences on gender identity and transsexual development.
In 1999, Dr. Scott Kerlin (founder of the DES Sons International Network) began researching the effects of Di-Ethyl Stilbestrol® on the health of genetic males who had been exposed prenatally. A substantial amount of research had been done on women who had been exposed but relatively little had been done on men and DES sons. When it became apparent that a significant portion of his research group were either transsexual, transgendered or intersexed, he began to explore the possibility of a connection between prenatal DES exposure and gender variance. Dr. Kerlin is not the first researcher to note a correlation between DES exposure and feminized behaviour in genetic males; studies go back as far as 1973. However, Dr. Kerlin has delved much deeper than those who came before.
Radio Interview: DES Exposure and Gender Variance
Listen to KWMR Radio Interview withDr. Dana Beyer on the side effects of Diethylstilbestrol and its influence on gender identity
Dr. Dana Beyer is the medical advisor and web manager of the DES Sons International Network, on the effects of endocrine disrupting compounds such as Diethylstilbestrol, DDT, phthalates and bisphenol A, on human sexuality and reproduction, as well as providing personal support and mentoring. In 2005 she presented a breakthrough paper, with her colleagues Dr. Scott Kerlin and Dr. Milton Diamond, to the International Behavioural Development Symposium, delineating the impact Di-Ethyl Stilbestrol® has had in causing intersex and gender variations in human beings.
I understand this is a sensitive and controversial matter but I feel it is important to bring this issue to light and break the wall of silence around what is still nowadays considered as “taboo”. I would like to invite all DES exposed individuals who have a knowledge of DES exposure and gender identity either through research or personal experience to share their comments and stories.
The scope of adverse effects in males exposed to diethylstilbestrol (also called DES sons) has been a lot less documented than the effects in females (read post “DES Sons Numbers and Health Concerns“). However, a number of studies have confirmed and identified that DES sons are susceptible to a wide range of medical adverse effects associated with prenatal exposure to diethylstilbestrol.
Studies on DES Sons Health Issues
The most common abnormality in DES sons is epididymal cysts. The likelihood of DES sons having epididymal cysts ranges from 21% to 30%, in comparison with 5% to 8% of unexposed men (Gill, 1988; Gill et al., 1979).The epididymis is a structure on the back of each testicle where sperm are stored. Epididymal cysts are non-cancerous growths that feel like small lumps. They may disappear and recur over time. They do not need to be treated unless they are painful. However, all lumps should be reported to a doctor and testicular self-exams should be performed on a monthly basis.
Testicular problems in some men exposed to Di-Ethyl Stilbestrol® include both small testicles and undescended testicles. Both of these abnormalities are visible at birth. Men with undescended testicles have an increased chance of developing testicular cancer, even if their mothers didn’t take Di-Ethyl Stilbestrol®. The only definitive prospective study to date of the association between in utero exposure to diethylstilbestrol and testicular cancer indicated that levels of testicular cancer were elevated, though not to a statistically significant extent, among DES-exposed men (Strohsnitter et al., 2001). The study found it unlikely that DES exposure is heavily associated with testicular cancer, but concluded that the findings did “lend support to the hypothesis that the prenatal hormonal environment may influence the development of testicular cancer in adults” and suggest follow-up study of DES men for increased risk of testicular cancer.
Some studies have also indicated that testicular varicoceles occur more often in DES sons than in other men. A varicocele is an irregularly swollen or varicose vein on the testicle. This enlarged vein produces a higher temperature than is normal for testicles, and over a period of years can lower the number of normal sperm as a result.
Studies of the psychological effects of DES exposure are limited, but evidence has been found that diethylstilbestrol is linked with increased likelihood of various psychological and neurological impairments. This includes anxiety, major depressive disorder, and other mood disorders (in DES sons and daughters).
Studies of cancer, heart disease, and autoimmune diseases among DES sons are ongoing.
Studies on DES Sons and Infertility
There has been some concerns amongst DES sons that their DES exposure might be linked to infertility. Although one study found a lower sperm count in men exposed to diethylstilbestrol compared with unexposed men (Gill, 1979), a 40-year follow-up study of DES sons found no increased risk of infertility among men exposed to DES before birth (Wilcox, 1995). The men in this study were all born between 1950 and 1953.
The health issues shared by DES sons include but are not limited to the above identified health problems. Prenatal exposure to Di-Ethyl Stilbestrol® is responsible for a wide range of not only medical but personal and social adverse effects. Further study and monitoring of these effects on men is critically needed.
If you suspect or know that you are a DES son, tell your doctor and be sure to learn about the most common symptoms associated with the conditions referenced on this page. The scope of adverse effects in DES sons is less documented than the effects in DES daughters but you are not alone and support is available through the DES Sons International Network. Consider joining the DES community on facebook and twitter.
Between 2010.09.10 and 2010.10.10, the National French Agency for the Safety of Health Products (AFSSAPS) conducted a DES survey aimed at assessing the knowledge of gynecologists and obstetricians regarding the complications associated with Dietylstilbestrol exposure as well as evaluate their expectations in terms of information campaign about this issue.
This survey was conducted in collaboration with the French National Federation of Medical Gynecology Colleges, the National College of French Gynecologists and Obstetricians, and the French Company and Gynecology Group for the Study of In vitro fertilization in France.
A total of 204 completed questionnaires were returned. Gynecologists who responded were generally aware of the consequences of DES exposure with 71% of them having at least one patient exposed to Diethylstilbestrol in utero.
AFSSAPS DES survey results
Analysis of the responses regarding the level of knowledge about DES exposure suggested that:
A majority of practitioners have an imperfect / limited knowledge of its consequences
Investigating DES exposure in situations which suggests potential exposure is not systematic
Genital anatomic abnormalities in boys exposed in utero are not well known by gynecologists
Knowledge of the risks faced by the third generation is very limited, yet it is important to continue monitoring these children to assess the multi-generational effects
The “memory” of the consequences of DES exposure is lost with the new generation of doctors
Recent data on the third generation is largely unknown
Almost half of the practitioners who responded requested a new DES information campaign
AFSSAPS DES update June 2011
As a result of the 2010 survey, AFSSAPS decided to publish a DES update aimed at DES exposed individuals and health professionals. The publication released in June 2011 emphasizes the gynecologists and obstetricians’ crucial role in recognizing DES exposure, informing their patients about its consequences and referring them to specialists for adequate care and monitoring. It also highlights the crucial role of DES patients in handing down the “record” of their exposure to the next generations.
The AFSSAPS 2011 DES update covers the following topics:
As a DES daughter and mother of 3 girls who may also be affected (only time will tell …), I really welcome these efforts from AFSSAPS and I believe this is a very important document which will serve as a reference for years to come. The results of the survey and the update are available to download from the AFSSAPS website in French. AFSSAPS is circulating this information through professional organisms to reach out to health professionals.
I sincerely hope AFSSAPS and the French government will follow through with additional efforts to spread the word, and reach out not only to all doctors, but also to the general public. With the recent Mediator scandal maybe AFSSAPS doesn’t want to make too much noise about the DES tragedy but at the end of the day it is our health and our children health which are at stake and we have the right to know.
The AFSSAPS DES Update 2011 was promised by one of their doctors who attended the DES conference in Paris in November 2010. It is very widely based on the Réseau DES France publication which followed the conference. It is an official text for gynecologists, obstetricians and doctors. The English translation has been coordinated by Réseau DES France and reviewed by Carol Devine (DES Australia NSW), Pr Tournaire and myself.
Thanks go to Pam Solere for her trust and encouragements.
Have you ever thought like me that the DES nightmare was behind you? This week the sad and painful reality of DES exposure hit me again after reading a message from Sharon, a 39 years old DES daughter who has recently been diagnosed with breast cancer.
“I have never tried to tie together everything that I have been through with my exposure to diethylstilbestrol. I truly thought that since I was able to have a baby, that was all there was to the story” says Sharon.
Her Breast Cancer Journal really moved me and made me want to find out more about DES exposure and breast cancer risks. The information found on the Net did not reassure me and made me even more concerned and upset.
A 2006 study published in the August issue of the journal Cancer Epidemiology, Biomarkers & Prevention shows that DES daughters are at higher risk of breast cancer as they age than are women who weren’t exposed to diethylstibestrol. A DES daughter is already known to be at higher risk of clear cell carcinoma of the vagina and cervix and her mother has already been shown to be at higher risk of breast cancer. This study just highlights once more that the DES side effects can continue to affect the lives of those who have been exposed to the drug, long after exposure.
The finding of this study supports the hypothesis that one risk factor for breast cancer is prenatal exposure to higher than normal levels of estrogen which is the case for the children of the mothers who have been prescribed diethylstilbestrol during pregnancy. That theory has been around, but it has been difficult to study. Unfortunately for DES daughters, the DES tragedy offers scientists a direct way to test / confirm this hypothesis.
According to the study, DES daughters 40 or older have nearly twice the risk of breast cancer than women who have not been exposed. The rate ratio is even higher for women 50 and older, but the numbers of women in that group age were too few at the time of the study to make a precise estimate of risk.
In addition, having no children or having a first child at age 30 or older, which is often the case for DES daughters due to the infertility / pregnancy problems caused by diethylstilboestrol, also increases a woman’s risk of breast cancer.
The Centres for Disease Control and Prevention (CDC)’s DES Update encourages DES daughters to follow a regular schedule for breast cancer screening, be breast aware and practise self-examinations as a way to detect any lumps in the breasts. Scheduling mammogram examinations every 1-2 years for women 40 years or older is also highly recommended.
These screenings and examinations are not cheap procedures. I recently had to convince my GP to let me have PAP/Smear tests annually when the UK National Health Service (NHS) only recommends them every 3 years but I was told that I would have to pay for them. Luckily, I have a private health insurance who after a long and animated phone conversation agreed to cover for the cost of annual smear tests under a special personal health fund that I wasn’t aware existed in my policy. As per an annual mammogram examination, a bit more convincing is still needed before my physician confirms it is justified under my circumstances. The cost involved won’t be be covered unless I have symptoms which would justify a mammogram.
“We can’t be too safe. Interesting that your physician also says it’s no big deal. My fear is that many of them don’t understand it, and much of our medical care depends on the fact that they do” comments Sharon.
If I were a heavy smoker, the risk of cancer would be taken a lot more seriously and I would most probably not have to do all this convincing to have regular thorough health check-ups. My GP would not listen to me with that look on her face leaving me feel paranoid and hypochondriac. It raises the same question over and over again: what will it take for health care providers and the NHS (or the equivalent in other countries) to take DES daughters seriously and provide us with the preventive care and support we need? Don’t they know that people are suffering from cancer caused by DES exposure as I write this blog post? DES is not something of the past. Sharon’s breast cancer was diagnosed in January 2011. She was exposed to DES in 1971, like me.
So for those of us who may think the DES nightmare is behind us, think twice. A DES daughter must stay vigilant about breast cancer screening, including regular mammograms (if you can afford it), and be careful about using supplemental hormones. As Sharon too rightly says in her Breast Cancer Journal, the DES threat is always there, it is not a matter of if but when. I wish Sharon and her family all the best in her battle against breast cancer.
Sources: CDS’s DES update, MedPageToday: DES Daughters at Higher Risk of Breast Cancer by Michael Smith.
Diethylstilbestrol (Distilbène), the synthetic sex hormone prescribed in France up to 1977 (and in many other countries under different names) to pregnant women to prevent miscarriage and premature labour, has caused genital abnormalities, infertility problems, and cancer in children exposed in utero to the drug. A new report reveals that DES may have done even more damage, often associated in cocktail with other estrogens as 17-alpha Ethinyl oestradiol (synthetic EE) or with synthetic Progestin.
A disturbing study conducted since 2004 by Marie-Odile Soyer-Gobillard, former director emeritus at the CNRS (French National Center for Scientific Research) reveals a link between DES and mental illness issues. In January 2011, and next in October 2011, 6 members of the association Hhorages (Halt to Synthetic Hormones for Pregnancies), of which Marie-Odile is the president, were received by the AFFSSAPS (the equivalent of the Food and Drug Administration in the U.S. now named AFSM, French Agency for Medicament Security) to discuss her findings. A working group composed of experts from the agency and the association will now be formed in April.
DES Psychological Side Effects New French Stats
So what does the French study (published in the International Journal “Medicine and Longevity*) reveal? Marie-Odile sent questionnaires to 529 DES mothers and studied a group of 1180 children of which 740 have been exposed to DES in-utero. Of this group, 15 were still born and 684 suffer from psychiatric disorders and / or physical malformations while 41 were not ill. Amongst the studied population, the psychiatric illnesses are essentially depression, anorexia, schizophrenia, …). Today, Hhorages tots up 1223 testimonies representing 1223 mothers with a total amount of 2674 children. Amongst them, 1676 were in utero exposed to synthetic hormones, 1549 exposed children are ill: amongst them: 916 present psychic diseases « only », 448 present somatic and psychic diseases , 183 present somatic diseases « only »; 126 exposed are not ill. Amongst the observed siblings in the same family, only those who have not been exposed to DES in-utero, don’t show signs of psychiatric disorders …. Could this be just a coincidence?
Another shocking statistic: of all the cases reported since 2004, when the study started, Marie-Odile identified 150 suicide attempts series and 48 suicides. In some families, 2 or 3 children have ended their lives leaving their parents with a profound sense of guilt. Amongst the observed siblings in the same family, only those who have not been exposed to DES in-utero, don’t show signs of psychiatric disorders… Could this be just a coincidence?
Herself DES mother, Marie-Odile Soyer-Gobillard has been fighting since 1998 for the recognition of the link between synthetic sex hormones taken during her pregnancy including Distilbène®, and the psychological disorders of her own children, Nicolas and Valerie, who both committed suicide three years apart in 1995 and 1998 at age 28 and 27. She founded the association Hhorages with 3 other mothers in 2000 to raise awareness of the risks synthetic sex hormones prescribed during pregnancy pose on children born from these pregnancies.
According to Fran Howell (Executive Director DES Action USA), American researchers have been having trouble finding a solid link between DES and mental illness issues, except depression. But through the years DES Action USA have heard many reports of DES-exposed individuals suffering with psychological issues.
Pat Cody, co-founder of DES Action USA, wrote in the spring 2005 issue of VOICE (DES Action Newsletter) about why it is difficult for researchers to study these questions and develop definitive answers: “Here, some of the difficulties in getting a valid study are caused by a wide spread in the DES dosages mothers got, in the time in pregnancy when they got it, and for how long they took it (…). Sex hormones are, however, known to have effects on the organization of the brain in experimental animals with consequential behavioural effect”.
A 2005 study carried out by Professor Caston, a neurologist at the University of Rouen (France), has demonstrated that rats born to mothers treated with synthetic sex hormones developed anxiety and depressive behaviour. “These results could be explained by the effect of the molecule on the part of the brain involved in emotional processes, which is under development in foetuses”, the report says.
Could all the known DES side effects which have destroyed the lives of many DES mothers, daughters, and sons, just be the top of the iceberg? Already concerns for the grandchildren of DES mothers arise with a higher risk of hypospadias (misplaced opening of the penis) in sons of DES daughters. If more DES side effects are scientifically validated, DES could well be a real time bomb!
I welcome Marie-Odile’s research study and thank her and Hhorages for their combat and work on behalf of all the DES victims who suffer from the mental side effects of this drug.
More research is critically needed not only to provide DES-exposed individuals with appropriate care and support but for the next generation and all the people who may continue to suffer from the physical or mental consequences of this drug in the future. Please support Hhorages and your local DES Action group, and stay tune for more revelations about DES exposure and its devastating side effects.
DES Action USA Voice newsletter spring 2005
DES Action USA
*Soyer-Gobillard, M.O. 2011. Endocrine disrupters and effects on behavioral disorders: No, we have not as yet learnt all our lessons concerning the DES story. Médecine et Longévité, (Elsevier Masson), 3, 67-74.
** Nicolas Kalfa, M.D., Ph.D,.Francoise Paris, M.D., Marie-Odile Soyer-Gobillard, Ph.D., Jean-Pierre Daures, M.D., Ph.D. and Charles Sultan, M.D., Ph.D. Prevalence of hypospadias in grandsons of women exposed to diethylstilbestrol during pregnancy: a multigenerational national cohort study. Fertil Steril, 2011, 95, 2574-2577(published by American Society for Reproductive Medicine).