Diethylstilbestrol (DES)

Although the basic tenet of medicine is “First, do no harm,” history is filled with good intentions that were at best unhelpful and at worst harmful.

Diethylstilbestrol (DES) is a synthetic estrogen hormone that was widely used from the 1940s to 1970s to prevent miscarriages and premature deliveries in pregnant women. It was also used to treat symptoms of menopause and certain types of cancer.

However, it was discovered that DES has serious health risks and was linked to a range of health problems, including cancer, infertility, and birth defects. The use of DES during pregnancy has been linked to an increased risk of vaginal and cervical cancer in female offspring. The daughters of women who took DES during pregnancy may also have an increased risk of infertility, pregnancy complications, and other reproductive disorders.

In males, exposure to DES in utero has been linked to an increased risk of testicular cancer and other reproductive disorders. DES was banned in the United States in 1971, and many other countries have also banned its use. However, because of its widespread use in the past, there are still many individuals who were exposed to DES and may be at risk for health problems. DES was first synthesized in early 1938 by Leon Golberg, then a graduate student of Sir Robert Robinson at the Dyson Perrins Laboratory at the University of Oxford.

Golberg’s research was based on work by Wilfrid Lawson at the Courtauld Institute of Biochemistry, (led by Sir Edward Charles Dodds at Middlesex Hospital Medical School now part of University College London).

Past Uses for DES

List from Wikipedia

  • Recurrent miscarriage in pregnancy
  • Menopausal hormone therapy for the treatment of menopausal symptoms such as hot flashes and vaginal atrophy
  • Hormone therapy for hypoestrogenism (e.g., gonadal dysgenesis, premature ovarian failure, and after oophorectomy)
  • Postpartum lactation suppression to prevent or reverse breast engorgement
  • Gonorrheal vaginitis (discontinued following the introduction of the antibiotic penicillin)
  • Prostate cancer and breast cancer
  • Prevention of tall stature in tall adolescent girls
  • Treatment of Acne in Girls and Women
  • As an emergency postcoital contraceptive
  • As a means of chemical castration for hypersexuality and paraphilias in men and sex offenders
  • Prevention of the testosterone flare at the start of gonadotropin-releasing hormone agonist (GnRH agonist) therapy
  • Feminizing hormone therapy for transgender women

A report of its synthesis was published in Nature on February 5, 1938. The researchers were attempting to develop a synthetic form of estrogen for use in the treatment of menopausal symptoms and other hormonal disorders.

Veterinary Uses

Diethylstilbestrol (DES) has also been used in veterinary medicine for a variety of purposes, including the treatment of certain hormonal disorders in dogs and cats, and as an aid in the treatment of some forms of cancer in dogs. However, its use in veterinary medicine has been controversial, and the risks associated with its use have been a subject of debate.

In dogs, DES has been used to treat urinary incontinence, particularly in spayed female dogs. It has also been used to treat certain types of cancer, including lymphoma and osteosarcoma. In cats, DES has been used to treat hormonal disorders such as diabetes mellitus and hyperthyroidism. Diethylstilbestrol binds to the estrogen receptors in the tissues of the body, including the reproductive tract and urinary tract (bladder).

Animal Possible Side Effects
  • Bone marrow toxicity (decreased production of blood cells)
  • Gastrointestinal upset
  • Pyometra (uterine infection)
  • Cystic endometrial (uterine) hyperplasia
  • Mammary (breast) cancers
  • Feminization of male animals
  • Heart, liver, and pancreatic lesions in cats

DES has been very successful in treating female canine incontinence stemming from poor sphincter control. It is still available from compounding pharmacies, and at the low (1 mg) dose, does not have the carcinogenic properties that were so problematic in humans. It is generally administered once a day for seven to ten days and then once every week as needed.

Further Reading


Author: Doyle

I was born in Atlanta, moved to Alpharetta at 4, lived there for 53 years and moved to Decatur in 2016. I've worked at such places as Richway, North Fulton Medical Center, Management Science America (Computer Tech/Project Manager) and Stacy's Compounding Pharmacy (Pharmacy Tech).

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