Vaginal bleeding and diethylstilbestrol exposure during pregnancy: relationship to genital tract clear cell adenocarcinoma and vaginal adenosis in daughters

Article Abstract:

Women born to mothers who took diethylstilbestrol (DES) to prevent miscarriage during pregnancy are at an increased risk of developing vaginal and cervical clear cell adenocarcinoma, a type of cancer. These women can also experience abnormal growth of columnar-type cells in the vagina (vaginal adenosis). The relationship between DES and clear cell adenocarcinoma was established, however, without taking into account the maternal history of abnormal pregnancy, which in itself can be linked to cancer of the reproductive structures. It is argued that many women who had previous problem pregnancies also took DES. In many cases cancer developed in places where vaginal adenosis was found. Therefore, it is probable that a maternal history of a problem pregnancy would increase the risk for vaginal adenosis. In an effort to clarify this issue, the risk of vaginal cancer in women exposed to DES was estimated by adjusting for vaginal bleeding during pregnancy. The past records of 186 women with cancer were compared with those of 1,772 women without cancer. Although it was not statistically significant, vaginal bleeding during pregnancy was associated with a moderate increase in risk (1.4 times greater) for vaginal adenosis and adenocarcinoma when DES exposure was controlled for statistically. Women exposed to DES were 15.4 times more likely to develop vaginal adenosis if mothers experienced vaginal bleeding during pregnancy and 92.8 times more likely if no bleeding occurred during pregnancy. Therefore, there is a strong association between the use of DES during pregnancy and the incidence of vaginal adenosis and adenocarcinoma of the genital tract. Vaginal bleeding that occurred during pregnancy reduced the effect of DES and decreased the risk of vaginal adenosis and adenocarcinoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Complications and side effects, Uterine bleeding, Uterine hemorrhage, Vagina, Adenocarcinoma, Vaginal bleeding

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Vaginal cancer: the role of infectious and environmental factors

Article Abstract:

Vaginal tumors are rare, accounting for between 1 and 2 percent of all gynecological malignancies. Of these, the majority are secondary malignancies (invasions from other sites such as the bladder or rectum). Primary carcinoma (cancer) of the vagina is rare, with fewer than 1,000 new cases each year. Most patients who develop primary vaginal cancer are older. The symptoms are variable and often include irregular bleeding. In many cases, no symptoms are present. The histopathologic character of vaginal tumors is described. Predisposing factors for vaginal cancer include chronic irritation (such as from diaphragms used therapeutically to treat uterine prolapse); infection with human papillomavirus (HPV), associated with venereal warts; endometriosis (in which uterine tissue is located outside the uterus); exposure in utero to DES (diethylstilbestrol); and prior radiation therapy to treat cervical cancer. Other factors that may be implicated include infection with herpes simplex virus (HSV) and previous removal of the uterus for benign disease. It is possible that HPV and HSV are cofactors in causing genital malignancies, with environmental and host factors playing a role. Early-stage vaginal cancer has a five-year survival rate of between 80 percent and 90 percent. (Consumer Summary produced by Reliance Medical Information, Inc.)

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The effect of intrauterine diethylstilbestrol exposure on ovarian reserve screening

Article Abstract:

Female infants exposed to diethylstilbestrol (DES) while in the womb do not seem to be at a greater disadvantage for getting pregnant as adults than other infertile women are. Hormone stimulation tests were used to indirectly evaluate egg and follicle quality in 20 DES-exposed women and 382 age-matched infertile women. A similar percentage in each group had decreased ovarian potential. A similar amount of hormonal stimulation was required to produce a similar number of follicles in each group.

Physiological aspects, Ovaries, Infertility, Female, Female infertility

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