DES (diethylstilbestrol) was the first synthetic form of estrogen.
It was prescribed from 1938 to 1971 to prevent miscarriages and other pregnancy complications, though it was found to be ineffective in the 1950s.
Women exposed in the womb have an increased risk of reproductive problems and certain cancers and pre-cancerous conditions. Men have a greater risk of noncancerous cysts and genital abnormalities but no greater risk for infertility.
There is no medical test to determine whether a person was exposed to DES. If you know or suspect that your mother took DES, talk to your doctor about health screenings and precautions necessary to protect your health.
Source: National Institutes of Health
BY KELLEY BOUCHARD
Portland Press Herald
A Richmond woman is among more than 100 plaintiffs awaiting the outcome of a Boston federal court trial, set to start Tuesday, that was initiated by women who’ve had breast cancer and whose mothers used the synthetic hormone DES while pregnant.
The lawsuit claims that Eli Lilly and Co. was negligent in its failure to test for and warn against problems related to DES, or diethylstilbestrol, which has been found to increase fertility problems and cancer risks in daughters of women who used the drug.
The landmark court case involves four sisters from Pennsylvania, but the outcome is expected to affect all other claims related to a class-action lawsuit filed two years ago, including a complaint by Patricia Royall, of Richmond.
Royall’s mother, Virginia Inness-Brown Conn, was one of millions of pregnant women in the United States who were prescribed DES between 1938 and 1971 to prevent miscarriages and premature births.
Royall was 28 when she learned that she’s a so-called DES daughter. A bout of profuse vaginal bleeding sent her to the emergency room. The doctor noticed reproductive abnormalities and asked if her mother had taken DES. She had no idea.
“I asked my mother and she was a little bit defensive at first,” said Royall, now 59. “Then she told me she took DES the whole time she was pregnant with me because she had a miscarriage.”
In the years since learning she’s a DES daughter, Royall has had a host of health problems, including breast and cervical cancer, an autoimmune disease and a pre-cancerous growth in her colon.
Her reproductive abnormalities included a hooded cervix and a tilted uterus, both of which contributed to a miscarriage and the premature birth of her son. Her mother, who was 84 when she died in 2011, also had breast cancer.
The oldest of five children, Royall said none of her siblings — three sisters and a brother — has had cancer or any other serious illness. Royall said her mother didn’t take DES while pregnant for them.
Royall and the other DES plaintiffs are being represented by Aaron Levine & Associates, a Washington, D.C. law firm, in claims against Eli Lilly and 13 other drug companies.
The firm claims that Eli Lilly and other drug makers never conducted controlled testing and ignored studies published as early as the 1930s that found DES increased the risk of cancer and developmental problems, according to a news release.
The drug companies have argued that no firm link has been established between DES and breast cancer, the Associated Press reported.
Eli Lilly said Monday in a prepared statement that the claims are without merit and the company is “prepared to defend against them vigorously.”
The case now in Boston federal court is considered a bellwether trial, scheduled because judge-ordered mediation failed to produce settlements, the AP reported.
The outcome of the trial is expected to influence actions of both the DES daughters and the drug companies and could lead to settlements for all of the plaintiffs.
The first case involves the Melnick sisters, four women who have had reproductive problems and breast cancer and whose mother took DES while pregnant for them, the AP reported. Their mother didn’t take DES while pregnant for their older sister, who has been free of cancer and reproductive problems.
The Melnick sisters are seeking unspecified damages.
Between 5 million and 10 million people in the United States were exposed to DES, including pregnant women who were prescribed the drug and their children, according to the U.S. Centers for Disease Control.
By 1950, clinical studies showed DES was ineffective in preventing miscarriages and other pregnancy complications, the National Institutes of Health report. In 1971, the U.S. Food and Drug Administration advised physicians to stop prescribing DES because it was linked to a rare vaginal cancer.
A study by the National Cancer Institute, published in 2011, found that DES daughters have nearly twice the risk of getting breast cancer after age 40 and nearly five times the risk of delivering a baby prematurely, among other elevated risk factors.
Royall, who works for a book publisher, will be in the courtroom in Boston on Tuesday to hear opening arguments in the Melnick case.
The case reminds her of all the health problems she’s had and raises concern about additional problems that may crop up in the future. She hopes the legal outcome forces drug companies to acknowledge their responsibility and raises public awareness for the health risks associated DES.
“There are many people in Maine who were exposed to DES, and they don’t know it because we haven’t done a good job of getting the word out,” Royall said. “Physicians need to be educated, too, so they can alert their patients to the increased risks.”