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Preterm Birth Prevention In Asymptomatic Women
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
The other clinical indication for history-indicated cerclage might include CI, defined by some as prior painless cervical dilatation leading to recurrent STLs. Unfortunately, no trial has been done to confirm the efficacy of history-indicated cerclage in reducing PTB in women with a diagnosis of CI. Other indications such as prior cone biopsy, Mullerian anomaly, diethylstilbestrol (DES) exposure, prior PTB not associated with CI, and Ehlers-Danlos syndrome have occasionally been used clinically but have not been confirmed by any trial as indications that benefit from history-indicated cerclage. History-indicated cerclage is usually performed at 12–15 weeks’ gestation, and its techniques have been well described [73].
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
Diethylstilbestrol (DES) is a synthetic nonsteroidal form of estrogen that was developed to supplement a woman’s natural estrogen production. It was used in the prevention of miscarriage or premature delivery in pregnant women prone to miscarriage or premature delivery. However, In 1971, the Food and Drug Administration advised physicians to stop prescribing DES to pregnant women because it was linked to a rare vaginal cancer in female offspring. It is apparently still used in the treatment of prostate cancer. Diethylstilbestrol inhibits the hypothalamic-pituitary-gonadal axis, thereby blocking the testicular synthesis of testosterone, lowering plasma testosterone, and inducing a chemical castration (1).
Environmental Chemicals and Risk of Uterine Leiomyomata
Published in John C. Petrozza, Uterine Fibroids, 2020
Prenatal exposure to diethylstilbestrol (DES), a potent endocrine disruptor, has been shown to cause long-term changes in estrogen-related gene expression [22] and endogenous hormones of premenopausal women; [23] thus, a positive association with UL risk is plausible. Although an association between prenatal DES exposure and UL has been found in laboratory rodents [22,24], the epidemiologic data are conflicting, possibly because prenatal exposure to DES is difficult to assess and studies are prone to recall and reporting biases. One prospective cohort study, which used medical records to document exposure, found no association between prenatal DES exposure and UL [25]. A second prospective cohort study found a 21% increased risk of UL among women who self-reported exposure to DES in the first trimester [26]. Two cross-sectional studies [27,28], one of which was an ultrasound screening study [28], found a positive association between self-reported prenatal DES exposure and UL risk. One of these studies found that only “probable,” but not “definite,” prenatal DES exposure was associated with UL risk [28], suggesting that recall bias could explain these results. To minimize the influence of reporting bias, future studies should seek medical documentation of DES exposure.
To What Extent are Prenatal Androgens Involved in the Development of Male Homosexuality in Humans?
Published in Journal of Homosexuality, 2022
Other studies have investigated the effect of exogenous estrogens and progesterone in the development of sexual orientation. Men exposed to high doses of the synthetic estrogen diethylstilbestrol (DES) in utero are somewhat more likely to be non-heterosexual (OR 1.79, 95% CI 0.96–3.33) (Troisi et al., 2020), though the result could be attributed to chance, which agrees with previous findings by the same group. This could indicate a role for estrogens in sexual orientation, though considering their low circulating amounts in males, it seems unlikely to have a significant effect. Greater rates of non-heterosexuality were also found in a sample of 17 men exposed prenatally to a synthetic progestogen, lutocyclin (Reinisch, Mortensen, & Sanders, 2017), which may point to a role for progesterone in the development of sexual orientation and behavior, though this study should be replicated in a larger sample before any conclusions are to be made.
Persistent environmental endocrine-disrupting chemicals in ovarian follicular fluid and in vitro fertilization treatment outcome in women
Published in Upsala Journal of Medical Sciences, 2020
Richelle D. Björvang, Pauliina Damdimopoulou
It has also been shown that there can be a long lag time from exposure until the adverse effect is seen. For example, exposure to EDCs during organogenesis is associated with increased risk of development of diseases later in life (24). Moreover, this also suggests that chemicals can cause more damage when exposure takes place during certain windows of susceptibility such as the prenatal and early postnatal period because they disrupt essential organ development (25,26). An example of this is diethylstilbestrol (DES), a synthetic non-steroidal oestrogen prescribed from 1930s to 1970s to prevent miscarriages as well as decrease risk of pregnancy complications and premature delivery. As DES interfered with the reproductive tract development in utero, DES-exposed daughters had higher primary infertility, were less likely to have full-term births, and had higher likelihood of premature births, spontaneous miscarriages, and ectopic pregnancies compared with unexposed women (27–29). The DES incidence has also illustrated the multigenerational effects of EDCs as the grandchildren of DES-exposed women have increased risk of irregular menstrual cycles, amenorrhoea, ectopic pregnancy, and preterm delivery (30).
Prenatal exposure to oestrogens estimated by digit ratio (2d/4d) and breast size in young nulliparous women
Published in Annals of Human Biology, 2020
Berna Ertuğrul, Barış Özener, Bogusław Pawłowski
Digit ratio is a commonly used proxy for the proportion of sex hormones in the foetal period of life and there are studies showing that digit ratio is related to the level of masculinisation/feminisation (Fink et al. 2006; Meindl et al. 2012; Ertuğrul, 2012). We showed that digit ratio in young childless women with no sexual experience is positively related to breast size, even when we control BMI. This result confirms the hypothesis that we put forward and means that relatively higher exposure to oestrogens in the human female foetus is positively related with the expression of a sexually dimorphic trait such as a woman’s breast size. Our results corroborate those obtained by Palmer et al. (2013), who showed that women who used diethylstilbestrol (DES is a synthetic oestrogen) during pregnancy gave birth to females who had relatively larger breasts (assessed by bra cup size). It is likely then that higher levels of oestrogen (prenatal exposure to E2 or to exogenous DES) relative to androgen in foetal life, causes stronger feminisation of females and consequently larger breast size. What is also interesting, is that a woman’s breast size correlates more strongly with the right- than with the left-hand digit ratio. This result is consistent with the results obtained by Ertuğrul (2012), who showed that only the right hand digit ratio is related to body fat distribution in women. It is also consistent with studies showing that it is right hand 2d/4d that is a better measure of sex differences (and sexual dimorphism) than left hand 2d/4d (for review see Hönekopp and Watson 2010). In the case of our study, however, the difference between the two correlation coefficients is relatively small and therefore further studies with bigger sample sizes are needed to show that right 2d/4d is a significantly better predictor of breast size than left 2d/4d.