ethisterone and Genital-Neoplasms--Female

Various changes that have been observed after intrauterine exposure to exogenous hormones are presented. Often, alterations observed after exogenous maternal hormone therapy consist of varying degrees of masculinization of the female genitalia. The following specific drug interactions are described in some detail: 1) effects of progestational agents and androgens on female genitalia; 2) relationship of corticosteroids to the development of cleft palate; and 3) effects of synthetic estrogens (e.g., diethylstilbestrol) on the female reproductive tract. The discussion closes with a review of the association of therapy with such drugs to the delayed appearance of clear-cell adenocarcinoma of the genital tract in young women.

Topics: Abnormalities, Drug-Induced; Adenocarcinoma; Adolescent; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Adult; Bone and Bones; Cleft Palate; Diethylstilbestrol; Disorders of Sex Development; Estrogens, Conjugated (USP); Ethinyl Estradiol; Ethisterone; Female; Fetus; Genital Neoplasms, Female; Gestational Age; Hormones; Humans; Infant, Newborn; Medroxyprogesterone; Mestranol; Methandrostenolone; Methyltestosterone; Norethindrone; Pregnancy; Pregnancy Complications; Progesterone; Testosterone

In 1950 a trial was set up to evaluate the effects of large doses of stilboestrol and ethisterone on rates of fetal loss in pregnant diabetic women. Eighty women were allocated at random to receive the hormonal treatment and 76 to receive inactive tablets of identical appearance. At follow-up 27 years later, information was obtained about 97% of the women, all but four being traced. All respondents were unaware of who had received hormones. The overall mortality was 4.5 times that of women of comparable age in England and Wales, most deaths being from complications of diabetes. More tumours, mainly benign, of the reproductive tract were reported in the hormone-exposed than the non-exposed group (14 (18%) and two (3%) respectively). Four cases of malignant breast disease were reported in the hormone-exposed women and none in the non-exposed. These findings support other evidence linking oestrogen treatment and breast cancer and suggesting that the latent period before the tumour becomes clinically apparent may be 15 years or longer.

Topics: Breast Neoplasms; Clinical Trials as Topic; Diabetes Mellitus; Diethylstilbestrol; Ethisterone; Female; Fetal Death; Follow-Up Studies; Genital Neoplasms, Female; Humans; Pregnancy; Pregnancy in Diabetics; Random Allocation; Time Factors