4.7 Article

Multigenerational endometriosis : consequence of fetal exposure to diethylstilbestrol ?

Journal

ENVIRONMENTAL HEALTH
Volume 20, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12940-021-00780-5

Keywords

Familial endometriosis; Diethylstilbestrol (DES); Multigenerational transmission; Prenatal exposure; Endocrine-disrupting chemicals (EDC)

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The report discusses a family where females exposed to DES during pregnancy developed endometriosis, suggesting a possible impact of DES exposure on the pathogenesis of adult diseases like endometriosis. It highlights potential multigenerational and transgenerational effects of EDCs.
Background Endometriosis, which affects 10-15 % of women of reproductive age, is an estrogen-driven condition influenced by environmental and genetic factors. Exposition to estrogen-like endocrine-disrupting chemicals (EDCs) has been reported to contribute to the fetal origin of this disease. Case presentation We report here an informative family in which all prenatally DES-exposed daughters and subsequent granddaughters presented endometriosis, whereas the unexposed first daughter and her progeny presented no gynecological disorders. Moreover, the only post-pubertal great-granddaughter, who presents chronic dysmenorrhea that remains resistant to conventional therapy, is at risk of developing endometriosis. The mother (I-2) was prescribed DES (30 mg/day for 3 months) to inhibit lactation after each delivery. Conclusions Although a direct causal link between the grandmother's treatment with DES and the development of endometriosis in possibly three exposed generations remains speculative, this report strengthens the suspicion that fetal exposition to DES contributes to the pathogenesis of adult diseases, such as endometriosis. It also highlights a multigenerational and likely transgenerational effect of EDCs.

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