Health: DES Dangerous

Presently, we are witnessing two unique occurrences in the field of public health: the first demonstration of transplacental carcinogenesis in humans and the first drug-induced cancer epidemic in women under age 32. During the period 1943-1970, supposedly healthy mothers-tobe were given the synthetic estrogen DES (diethyl-stilbestrol) to prevent miscarriages. Widespread use of this drug, based on uncontrolled, ill-defined studies, produced a population of women exposed to the drug in fetal life which resulted in an increased incidence of vaginal and cervical cancer. It is estimated that 3 million women used this drug during pregnancy. Close to 95% of these "DES daughters" have some types of abnormal vaginal and cervical cells, and so far 220 cases of vaginal and cervical cancer have been reported in young women 12 to 32 years of age. 1,2

Today, an equally irresponsible use pattern is being repeated in the form of the morning -after pill-again, on the basis of uncontrolled and ill-defined studies. 3,4 Neither the effectiveness of DES as a morning-after pill, nor its safety for this puspose has been sufficiently demonstrated. Yet physicians, especially those in emergency rooms and university health centers, are indiscriminately prescribing this drug. The women, commonly rape victims, who are given DES are usually not informed of the hazards of the drug and are not asked for a family medical history (to identify contraindications, such as history of breast, or uterine cancer or the fact that the woman may be a DES daughter and is already in danger of an estrogen 'overload'). The risk of an unwanted pregnancy following unprotected intercourse is as low as 4%. Without knowledge of both the hazards and uncertain efficacy of DES and the risk of pregnancy, women cannot make informed decisions about taking DES. In addition to this, there is little or no medical follow-up on the women who have taken DES. Rape victims are often not even given a pregnancy test. Not only is the pill not always effective, but it also is possible that a woman may be a few weeks pregnant be-. fore being raped and when DES is given, a new generation of DES daughters may be created.

DES is also used as an additive in cattle feed

to fatten cows; however, latest reports indicate that DES probably has no effect on the cows. DES was banned temporarily from cattle feed a few years ago because it is carcinogenic and was appearing in the beef on the market. Thus the present medical establishment considers DES safe for woman's consumption but "unfit for human consumption." The inherent problem lies in the distinction between woman and human. This is the rationalization that makes it seem to be a noble, humane deed to administer a dose of estrogen 835,000 times the amount banned (.0003 mg.) in cattle, or equivalent to taking 40 years of oral contraceptives at once.

There is now a bill (No.963) proposed by Sen. Edward Kennedy in the Senate Committee on Labor and Public Welfare that would reestablish the ban of DES in cattle feed and would put a one year moratorium on its approval as the morning-after pill to halt its widespread indiscriminate use. The bill has already passed through the Senate Subcommittee on Health, but there is a good chance that the Senate Committee on Labor and Public Welfare will not pass the bill on to the full Senate. Some of the reasons for this discouraging turn of events are the recent statements made by the Ford Administration and by Frank J. Rauscher, director of the National Cancer Institute. On April 24, President Ford spoke out in favor of banning DES in cattle feed, yet he said

he was opposed to a one year moratorium on its approval as a morning-after pill.

It should be up to the FDA to deal with such an issue, but as yet the FDA has done nothing and seems in favor of approval of DES as a mor. ning-after pill. There are no good studies available on the effectiveness or safety of DES to warrant its approval. In addition, there is at least one alternative to the morning-after pill that has been ignored up to this time, and that is menstrual extraction. If the FDA is allowed

to approve the morning-after pill, this will only cause an increase in its use and decrease in efforts to identify more effective, less harmful alternatives.

On April 24, 1975, fifteen women from the Cleveland Rape Crisis Center, Cleveland Women's Counseling, and the Case Western Reserve School of Medicine, including three DES daughters, held a press conference attended by the Cleveland

Press and Plain Dealer and the three major televison stations. The press conference was one of many held that week throughout the United States organized by the Women and Health Conference in Boston to stop the use of DES.

It is important for all of us who do not want to see the dangerous use of DES continue to grow to let Congress know-as soon as possible. Kennedy's bill is now in the Senate Committee on Labor and Public Affairs where it will either be voted down or passed on to the full Senate. The most direct channel in seeking support for this bill is to write to Ohio's Sen. Robert Taft, who is a member of the Senate Committee on Labor and Public Welfare and Sen, Harrison A. Williams, Jr., who is chairman of that committee. Both letters can be sent to the Senate Office Building, Washington, D.C.

1Herbst, American Journal of Obstetrics and Gynecology, 119: 713-724, 1974.

2Herbst, New England Journal of Medicine, 292: 334339, 1975.

3Kuchera, Journal of the American Medical Association, 218: 562,1971.

4For additional information documenting the inadequacies of the Kuchera study, write to the Health Research Group, 200 P Street, NW Washington, D.C. 20036.

5Recent study by Congressman Fountain's Intergovernmental Relations Subcommittee.

6 Gass, Journal of the National Cancer Institute, 33, 6, 971, (1964).

big mamas are better

At one time doctors believed that the fetus was like a parasite which would make up for any deficiencies in the mother's diet by taking what it needed frorn her body stores. Evidence has shown this to be false. What you eat builds your baby. Birth defects, epilepsy, and cerebral palsy result from bad diet in preg. nancy, drugs or both.

It is ironic to note that good breeding stock receive better care and attention than do most pregnant women according to Dr. Brewer (a pioneering doctor briefly mentioned in "The Pregnancy Survival Kit", WSW March, 1975). "Any veterinary school has a good program in nutrition but no medical school does."

Dr. Brewer recently put together a film to aid in training medical workers in prenatal nutrition, Although his methods are unusual his delivery is simple and convincing. Using a group therapy type situation he sits among his patients with a large paper shopping bag and pulls from it a quart of milk and two eggs: "In your average American supermarket you will find 10,000 items-but milk and eggs are your best buyI call eggs 'golden nuggets of nutrition","

What should you eat?

First of all, protein.

Many years ago, Ms. Bertha Beck, a public health nutritionist at Harvard, found that the healthiest babies were born to women who had eaten plenty of protein during pregnancy, while stillborn and newborn dead babies were born to women with the poorest diets. In fact 40% of the women who had poor diets suffered toxemia -a severe disease of pregnant women which can be fatal.

Dr. Brewer told of one healthy pregnant woman whose doctor was worried that she was consuming too much protein. She was put on a no protein diet for two and a half weeks. The result of this was that she contracted toxemia and her child showed fetal damage.

Pregnant women should consume about 40 to 60 grams of complete protein each day. Milk, eggs, cheeses and meats are some of the things that contain these complete proteins. Incomplete proteins found in vegetables, breads and some grains can be eaten in combinations with each other to provide sources of complete protein. (see chart for sources and gram weights) Small and frequent protein snacks will help nausea cont. on page 9 and vomiting.

SOURCES OF PROTEIN

soybean flour, low fat whole-wheat flour wheat germ

brewers yeast powdered skim milk instant non-instant

AMOUNTS; COMPLETENESS:

GRAMS

1 cup/complete

1 cup/incomplete

60 8-12

1⁄2 cup/complete

2/3 cup/complete

1/complete

•

milk, whole or skim buttermilk

1 qt/complete

cottage cheese

natural cheeses

32-35

soybeans, cooked

peanut butter

1⁄2 cup/complete

2 slices/complete

cooked cereals

• prepared cereals

• navy or lima beans macaroni or noodles

bread or bacon

•

nuts and seeds

• meat, fish, fowl

brown rice

1⁄2 cup/complete

2 tbsp./incomplete

3/4 cup/incomplete

12-14

20 9

10-18

1 cup/incomplete

1-3

1 cup/incomplete

6-8

3/4 cup/incomplete

3-4

1 dice/incomplete

1⁄2 cup/either/or

14-22

1⁄4 lb./complete

10-22⭑

I cup/incomplete

*Depending on whether it has little fat or much, and on boniness.

page 3/What She Wants/June, 1975