DES: The Smith and Smith Regimen and It's Consequences

The treatment called the Smith and Smith regimen treatment was universally used by gynecologists in it's day. Never heard of it? It sparked a generation of disaster. In 1949 the New England Journal of Medicine, a gynecologic paper advocated a radical new treatment that could prevent many pregnancy complications: miscarriages, preterm births to name the two most important. The paper described a regimen that came to be known as the "Smith and Smith" regimen which advocated the use of the estrogen, DES (diethylstibesterol). The regimen had become widespread as an off label treatment, and late in 1947 the FDA had actually granted Squibb an approval for the process. Twenty-three yeas later, in 1973, Dr. Arthur Herbst at the University of Chicago, described a vaginal cancer in a young women who had been exposed to this drug while being a fetus (in utero). And there is a DES registry that has been going since the early 70s to track these rare vaginal cancers. They were the DES daughters. Not all the changes they experienced were serious. Some changes lead to non-cancerous but unique physical properties lie the "cockscomb" hood of the cervix. And Gyno Gab Gal will occasionally see this change in women who have not had any unusual hormonal exposure when they were maturing through fetal life. DES itself is a particularly unique estrogen type drug. It has had successful uses in prostate cancers, breast cancers, as a morning after pill and to stop uterine hemorrhaging. A Ying and Yang treatment of gynecology, with the bad so over shadowing the good that it passed from being famous to ignominy.

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Passing Your Uterine Lining, Menstrual Period Norms

Decidual Cast Periods can be fairly easy, passing some tissue at a time, or off can come the whole lining in one piece called a decidual cast. Generally the lining of the uterus is only 6-8 mm thick at the time of the menstrual period, and it is shed gradually, a few cells at a time. The decidual cast is when the entire lining passes spontaneously. It's not uncommon, but it usually both uncomfortable, and alarming to some. But us women are designed to have some sort of periods Or Not? We have to pass tissue each month. Or Not? Are they good for us? Or Not? Do we want them? Or Not? Is this something that is individual? Or Not? It's a complex topic that I will be discussing a lot over my time in this blog. So lets start with basics: How much do we bleed and what are we loosing, and just what was this that the patient passed? And another basic: track your periods, and the Women's Health Practice site http://www.womenshealthpractice.com/media/pdf/menstrual_chart.pdf you

Endocervial polyps

2 cm Endometrial Polyp After Removal Polyps in the cervix are almost never cancerous, but can bleed or get infected and should be removed. The are not directly related to an endometrial or uterine polyp (which is a precancerous condition), but your gyno may want to make sure these two conditions do not co-exist.

Irregular Periods can Be the Sign of Other Medical Conditions

Heavy menstrual Bleeding Menstrual Period Norms The menstrual period's normal physiologic function to shed the lining and then prepare the lining for a pregnancy. Thus a sample of the lining under the microsope looks like it has glands within tissue. It’s hard to know if this is a heavy period, or one that is really so heavy that you need treatment without really checking completely with your gyno! Experts have used a number of definitions to determine if the period you are having is too heavy. Your perception is important. The actual amount of blood lost is important, but that can be determined by collecting each pad and weighing them before and after blood collection. So gynos have struggled with how to determine the formal definition of heavy bleeding. A basic check up, and a basic blood count, is not going to really make your version of heavy periods fit the typical “FDA” approved definition because that is defined by the exact amount of blood lost, which is los

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