February 2013 - Page 2 of 3

10 Perfectly Awful Valentine Gifts For That Special Lady In Your Life

Published on February 14, 2013

2331 views

A list of neither tasteful nor romantic Valentine gifts for that special lady in your life. Whomever thought these were a good idea, doesn’t date women much. On the other hand, if you’re looking for a humorous gift here are some possibilities.

1. For that special lady who just wants to spend more time together:

2. For the woman who loves animals:

Name a roach

3. For that special lady who likes to plan ahead:

4. For the gal who thinks flowers are unoriginal:

The wrong way to give flowers - valentine's day fails

5. For the active woman with a sweet tooth:

6. For that special lady who wants a romantic getaway:

7. For the vegetarian your life:

8. For that special lady who doesn’t know how good she has it:

9. For that special lady who loves jewelry:

10. For that special lady that just wants to cuddle on Valentines Day:

OK, number 10 isn’t so bad, but it’s not exactly romance inspiring.

Have a perfectly awful Valentine gift or story? How about awful Valentine gifts for the men in your life? Share your Valentine gift missteps and failures.

What’s in Your Meat?

by Chandler Marrs, PhD

Published on February 13, 2013

3126 views

A lot of antibiotics, growth hormones and myriad of antibiotic-resistant strains of bacteria, that’s what’s in your meat. The FDA’s Center for Veterinary Medicine released its third annual report on antimicrobials sold or distributed for food-producing animals in 2012. Guess what, the 2008 ‘guidance’ offered to industrial meat farmers to reduce the use of prophylactic antibiotics in their livestock isn’t working out so well. According the report, both antibiotic use and antibiotic-resistant strains of bacteria are increasing, rather rapidly, especially in poultry. In 2011:

29.9 million pounds of antibiotics were sold in the US for meat and poultry production
7.7 millions pounds of antibiotics were sold in the US for humans

Out of some 1840 retail meats tested (meats destined for sale, not the animals, the packaged meats in your supermarket):

Escherichia coli (E. coli) bacteria was found in 64% of the samples. Pork chops had the lowest prevalence (39.8%) and ground turkey had the highest (80.2%). (Remember the connection between E. coli in poultry and treatment resistant urinary tract infections in women.)
Salmonella bacteria was found in 44.5% of meats sampled and antibiotic resistance grew from 10-44% depending upon the strain of bacteria.
Multi-drug resistance grew by 43% in chicken breast and 33% in ground turkey since 2010.

And that’s just the beginning. Earlier this year, researchers found the deadly methicillin-resistant staphylococcus aureus (MRSA) bacteria in pig farms and retail meats. MRSA was not tested in these samples, neither were growth hormones or growth promoting drugs like ractopamide – banned in other countries but not in the US – though fed to 60-80% of the livestock here and thought to be responsible for more sickened or dead pigs than any other drug on the market. Nope, those endocrine disrupting chemicals weren’t measured.

It seems we humans are a veritable garbage dump for chemical waste disguised as food. Thank you Big Ag! And thank you FDA for such a stellar job ‘regulating’ these chemicals. It was a stroke of brilliance letting these companies decide the safety of their own drugs and chemicals. It is much more efficient that way. And providing gentle ‘guidance’ to nudge them to do to the right thing – that shows leadership and an unparalleled commitment to human health.

I think it’s time for a new model, how about you?

Will the Sunshine Act Curb Pharma Payments to Doctors?

by Chandler Marrs, PhD

Published on February 12, 2013

2645 views

Just two weeks ago, as part of the Affordable Care Act, the Centers for Medicare and Medicade Services published its final rule on the reporting mandates for physician payments from pharmaceutical and medical device makers. Called the Physician Payment Sunshine Act, this law requires:

applicable manufacturers of drugs, devices, biologicals, or medical supplies covered by Medicare, Medicaid or the Children’s Health Insurance Program (CHIP) to report annually to the Secretary certain payments or transfers of value provided to physicians or teaching hospitals (“covered recipients”).

Why Is This Important?

For too many physicians, the medications they choose to prescribe are influenced by these payments. A case control study at a university hospital found that physicians who requested a new drug be added to the formalary were 19X more likely to have received money or gifts from the drug company. According to the New England Journal of Medicine as of 2007 fully 94% of all physicians accepted gifts from pharma, although by 2009, only 84% of physicians accepted gifts from pharma.

In their Dollars for Docs series, Propublica not only detailed the trail of money from the pharmaceutical industry to physicians and the changes in prescribing practices that ensued, but also, found that over 250 of the physicians receiving these payments had been disciplined by their state’s medical boards with the public never the wiser.

Wouldn’t you want to know if your physician was receiving payments to ‘consult’ on a particular drug or medical device? What if that drug or device turned out to be dangerous like, Avandia or Vioxx or in the case of women’s health Yasmin, Yaz or Ocella or even the vaginal mesh implants? I would. And soon, you will be able to find this information, at least for those physicians that accept medicare or medicade. For the remaining physicians, we’ll have to rely on the stellar, investigative reporting of organizations like Propublica.

What Is the Physician Payment Sunshine Act?

The Physician Payment Sunshine Act mandates payments or ‘transfer of value’ to physicians be reported to the Secretary of Health and Human Services. Collection of this information is set to begin in August with full compliance and reporting expected in 2014.

The cool thing about this act, if it is implemented correctly, is that payment or transfer of value includes money for marketing activities, such as promotional or conference talks and consultation services. It also will include research grants and “charitable” contributions (which usually come with some promotional strings attached), funding to attend conferences, honoraria and royalties and license fees. The pharmaceutical and device companies making these payments will be required to list names, address, amount of payment, date of payment(s) and describe the service for the payment made for anything over $10. The database will be searchable so that patients can determine what monies their physicians received from pharma or device companies.

Where the Sunshine Act Fails

From the original to the final regulations, a work-around for paying physicians to speak at pharma sponsored continuing medical education (CME) events was added. According to the regulations, so long as the sponsoring company doesn’t pay the physician/speaker directly, those fees are acceptable and need not be listed publicly. Instead, the pharma company must pay a third party vendor to arrange and pay the speakers. CME conferences are where most physicians learn the latest drug therapy, device or medical technique. It is unlikely that speakers at these conferences will speak against the sponsor’s product. Funneling the payments through a third party vendor, who is also paid by the sponsor, is no more than a quick pass at laundering the fees.

What Do Physicians Think About the Sunshine Act?

The opinions are mixed, at least publicly. Some physicians are fully behind the new efforts in transparency and have begun their own campaigns to disentangle the marketing relationships between pharma and physicians. The National Physicians Alliance sponsors the Unbranded Doctor campaign:

The National Physicians Alliance’s Unbranded Doctor is unmasking the pharmaceutical industry’s bogus claim that its marketing efforts are just educational ventures for physicians. By signing up physicians to renounce gifts, lecture fees, and “education” from companies, the Alliance is championing objectivity, integrity, and professionalism.

—Jerome Kassirer, MD
former Editor-in-Chief, New England Journal of Medicine

Similarly, the British Medical Journal (BMJ) has positioned itself as a lead proponent of transparency and open data. On the other hand, CME released a survey of over 500 physicians asking if the new regulations to list publicly whether industry sponsored their attendance at CMEs would curtail their attendance. The result was a resounding – yes.

75% of physicians said the disclosure rules would affect their decision to attend at least somewhat.
47% of physicians said the disclosure rules would affect their decision to attend to a great extent.
46% of CME speakers said the disclosure rule would affect their decision to participate as a panelist or presenter to a great extent
25% percent said it would somewhat affect their participation

Will the Sunshine Act Curb Pharma Payments to Doctors?

Probably not. Unless and until full transparency about medical research, clinical trials and adverse events are made open and accessible to patients and physicians, medical marketing, fabricated data or omitted data, publication bias, and conflicts of interest will continue to pervade our healthcare system. Dangerous medications like the Yasmin suite of birth control pills and unsafe medical devices like J&J’s Gynecare Prolift will remain on the marketplace long after any reasonable person could vouch for their safety.

The Sunshine Act will, however, give patients one more tool to evaluate their physicians and give researchers, investigators and others a way to identify and publicize bad behavior. Who knows, maybe it will even save some money.

To find out if your physician receives money from the pharmaceutical industry go to Dollars for Docs.

We Need Your Help

More people than ever are reading Hormones Matter, a testament to the need for independent voices in health and medicine. We are not funded and accept limited advertising. Unlike many health sites, we don’t force you to purchase a subscription. We believe health information should be open to all. If you read Hormones Matter, like it, please help support it. Contribute now.

Yes, I would like to support Hormones Matter.

Photo by kike vega on Unsplash.

Photo by Hush Naidoo Jade Photography on Unsplash.

Opioids, Chronic Pain and Low Testosterone in Men

by Chandler Marrs, PhD

Published on February 11, 2013

3234 views

Does your guy suffer from chronic pain? Does he use opioid based pain-killers on a regular basis? Then he may also have low testosterone. Low testosterone or as the advertisers call it, Low T, is associated with a range of health issues beyond just reduced libido or sex drive. His low testosterone could be an important factor in his health and recovery.

Testosterone influences, muscle mass, bone density, cognition and memory, depression, and even insulin production. Many men with low testosterone are at risk of osteopenia and osteoporosis. Lower testosterone or hypogonadism has even been associated with an increased risk of heart attack. That means, in addition to worrying about managing chronic pain, the risks associated with long term opioid use, you and your guy now also should be aware of the critical hormone changes taking place. It is possible these hormone changes are compounding an already difficult recovery.

The study, published in the Clinical Journal of Pain, found that 53% of the men tested who were using daily opioids had low testosterone. Moreover, 74% of men using long-acting or time-released opioid pain killers had low testosterone compared to only 34% of those using short acting opioid pain-killers. Interestingly, the morphine-standardized equivalent dose (MSE), a measure of how much pain-killer is circulating in the bloodstream, was not associated with the testosterone levels. This means that higher dose pain killers were not tied to lower testosterone, only the duration of the medication action was associated with the hormone change. Long-acting (time release) pain-killers were linked to lower testosterone while short-acting pills were not.

Long-acting Opioids

Buprenorphine
Fentanyl
Methadone
Morphine CR
Oxycodone

Short-acting Opioids

Oxycodone IR
Hydrocodone

If your guy is using is opioid pain-killers to manage a chronic pain from injury, have his doctor check his testosterone levels too.

Medical Disclaimer: All material on this web site is provided for your information only and may not be construed as, nor should it be a substitute for, professional medical advice. To read more about our health policy see Terms of Use.

Is it Endometriosis or Something Else?

by Center for Endometriosis Care

Published on February 10, 2013

3869 views

Endometriosis is an often misunderstood disorder affecting an estimated 176 million women and adolescents around the world, during what should be the “prime years of their lives” (Hummelshoj). Commonly characterized by symptoms that may be so severe as to interrupt one’s daily routine, whether with periods or at any time during the month, endometriosis accounts for the leading cause of pelvic pain in women of all ages.

Girls and women who suffer primarily during menses only may think, “Of course everyone’s periods are super painful – that’s how it’s supposed to be, right?” This is actually incorrect. Endometriosis is among the most common of diagnoses in adolescents and women with pelvic pain. Unfortunately, due to widespread lack of awareness and disease education, early symptoms are often dismissed as pelvic inflammatory disease or infection, ovarian cysts, appendicitis, IBS, Interstitial Cystitis, “normal” pain, or worse, an “in your head” diagnosis. This contributes to a near-decade delay in proper diagnosis and intervention. The good news is, accurate diagnoses are increasing as doctors and patients alike become better at recognizing the signs of endometriosis, particularly in younger women and girls. Early intervention combining timely diagnosis with proper treatment is essential towards preventing symptom progression and development of infertility (Sanfilippo et al.).

Though many women and girls may experience some discomfort during menstruation, “killer cramps” are NOT normal – despite what the media, friends and even well-intentioned loved ones may tell us. Pain is the body’s way of saying something is wrong. Symptoms that get in the way of school, work, sports, extracurricular or social life are an indication something is awry, as are persistent symptoms at any time of the month.

So What’s Normal?

minor period discomfort that may even require over the counter medication
occasional irregular or absent periods, particularly if athletic
“functional” ovarian cysts
pain during ovulation

What’s Not Normal?

severe and incapacitating period pain or pelvic pain at any time of the cycle that interrupts normal routine
GI discomfort, often but not necessarily around the time of menstruation
bladder pain or discomfort, during your period or apart from menses
chronic heavy bleeding and long cycles
if active, pain with sexual activity (especially upon penetration)
“chocolate” cysts known as “endometriomas”
subsequent allergies, food insensitivities or intolerances, chemical sensitivities, fatigue, or autoimmune conditions like thyroid disease may also be present in some women and girls with the disease

Time to See a Doctor

Any ongoing, worsening pain that has no obvious explanation should be evaluated further. “The younger the patient, the more valuable the early evaluation.” (Robert B. Albee, Jr., MD).

Sound Familiar?

you have pelvic pain during your period or at any time of the month that causes you to miss school, work or activities
you experience chronic stomach upset such as nausea, diarrhea or constipation
you have painful urination in absence of infection
if sexually active, intercourse or sexual activity are painful
you have family members who have been surgically diagnosed with endometriosis

If you’ve answered yes to any of the above, talk to a trusted nurse or doctor about endometriosis.

Endometriosis is NOT…

An infection or sexually transmitted disease (“STD”)
Contagious or preventable
Caused by abortion
Caused by backflow periods and thus cured by hysterectomy
Untreatable!

You cannot “catch” endometriosis, and it isn’t an infection of any sort. You can’t “give” it to anyone else, and there is no absolute prevention. There are treatments that can help, however; and many women and girls live quite well in spite of the disease and are able to control their symptoms long-term through different options. The cornerstone of any effective treatment regimen is quality surgery; most notably, Laparoendoscopic Excision (LAPEX).

Being aware of signs of endometriosis can help get early diagnosis and treatment – critical to effective management. Pain – menstrual or otherwise – that interrupts one’s life is never normal – being aware of abdominopelvic pain, GI and/or urinary distress, and/or pain with sexual activity are significant indicators of endometriosis. The most important step a young woman can take is not trivializing her body’s signals. Pain is a sign that something isn’t right.

Societal taboos and a culture of menstrual misinformation may lead women and girls to think their pain is “in their head”, or they may even be told by others that they are “faking it” to get out of work or class – or that crippling period cramps are “totally normal” and “part of being a female”, but these outdated notions simply aren’t true. If you are experiencing pain or symptoms that get in the way of your life, see your doctor.

About the Authors: The Center for Endometriosis Care is a COEMIG-Designated Center of Excellence in Minimally Invasive Gynecologic Surgery which was founded over two decades ago by renowned laparoscopic excision (LAPEX) pioneer Robert B. Albee, Jr., MD, FACOG, ACGE. The Center is run under the leadership of Medical Director Ken R. Sinervo, MD, FRCSC, ACGE along with a caring, compassionate staff. We continue our efforts as architects of the legacy in gold standard endometriosis care.

Medical Disclaimer: All material on this web site is provided for your information only and may not be construed as, nor should it be a substitute for, professional medical advice. To read more about our health policy see Terms of Use.

Not By The Hair of My Chinny-Chin-Chin!

by Lana Hanson

Published on February 7, 2013

2865 views

NEWS ALERT! Researchers have worked around the clock to discover a direct correlation between the physical phenomenon of unwanted facial hair — known as Hirsutism — that some women grow at the onset of middle age, and another rapidly emerging, emotional disease that’s affecting pre-menopausal women — which scientists have aptly named the “AW HELL NAWS!!!”

In the wake of the physical malady of hirsutism, tweezer sales and waxing services have risen sharply of late for women in the 35-40 year old demographic. Doctors’ offices are now flooded with frantic women who’ve looked in the mirror and found long, thick chin whiskers on their otherwise easy, breezy, beautiful Cover Girl faces. Panic has ensued: Testosterone’s taken the wheel, while Estrogen’s passive-aggressively griping from the hormonal back seat.

Emotional data reveals that “Deep depression is afflicting men worldwide- everywhere from Battle Axe to Timbuktu. Quite suddenly, men (even gigolos) in relationships with previously sugar-and-spice/everything-nice women just simply trying to float previously successful pick-up lines are being shut down — hard — by abrasive, impatient, uncooperative women. Men are feeling an odd combination of both “getting their heads bit off” and “losing their balls to gals’ purses.”

Reports are, this emotional epidemic has taken precedence over all other governmental concerns and even travelled as far up the executive branch as The White House, where First Lady Michelle Obama (who may or may not have chin hairs) has perfected the “Eye Roll” symptom and sent even The Commander in Chief to lie and whimper on the Oval Office carpet with Bo, the First Dog. Seems that the triumphant slogan “Yes We Can!” has been trumped by a new one: “Aw Hell Naw!!!” It has been documented that Hilary Clinton’s sent a sympathetic tweet to Michelle that reads, “‘Bout time, Girl. Welcome to the Dark Side!”

A Navy Seals team’s been assembled to swiftly take down any female bordering on this kind of “time of the month” female guerilla terrorism against the male gender. The Terror Alert Chart’s set at Code Red…in particular, Bitch Red.

The world’s leading scientists went straight to work when this phenomenon first raised its bristly head, devising controlled studies to analyze it. The research evidently got off to a great start, as lab rats proved compliant in the experiments. But all tests came to a screeching halt when the studies attempted to replace rats with middle-aged women. Why? Because the women subjects’ response to this was (have you guessed already?) “AW HELL NAW!!!”

Latest reports are that all further scheduled studies along these lines have been scrapped.

What is DES and Why You Should Care

by Chandler Marrs, PhD

Published on February 6, 2013

6804 views

Diethylstilbestrol or DES is synthetic estrogen developed in the late 1930s. It was initially approved by the FDA in 1941 for vaginitis and as an early hormone replacement therapy for menopausal women. It was later approved a variety of low estrogen indications. In 1947, the FDA approved its use in pregnant women with a history of miscarriage. DES had been used off-label for miscarriage prevention since the early 1940s, despite the fact that little evidence supported its use and animal studies indicated clear carcinogenic and congenital reproductive abnormalities in the offspring.

After 10 years of widespread use and marketing, a double-blind, placebo-controlled study on the efficacy of DES was finally conducted. As one might expect, it was found ineffective in preventing miscarriage. In fact, women on DES had a higher risk of miscarriage. Later studies in the 1960s began detailing the adverse events associated with this drug. Despite mounting evidence of the dangers of diethylstilbestrol, it remained on the market and widely used through the early 1970s in the US and into the 1980s in some European countries. In the US alone, it is estimated that between 5-10 million women and their children were exposed to DES. Because the compound was never patented, 287 drug companies sold DES under a multitude of brands and for an array of low-estrogen conditions.

In addition to diethylstilbestrol use in humans, it was used widely in farm animals to fatten up the chickens and cattle, beginning in the early 1950s and through the 1970s. DES was found to cause cancer and interestingly enough, cause gynecomastia (man boobs) and sterility in the poultry workers. Well before DES was banned in humans, the FDA banned it in poultry under the newly enacted Delaney Clause to the FDA 1958. It seems man boobs and sterility was all it took to ban the product in chicken farms. Miscarriage, congenital abnormalities and cross-generation cancer risks, on the other hand, were not sufficient to initiate its ban in large cattle or humans. It was another 20 years before diethylstilbestrol was banned in cattle or humans and many years after before it was removed from the food chain (if it even is now). “In 1980, half a million cattle from one hundred and fifty-six feedlots in eighteen states were found with illegal DES implants.” Even upon FDA’s decision to withdraw its approval of DES in cattle and feed, it did so on grounds of the procedural non-compliance of the manufacturers, erstwhile maintaining the safety of diethylstilbestrol, “because there is no evidence of a public health hazard.” Despite its clear carcinogenic and teratogenic risks, it is still used in veterinary care.

Diethylstilbestrol Risk for Humans

Amongst those suffering the most from DES exposure are men and women who were exposed in utero as developing fetuses. DES was given to pregnant women from the 1940 through 1971 in the US and into the 1980s in some European countries. If you were born anytime between 1940 and 1980, ask your mom if she was given DES to prevent miscarriage. It was sold under dozens of brand names (click here for brand names).

Sons and Daughters of DES

The range of depth of reproductive abnormalities, endocrine and health issues found in the children and grandchildren of DES moms, is expanding regularly. If your mom or grandmother was given DES, here is a list of health issues to look for:

DES Daughters

In a large cohort study comparing the reproductive health of the daughters of women prescribed DES during pregnancy to the health of women whose mothers had not been given DES, researchers found a 2-8 times higher incidence of the following conditions:

Infertility
Spontaneous abortion
Ectopic pregnancy
Second trimester pregnancy loss,
Preterm delivery
Preeclampsia
Stillbirth
Neonatal death
Early menopause
Breast cancer
Cervical neoplasia
Clear cell adenocarcinoma

The increased risk of miscarriage and adverse pregnancy outcome in DES daughters is overwhelmingly linked to structural abnormalities with uterus. Fully 69% of DES daughters who have had difficult with infertility and miscarriage have an abnormally shaped uterine cavity or structural changes to the cervix (44%).

DES and Endometriosis

Of particular interest to Hormones Matter followers, DES exposure in utero is linked to an 80% increase in endometriosis. We will be digging deeper into the DES – endometriosis connection in the coming weeks.

DES Sons

Sons of women given DES during pregnancy are three times more likely to have structural abnormalities of the genitals including:

epididymal cysts
undescended testes
extremely small testes
hypospadias (misplaced urethral opening)
micropenis (some, but not all)
increased risk of infertility
increased risk of testicular and prostate cancer (although the research has just begun)

In the animal research, offspring of DES exposed mothers shows a vast array of structural and morphological changes across multiple physiological systems ranging from sex reversal in male fish to structural and functional changes in pancreatic cells. The full scope of damage from DES is yet to be determined.

DES Grandchildren

Yes, there are third generation effects from this drug. Researchers are just beginning to untangle the third generation effects. In women, menstrual irregularities appear more common as do the various forms of cancer, but the data are unclear. In men, hypospodias may be more frequent, but again the data are mixed.

Endocrine disruptors like diethylstilbestrol impact human health in ways we are only just beginning to understand. The current methods for measuring and calculating risk for endocrine disruptors is out-dated and based on standard, linear, dose-response curves that not only fail to account for how hormone systems work, but also fail to address possible transgenerational effects. Hormones matter and sooner or later we must address the broader endocrine system in pharmaceutical and environmental regulation. As women, we ought to be fighting for sooner.

Mammograms: What Would Dolly Parton Do?

by Lana Hanson

Published on February 1, 2013

2598 views

If names always signified what they actually were, getting a mammogram would mean that upon your 40th birthday, you’d get not a telegram, but the sensational Nathan Lane would appear on the “Wipe Your Paws” welcome mat outside the front door, wearing only a shimmery paper gown and belting out a peppy tune. What a toe-tapping treat. Turns out this rite of passage fills us with dread like hearing Psycho shower scene music. As if, by 40 your boobs haven’t been handled rough enough?! Maybe this was the REAL reason Janet Leigh screamed her little wet head off. She finally realized doing the “Breast Self Exam” was not the end-all-be-all.

Maybe it’s for the best that mammograms become a required, yearly blow to one’s dignity. By middle age, most women have been-there-done-that at no less than 10x over. In short, we just simply don’t have the time, patience, energy or pride to give a rat’s ass. When the appointment date arrives, these leather-tough broads slap a tit on the X-ray slide like a child gleefully inserts a plump pastry into an Easy Bake Oven.

But even these warriors had a first time. Don’t you dare chicken out! Think of yourself as a soldier going to war against the dastardly army of breast cancer and your lieutenant is none other than that tiny tart from Tennessee – Dolly Parton. Put on your big girl panties and don your WWDPD plastic wrist band and buck up! Time’s a wastin’! Your tits are defenseless without ya!

However, don’t barge into battle blindly: just leaving the house with no deodorant, perfume or lotion on – per the mammogram commandments – is a bold move. By the time you undress in the doctor’s office, you could very well reek like a Subway meatball foot-long. Your extremities get squeezed to the extreme and will look like something straight from Looney Tunes. On the flip side, the female technician touches your breast so tenderly and coos such foreplay sweet talk like “Move a little to the left” or “Hold your breath”- that you seriously consider asking her out for coffee after.

Then lickety-split you’re done and dressed. Quite suddenly you feel important and wise and well…powerful. The results of your test will be whatever they will be, as these things always are, when left up to God or the fates. But at least you have begun the battle. Imagine Dolly’s huge boobs coming in for a victory hug. Deep in that smothered, Southern-fried embrace, you grin. You done good soldier, you done good.

February 2013 - Page 2

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Why Is This Important?

What Is the Physician Payment Sunshine Act?

Where the Sunshine Act Fails

What Do Physicians Think About the Sunshine Act?

Will the Sunshine Act Curb Pharma Payments to Doctors?

We Need Your Help

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You might be interested in

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So What’s Normal?

What’s Not Normal?

Time to See a Doctor

Sound Familiar?

Endometriosis is NOT…

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Diethylstilbestrol Risk for Humans

Sons and Daughters of DES

DES Daughters

DES and Endometriosis

DES Sons

DES Grandchildren

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