Hirsutism and menstrual patterns in women exposed to diethylstilbestrol in utero

Hirsutism and menstrual patterns were evaluated in 32 female patients with documented diethylstilbestrol (DES) exposure in utero. Nine nonhirsute regularly menstruating and nine consecutive hirsute oligomenorrheic women with no known DES exposure served as controls. Hormone measurements included follicle-stimulating hormone, luteinizing hormone, prolactin, cortisol, testosterone, androstenedione, dehydroepiandrosterone, sex hormone-binding globulin, and estradiol. Hirsutism was present in 72% and irregular menses occurred in 50% of DES-exposed patients. The mean age of the DES-exposed group was 26.8 +/- 0.7 years (mean +/- SEM). The mean age of mildly hirsute DES-exposed patients (24.7 +/- 1.4 years) was significantly lower (p less than 0.05) than that of severely hirsute DES-exposed patients (28.8 +/- 1.1 years). Mean testosterone, androstenedione, sex hormone-binding globulin, testosterone/sex hormone-binding severely hirsute DES-exposed group but higher than in nonhirsute control subjects. Mean testosterone, androstenedione, sex hormone-binding globulin, testosterone/sex hormone-binding globulin, and luteinizing hormone levels in hirsute DES-exposed patients were similar to those in hirsute control subjects but significantly higher than those in nonhirsute control subjects. Mean DHA levels as well as the clitoral indices were comparable in all groups. Our data suggest that DES exposure in utero may result in hypothalamic-pituitary-ovarian dysfunction.