There are a number of men who have written on various listservs that they use DES (diethylstilbestrol) as a hormonal suppressant. Actually, the current standard of care calls for the use of the gonadotropin-releasing hormone (GnRH) agonists, leuprolide and goserelin for a hormone blockade.
So, what is the actual role of DES and why isn’t DES considered the standard of care?
DES is an older form of androgen deprivation therapy that has largely been abandoned because it causes a greater risk for complications like blood clots and deep venous thrombosis.
Some physicians, with the goal of preventing blood problems when prescribing DES will also prescribe Lovenox (enoxaparin) or Coumadin (warfarin) which “thin” the blood. These additional drugs are hard to balance and bring additional side effects and problems to the table.
So, as a primary hormone blockade treatment one is always better taking a GnRH instead of DES. However, DES does still have an important role as a secondary hormone blockade when the GnRHs stop working.
If you start DES follow your doctor’s directions carefully.
Joel T Nowak MA, MSW
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