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A drug that millions of pregnant women took decades ago to prevent miscarriage and complications has put their daughters at higher risk for breast cancer and other health problems that are showing up now, a new federal study finds.

Many of these daughters, now over 40, may not even know of their risk if their mothers never realized or told them they had used the drug, a synthetic estrogen called DES.

The new study suggests infertility is twice as common and breast cancer risk is nearly doubled in these daughters.

The sons of DES users also face health risks — testicular problems and cysts — but these are less well studied and don’t seem to be as common.

Even less is known about the third generation — “DES grandchildren.” Some research suggests these girls start menstruating late and have irregular periods, possible signs of fertility issues down the road.

In the United States alone, more than 2 million women and 2 million men are thought to have been exposed to DES while in the womb and may now want to talk with their doctors about when they should be screened for health problems.

The study is in today’s New England Journal of Medicine.

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