In a clinical trial from 1969 to 1972, Sir Graham Collingwood Liggins and Ross Howie showed that if doctors treat pregnant women with corticosteroids before those women deliver prematurely, then those women's infants have fewer cases of respiratory distress syndrome than do similarly premature infants of women not treated with corticosteroids. Prior to the study, premature infants born before 32 weeks of gestation often died of respiratory distress syndrome, or the inability to inflate immature lungs. Liggins and Howie, then both at the University of Auckland in Auckland, New Zealand, published their results in A Controlled Trial of Antepartum Glucorticoid Treatment for Prevention of the Respiratory Distress Syndrome in Premature Infants in 1972. The study built on experiments Liggins had earlier conducted with sheep. Liggins' corticosteroid experiments changed the way doctors treated pregnant women experiencing preterm labors, and they improved the life expectancy of prematurely born infants.
In his 1991 article Screening for Congenital Hypothyroidism, Delbert A. Fisher in the US reported on the implementation and impact of mass neonatal screening programs for congenital hypothyroidism (CH) from the early 1970s through 1991. CH is a condition that causes stunted mental and physical development in newborns unless treatment begins within the first three months of the newborn's life. In the early 1970s, regions in Canada and the US had implemented screening programs to diagnose and treat CH as quickly as possible after the infant's birth. By 1991 many other countries had adopted the early screening program, and Fisher estimated that 10 to 12 million newborns per year were tested in the early 1990s. The screening programs, along with physician education and improved screening techniques, such as radioimmunoassay, helped significantly reduce the incidence of abnormal newborn development resulting from untreated congenital hypothyroidism.
Frank Rattray Lillie's research on freemartins from 1914 to 1920 in the US led to the theory that hormones partly caused for sex differentiation in mammals. Although sometimes applied to sheep, goats, and pigs, the term freemartin most often refers to a sterile cow that has external female genitalia and internal male gonads and was born with a normal male twin. Lillie theorized that a freemartin is a genetic female whose process of sexual development from an undifferentiated zygote was suppressed or antagonized by her twin's release of male hormones via their shared blood circulation in utero. Despite publications of similar findings by physician Julius Tandler in Vienna, Austria, in 1910 and physician Karl Keller in Wiesensteig, Germany in 1916 prior to Lillie's research, Lillie often receives credit for the hormonal theory of sex differentiation in the freemartin. Lillie's study of freemartins, and the subsequent research by graduate students in Lillie's laboratory at the University of Chicago in Chicago, Illinois, prompted many embryologists to research sex differentiation and hermaphroditism in mammals.
Diethylstilbestrol (DES) is an artificially created hormone first synthesized in the late 1930s. Doctors widely prescribed DES first to pregnant women to prevent miscarriages, and later as an emergency contraceptive pill and to treat breast cancer. However, in 1971, physicians showed a link between DES and vaginal cancer during puberty in the children of women who had taken DES while pregnant. Consequently, the US Food and Drug Administration (FDA) banned its use during pregnancy. In the late 2000s, several studies showed that the grandchildren of women who had consumed DES also suffered medical issues. By the early decades of the twenty-first century, roughly ten million people in the US had been exposed to DES, and three generations of individuals had suffered medical issues due to DES exposure. Researchers class DES as an endocrine disruptor, which affects the form and function of the hormone (endocrine) system.
In 2017, Julie Carré, Nicolas Gatimel, Jessika Moreau, Jean Parinaud, and Roger Léandri published “Does Air Pollution Play a Role in Infertility?: a Systematic Review,” hereafter “Does Air Pollution Play a Role,” in the journal Environmental Health. The authors completed a systematic literature review to investigate the effects of air pollutants on fertility in exposed populations. Since air quality has an impact on overall health as well as on reproductive function, the authors sought to increase the awareness of the importance of environmental protection issues among the general public and the authorities. The article “Does Air Pollution Play a Role” provided the foundation for further research on how air pollution can contribute to low reproductive capacity in areas with high exposure.
In 1953, Raymond Greene and Katharina Dalton, who were doctors in the UK, published The Premenstrual Syndrome in the British Medical Journal. In their article, Dalton and Greene established the term premenstrual syndrome (PMS). The authors defined PMS as a cluster of symptoms that include bloating, breast pain, migraine-headache, fatigue, anxiety, depression, and irritability. The article states that the symptoms begin one to two weeks before menstruation during the luteal phase of the menstrual cycle, and they disappear upon the onset of the menstrual period. Menstruation is the monthly series of changes a woman's body undergoes in preparation for the possibility of pregnancy. Dalton and Greene described how progesterone affected women during different phases of their menstrual cycles. The paper convinced many about the phenomenon of PMS, and docotors and scientists adopted Dalton's and Green's term. The paper furthered research about the role of hormones in physiology and of conditions linked to the reproductive system.
Estrogen is the primary sex hormone in women and it functions during the reproductive menstrual cycle. Women have three major types of estrogen: estrone, estradiol, and estriol, which bind to and activate receptors within the body. Researchers discovered the three types of estrogen over a period of seven years, contributing to more detailed descriptions of the menstrual cycle. Each type of estrogen molecule contains a slightly different arrangement or number of atoms that in turn causes some of the estrogens to be more active than others. The different types of estrogen peak and wane throughout women's reproductive cycles, from normal menstruation to pregnancy to the cessation of menstruation (menopause). As scientists better explained the effects of estrogens, they used that information to develop oral contraceptives to control pregnancy, to map the menstrual cycle, and to create hormone therapies to regulate abnormal levels of estrogen.
Sindell v. Abbott Laboratories was a 1980 California case that established the doctrine of market share liability for personal injury cases. For such liability, when a drug causes personal injury and the manufacturer of the drug cannot be identified, each producer is responsible for paying the settlement in proportion to the percentage of the market they supplied. Judith Sindell and Maureen Rogers brought the case against the producers of diethylstilbestrol (DES), which their mothers had taken during pregnancy to prevent miscarriage and other complications. Sindell and Rogers alleged that their mothers' ingestions of DES during pregnancy later caused Sindell and Rogers to develop cancers at the onset of puberty, but they could not identify the specific manufacturer of the drug. The market share liability ruling in Sindell allowed millions of DES-affected individuals to seek restitution for reproductive cancers caused by prenatal exposure to DES.
In 1996, the US Congress mandated that the US Environmental Protection Agency (EPA) create and regulate the Endocrine Disruptor Screening Program. The program tests industrial and agricultural chemicals for hormonal impacts in humans and in wildlife that may disrupt organisms' endocrine systems. The endocrine system regulates the release of small amounts of chemical substances called hormones to keep the body functioning normally. Some chemicals can impede the endocrine system's function by mimicking or blocking hormone reception, which can disrupt processes of development and reproduction and harm organisms. As of 2017, the Endocrine Disruptor Screening Program is the largest US program to identify and regulate chemicals that affect the normal production of sex hormones like estrogen and androgen, which can have long-term effects on development and reproduction.
Edward Charles Dodds researched the function and effects of natural and artificial hormones on the endocrine system in England during the twentieth century. Though he first worked with hormones such as insulin, Dodds focused on the effects of estrogen in the body and how to replicate those effects with artificial substances. In 1938, along with chemist Robert Robinson, Dodds synthesized the first synthetic estrogen called diethylstilbestrol. Despite the wide use of diethylstilbestrol to treat a variety of hormonal problems like miscarriages during pregnancy and menopause, Dodds argued against the use of synthetic substances in the human body due to their unknown effects. Just before Dodds's death, his hypotheses were confirmed when researchers showed that people exposed to diethylstilbestrol often developed cancer. Dodds was one of the first researchers to investigate the endocrine or hormone system in humans, and his research led to the creation of other synthetic hormones used in contraceptive pills and hormone replacements.