Department of Obstetrics and Gynecology, Assiut University, Assiut, Egypt.
Int J Gynaecol Obstet. 2019 Feb;144(2):129-134. doi: 10.1002/ijgo.12694. Epub 2018 Nov 2.
Efforts by the health and scientific community have focused on providing women with the means to control and regulate their fertility. We paid less attention to the reality of women achieving their reproductive revolution while burdened with a reproductive system that evolved to fit the life of our ancestor hunter-gatherers, where women were destined to spend most of their reproductive years pregnant or breastfeeding. This state of evolutionary mismatch impacts on women's health as the reproductive system continues incessantly to work, producing a monthly ovum and exposing the reproductive organs to cyclic hormonal stimulation without the benefit of pregnancy and breastfeeding. Women have to cope with a life of menstrual cycles, decreased fecundity owing to reproductive ageing, and a higher risk of reproductive cancers, in addition to uterine fibroids, and endometriosis. The burden will increase in low-resource countries as more women are adopting the new model of reproductive behavior, and resources to cope with the impact are limited. The reproductive revolution is benefiting not only women, but also their societies and the world at large. The health profession and the scientific community have an obligation to support women to cope with the impact of reproductive evolutionary mismatch.
医学界和科学界一直致力于为女性提供控制和调节生育能力的方法。我们较少关注这样一个现实，即女性在实现生殖革命的同时，却承受着一个为适应我们祖先狩猎采集者生活而进化的生殖系统，在这种生活方式中，女性注定要将大部分生育期用于怀孕或哺乳。这种进化不匹配的状态影响了女性的健康，因为生殖系统不断地运作，每月产生一个卵子，并使生殖器官受到周期性激素刺激，而没有怀孕和哺乳的益处。女性还必须应对月经周期、生殖衰老导致的生育能力下降以及生殖癌症风险增加的问题，除此之外，还有子宫肌瘤和子宫内膜异位症等问题。随着更多的女性采用新的生殖行为模式，资源来应对这种影响的能力有限，这种负担将在资源匮乏的国家增加。生殖革命不仅使女性受益，也使她们的社会和整个世界受益。医疗保健专业人员和科学界有责任支持女性应对生殖进化不匹配的影响。
