少産少子化時代の産婦人科医療の役割

For recent 30 years, the number of the times of pregnancy and delivery which Japanesewomen experienced has decreased continuously. These decreases have influenced women’shealth and reproductive functions and are caused for the increment of several diseases.It has been reported that the incidence of appearance of endometriosis and uterinefibromas are increased in parallel with decrement of the number of times of pregnancy anddelivery. Furthermore, we have well-known that these decrements also increase the incidenceof occurrence of uterine endometrial cancer, ovarian cancer and breast cancer in malignantdiseases.The length of life in Japanese women is remarkably extended, and the women’s life periodafter menopause is considerably longer because the average of age of menopause inthem is not changed. After menopause, women’s reproductive function is remarkably suppressedand its activity of production of estrogen is diminished. Low level estrogen is dueto a lot of diseases, for example, climacteric syndrome, osteoporosis, hyper cholesterolnemia,etc.Recent progress in treatment for sterility is remarkably. But, on the other hand, it alsooccurs a lot of problems. Positive treatment for sterility is caused to some side effects,multipregnancy and ovarian hyperstimulation syndrome. The treatment for old agedwomen is due to increasing babies with malformation. The assisted reproductive technologyhas serious ethical and economical problems.These situations require gynecologists to know the change of women’s health and reproductivefunction by decreasing the number of the times of pregnancy and delivery and tobe a general physician for women through their whole life.