Impact of reproductive evolutionary mismatch on women's health and the need for action and research

摘要

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.