Reproductive health as a sentinel of chronic disease in women.

摘要

At the turn of the 19th Century, as John Mason Good assembled his four volume opus on medicine, the chief threats to women's health were infection and childbirth, and many women did not survive to menopause. Two centuries later, women in the developed world succumb to cardiovascular disease or cancer, conditions that rarely strike women of reproductive age. In our modern day fight against these diseases of maturity, we have focused on risk factors and interventions for postmenopausal women. As a result, we have forgotten the wisdom expressed by Good at the dawn of the Victorian era: women's reproductive health is intimately linked with their overall physical and mental health. The vitality and performance of women's reproductive axis - as revealed in patterns of menstruation, fertility and pregnancy - yield important information about subclinical disease trajectories.