The evolutionary origin and significance of menopause.
The evolutionary origin and significance of menopause.
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更年期的进化起源和意义。
DOI：
10.1097/gme.0b013e3181ed957a
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Simon,JamesA
中科院分区：
文献类型：
--
作者：
Pollycove,Ricki;Naftolin,Frederick;Simon,JamesA
当代女性的预期寿命很长（81岁，美国），特别是相对于绝经年龄（51岁，美国）。绝经是生殖老化和卵泡耗竭（卵巢衰竭）的结果，导致循环雌激素血清浓度非常低，生物学上不利的代谢改变。从拮抗多效性的角度来看，持续的低雌激素内分泌环境，在哺乳期是有益的，导致绝经后几种年龄相关疾病的加速（即绝经后晚期骨质疏松症，心血管疾病和认知能力下降）。具体而言，类似的hypoestrogenic激素环境中存在产后哺乳提供生物优势（健身）的母亲和新生儿。进化医学的这些观点鼓励对激素疗法进行重新评估，并根据所提供的数据，作者提出了预防绝经后妇女疾病和降低发病率的额外机会。
Contemporary women have long life expectancy (81 y, United States), especially relative to the age at menopause (51 y, United States). Menopause is a consequence of reproductive aging and follicular depletion (ovarian failure), yielding very low circulating estrogen serum concentrations and biologically disadvantageous metabolic alterations. Stated in terms of antagonistic pleiotropy, the ongoing hypoestrogenic endocrine environment, beneficial during lactation, results in acceleration of several age-related illnesses after menopause (ie, late postmenopausal osteoporosis, cardiovascular disease, and cognitive decline). Specifically, the similar hypoestrogenic hormonal milieu present during postpartum lactation provides biologic advantages (fitness) to both mother and newborn. These precepts of evolutionary medicine encourage a reassessment of hormone therapy, and on the basis of data presented the authors propose additional opportunities for disease prevention and morbidity reduction in postmenopausal women.*