The science of gynecology is undergoing a change and is swiftly turning into a holistic discipline, i.e. that of gender specific medicine. The rationale for this is that the hormones of the ovary are not only responsible for reproduction but also perform a number of extragenital functions that extend far into other disciplines, giving rise to a different frequency of diseases in women than in men. For example, females are five times more likely to be affected by rheumatoid arthritis than males, the same also holding true for autoaggressive conditions. This phenomenon may be accounted for by the fact that physiologic autoaggression is involved in the reproductive process. Similarly, there is a difference between women and men in regard to the sicca phenomenon, or to such disorders as connective tissue weakness, cellulite, venous conditions or hyperyholesterolemia. A cause-related treatment of such problems is now available through a specific endocrine therapy. That is why gynecologists in future will increasingly have to adopt an interdisciplinary approach.
One hundred years ago Professor Wertheim, the famous surgeon in gynecology, performed his first radical operation on a patient with carcinoma of the cervix.
In contrast to abdominal radical hysterectomy, Schauta preferred the vaginal axis and promoted the vaginal radical hysterectomy. Two surgical traditions have emerged from this scientific discussion, and for most of the last century, surgery has been one of the main topics in gynecology. There has also been a common opinion in our discipline: The qualification and value of a gynecologist was exclusively measured by the number of hysterectomies and abdominal operations, which he performed.
But time has changed and, following the rapid progression and research in the field of gynecological endocrinology, the profile of our discipline is also changing. The priority of surgical intervention in gynecology is declining and the new qualification for gynecologists will be measured by their capacity to prevent many surgical interventions and to treat the various gender-specific disorders in the light of the scientific background of gynecological endocrinology. What we have learned in the past few years is that there is a strong influence of ovarian steroids on neurological, dermatological, rheumatological and metabolic diseases, and that gynecology will therefore also change its traditional name, giving rise to a new discipline: gender -specific medicine. To strengthen this development it is necessary to focus on characteristic different gender-specific problems which will help to illustrate the facts.
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