During human evolution, major changes in our societal conditions and environment took place without sufficient time for concomitant genetic alterations, leading to out of step adaptation and diseases in women. We first discuss recent societal adaptation mismatch (menstrual bleeding; increases in cancers of reproductive organs, endometriosis; mother’s nursing; polycystic ovarian syndrome; transgenerational epigenetic modifications), followed by Darwinian out of step adaptation (labor difficulties; sex chromosomes, human diseases and sex disparity in genomic DNA). We discuss the evolutionary basis of menstrual bleeding, followed by recent increases in cancers of reproductive organs and endometriosis. The importance of breastfeeding by mothers is also emphasized. Earlier onset of menarche, decreased rates of childbirths and breastfeeding resulted in increased number of menstrual cycles in a lifetime, coupled with excess estrogen exposure and incessant ovulation, conditions that increased the susceptibility to mammary and uterine cancers as well as ovarian epithelial cancer and endometriosis. Shorter lactation duration in mothers also contributed to more menstrual cycles. We further discuss the evolutionary basis of the prevalent polycystic ovary syndrome. During the long-term Darwinian evolution, difficulties in childbirth evolved due to a narrowed pelvis, our upright walking and enlarged fetal brain sizes. Because there are 1.5% genomic DNA differences between woman and man, it is of significance to investigate sex-specific human physiology and diseases. In conclusion, understanding out of step adaptation during evolution could allow the prevention and better management of female reproductive dysfunction and diseases.

中文翻译：

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进化过程中不合时宜的社会和达尔文式适应是导致多种女性健康问题的原因

在人类进化过程中，我们的社会条件和环境发生了重大变化，而没有足够的时间进行伴随的基因改变，导致女性适应失调和疾病。我们首先讨论最近的社会适应不匹配（月经出血；生殖器官癌症增加、子宫内膜异位症；母亲的护理；多囊卵巢综合征；跨代表观遗传修饰），然后是达尔文失步适应（分娩困难；性染色体、人类疾病和性基因组 DNA 的差异）。我们讨论了月经出血的进化基础，以及最近生殖器官癌症和子宫内膜异位症的增加。还强调了母亲母乳喂养的重要性。初潮较早，分娩率和母乳喂养率的下降导致一生中的月经周期次数增加，再加上过量的雌激素暴露和不断排卵，这些情况增加了对乳腺癌和子宫癌以及卵巢上皮癌和子宫内膜异位症的易感性。母亲的哺乳期较短也有助于更多的月经周期。我们进一步讨论了普遍的多囊卵巢综合征的进化基础。在长期的达尔文进化过程中，分娩困难是由于骨盆变窄、我们直立行走和胎儿大脑尺寸增大而演变的。由于女性和男性之间存在 1.5% 的基因组 DNA 差异，因此研究性别特异性的人类生理和疾病具有重要意义。综上所述，