心身症としての女性不妊診療のありかた(<特集>女性をめぐる心身医学)  [in Japanese] An Approach to Management of Female Sterility from the Viewpoint of Psychosomatic Disease(<Special Issue>Clinical Management in Female Psychosomatic Disorders)  [in Japanese]

女性は心身状況不良時に妊娠すると,その後の妊娠経過に異常をきたし,流産や病的分娩によって母児の生命リスクが高まるため,そのような病況下では妊娠が成立しないように妊孕機能をマイナス制御する生体機構として,自律的に起動する自己防衛反応としての母性保護作用が存在する.心身症は現代の不妊症にとって重要な要因となった.不妊症と心身症との関連を自律神経失調症とうつ病との関連から,自院例におけるKupperman更年期不定愁訴とSRQ-Dとの相関から検討した.この結果,両症と卵巣機能不全不妊症には相関関係があることが明らかになった.このため現代の不妊症治療では心身症に対する対応が重要になり,薬物治療は漢方療法が主体的役割を担うと思慮された.

If females become pregnant when their physical and/or mental condition is poor, the course of pregnancy is likely to be abnormal, elevating the mother-child survival risk through abortion or pathologic delivery. To avoid this, females are equipped with a maternity-protective mechanism (an autonomically driven host defensive reaction) by which minus control of pregnancy is effected so that pregnancy will not develop during such pathologic conditions. Thus, psychosomatic disease is now an important factor determining female sterility. The present study was undertaken to analyze the relationship between female sterility and psychosomatic disease through analyzing sterility in relationship to autonomic imbalance and depression, based on the data on Kupperman index for climacteric symptoms and SRQ-D score collected from the cases managed at our hospital. The analysis revealed that autonomic imbalance and depression correlate with sterility due to ovarian dysfunction. This result suggests that management of psychosomatic disease is important when dealing with female sterility in the present age and that Kampo (traditional Chinese herbal) medicine will play a significant role in management of such cases.