[Gynecological problems of the aging woman]

The increasing number of old aged women requires the establishment of geriatric gynecology as a new subspecialty of our profession. The care of senior women in the gynecologists office should not be limited to the conventional gynecological diseases. These are of course dealt with in this paper; however should also be included, in a new understanding and broadening of our specialty, the women-specific diseases of old age. These extragenital diseases are therefore also touched upon. This extension of gynecology follows logically from the broad spectrum of effects of the female sexual hormones in the hands of the gynecologists and especially of long-term estrogen substitution into many neighbour medical specialties, like internal medicine, orthopedics, psychiatry and others. The gynecologist must have a working knowledge of these women-diseases including their physiopathology, differential diagnosis, treatment and, above all, prevention. The new understanding is moreover based upon the unique position of the gynecologist in the regular prevention and last, not least, upon the special confidence of the clients to their women-doctor and upon the special human intimacy in the relation between female patients and gynecologists. The care of senior women today includes life style counseling with the aim of prevention of preventable diseases. Also these points of view are touched upon. Medicine, which has given thirty additional years to the life of women, has also to take the responsibility to preserve physical and mental wellness through this segment of existence in good life quality saving the seniors from suffering of the preventable diseases of old age.