Zusammenfassung
Am 12. Oktober 1999 überschritt die Weltbevölkerung die 6-Milliarden-Grenze und selbst konservativen Prognosen zufolge werden im Jahr 2020 8 Milliarden Menschen auf der Erde leben (Abb. 20.1). Den wesentlichen Anteil an dem enormen Bevölkerungswachstum haben die Entwicklungsländer, während die Einwohnerzahl in den Industrienationen eher stabil ist. Die explosionsartige Zunahme der Weltbevölkerung führt zu kaum beherrschbaren ökologischen und ökonomischen Problemen. Als Beispiel sei Indien erwähnt, wo 1/6 der Weltbevölkerung auf 2,5% der Landmasse der Erde lebt, und das ungebremste Bevölkerungswachstum den teils spektakulären wirtschaftlichen Fortschritt zunichte macht. Durch medizinischen Fortschritt wurde es möglich, die Sterblichkeit, vor allem auch der Kinder, entscheidend zu verringern. Mehr und mehr Menschen erreichen das reproduktionsfähige Alter. Die Lebenserwartung des Menschen ist nicht zuletzt durch die Möglichkeit wirksamer ärztlicher Intervention gestiegen. Andererseits bietet die Medizin jedoch nur in sehr beschränktem Umfang Möglichkeiten, die Fortpflanzung den geänderten sozialen und kulturellen Lebensbedingungen anzupassen. So wird auch heute noch in vielen Ländern der als ethisch und kulturell unakzeptabel geltende Schwangerschaftsabbruch zur „Familienplanung“ angewandt. Bei täglich ca. 910 000 Konzeptionen, die zu etwa 50% ungeplant und zu 25% ungewollt eintreten, erfolgen täglich weltweit 150 000 Schwangerschaftsabbrüche wegen ungewollter Schwangerschaft. Hiervon enden 500 Abbrüche auch für die Mütter tödlich (WHO 1992). Vergleichende Untersuchungen belegen eindeutig, daß die Zahl der Schwangerschaftsabbrüche in den Ländern am höchsten ist, in denen wirksame kontrazeptive Methoden nicht zur Verfügung stehen (Abb. 20.2). So ist die Schwangerschaftsabbruchrate in den Niederlanden und in Deutschland am geringsten, während sie in den ehemaligen Ostblockstaaten, auf Kuba und in Vietnam am höchsten ist. Das Beispiel Russlands illustriert diese Wechselbeziehung: Unmittelbar vor der Auflösung des alten Sowjetimperiums betrug die legale Abortrate 127/1000 Frauen/Jahr. Mit Fall des eisernen Vorhangs stieg der Verbrauch an modernen Kontrazeptiva rapide und die Abortrate sank auf 68 im Jahre 1996. In den westlichen Industrienationen basieren die niedrigen Geburtenraten und die mehr oder weniger stabilen demographischen Verhältnisse, die für die Prosperität dieser Länder von entscheidender Bedeutung sind, im wesentlichen auf Methoden der Kontrazeption.
Zu den Aufgaben der Andrologäe gehört es, Methoden zur Kontrazeption auf Seiten des Mannes zur Verfügung zu stellen. An die grunds?äzlichen Überlegungen in Kap.1.7 anknüpfend sind derartigeVerfahren sowohl zum Erhalt einer stabilen Bevölkerung in den Industrienationen als auch zur Eindämmung des Bevölkerungswachstums in Entwicklungsländern erforderlich.
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Nieschlag, E., Behre, H.M., Engelmann, U., Schwarzer, U. (2000). Männlicher Beitrag zur Kontrazeption. In: Nieschlag, E., Behre, H.M. (eds) Andrologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-05739-1_20
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