Hysterectomy at 35, Alzheimer’s at 60
Removing the uterus without hormonal replacement is no minor detail.
The early loss of estrogen is not just a reproductive matter: it is a direct blow to the female brain. Clinical evidence shows that hormones, especially estrogens, play a fundamental neuroprotective role.
When menopause occurs surgically—whether through hysterectomy with or without oophorectomy—the risk of cognitive decline and dementia rises significantly. The younger the patient at the time of surgery, the greater the impact.
Several studies have documented this: oophorectomy before natural menopause increases the risk of cognitive decline and dementia by more than 40%. A meta-analysis including nearly 19,000 women showed that surgical menopause before the age of 45 is associated with a 70% higher risk of dementia. Neuroimaging studies also demonstrate that early removal of the ovaries reduces the integrity of white matter in the brain, a marker linked to poorer cognitive performance.
Even when only one ovary is removed, the risk still increases. The remaining ovary may continue to produce some hormones, but it does not fully compensate for the loss. Each ovary represents a crucial reserve of protection against brain aging.
The surgical removal of reproductive organs without proper hormonal strategy accelerates aging and increases the risk not only of dementia, but also of osteoporosis and cardiovascular disease—two conditions strongly linked to the abrupt decline in estrogen levels.
Hormone replacement therapy plays a critical role here: maintaining adequate estrogen levels at least until the natural age of menopause (~50 years) can mitigate or even neutralize this excess risk. Conversely, starting therapy too late does not provide the same protection.
A hysterectomy at 35 can mean Alzheimer’s at 60.
The premature loss of estrogen has profound consequences for the brain, the bones, and the heart.
Today we know that Alzheimer’s is not an irreversible sentence: it can be improved or even reversed with the right hormonal supplementation and a healthy lifestyle.
For this reason, it is essential in current medical practice to protect organs and avoid unnecessary removal, understanding that each surgery carries a significant long-term risk.
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