Nezam El-Tayebat Fact CheckA scientific assessment of the “نظام الطيبات” nutrition system
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Mostly true True only under certain conditions Certainty of evidence: low provisional C-ORG-11

Oophorectomy before menopause raises the risk of cognitive impairment or dementia (HR 1.46), more so the younger the age at surgery (Rocca 2007).

In short: Mostly correct with a condition: the cited Rocca 2007 result is reported accurately, and dementia risk appears higher mainly when both ovaries are removed at about 45 or younger; pooled studies across all ages do not show a clear increase.
Conclusion: Association correctly reported and consistent.
  1. Original statement
  2. Scientific assessment
  3. Scientific evidence in detail
  4. In plain language
  5. Studies on this claim
  6. Regional context
  7. What applies in my country?
  8. References

Original statement

وروكا (Neurology 2007) ربط استئصال المبيضين قبل سن اليأس بزيادة خطر الخرف (HR 1.46).

verbatim according to source. Translation by the project; the Arabic wording is authoritative.

Translation

Oophorectomy before menopause raises the risk of cognitive impairment or dementia (HR 1.46), more so the younger the age at surgery (Rocca 2007).

Origin

Source status
Archive editors
Attribution
Archive editors (eltayebat.com); not necessarily Elawady's own words
Origin
https://eltayebat.com/rule/unnecessary-organ-removal/
Attribution uncertainty
Editorial summary/narrative and study selection written by the archive operators; the archive states that the cited research documents harm independently of Dr. Diaa's words.
Claimed mechanism

Loss of estrogen neuroprotection.

Claimed health effect

Dementia.

Population concerned

Premenopausal women

Geographic restriction by Elawady

not applicable

Scientific assessment

Mostly true – Correct at its core, but with limitations or minor inaccuracies.

Certainty of evidence: low – Further research is likely to change the assessment considerably.

1. What was claimed?

Premenopausal oophorectomy linked to dementia.

2. What is demonstrably correct?

HR 1.46 (1.13-1.90), with age gradient (A-ORG-14). A meta-analysis gives dementia HR 1.70 (1.07-2.69) for BSO before 45 (I-ORG-10), but this is based on two Mayo Clinic cohorts from the same group as Rocca 2007, is graded very low certainty, and the unstratified estimate was not significant (HR 1.36, 0.99-1.85); it is not an independent confirmation.

3. What is wrong or exaggerated?

Nothing substantial in the reporting; causality is not proven and the meta-analytic support is not independent of the original cohort.

4. What remains unclear?

Causality; role of estrogen therapy.

5. Which studies support it?

A-ORG-14; I-ORG-10 (partly, not independent).

6. Which studies contradict it?

None.

7. What applies to Germany and Europe?

Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).

8. What is known about Egypt?

No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.

9. What practical conclusion is appropriate?

A consideration when deciding about removing healthy ovaries before menopause.

Assessment details

Rationale for certainty of evidence

One population-based cohort shows the association; the meta-analysis (I-ORG-10) relies on cohorts from the same group, is graded very low certainty and is non-significant when unstratified; observational.

Source quality

Correctly reported.

Regional transferability

US data; applicable.

Individual exceptions

Effect may be reduced by estrogen therapy (A-ORG-15 for multimorbidity).

Regional scope of the claim
general (biological/medical)
Last reviewed
26 October 2026 provisional

Scientific evidence in detail

True only under certain conditions – The claim holds only for certain doses, groups of people, preparations or circumstances.

Research question: Does oophorectomy before menopause increase the risk of cognitive impairment or dementia, more so at younger ages (Rocca 2007, HR 1.46)?

Research question in detail (PECO)
Population
Women with premenopausal bilateral or unilateral oophorectomy
Intervention or exposure
Oophorectomy before menopause
Comparison
Women without oophorectomy
Geographic scope
universal biology
Outcomes
  • Dementia
  • Cognitive impairment
  • Cognitive decline

Study results as reported by the authors. Our assessment follows below.

What speaks for the claim?

What speaks against the claim?

What does the overall evidence say?

Editorial assessment based on the studies above – not itself a study result.

Which position is better supported?

Rocca 2007 is correctly reported; the association is consistent mainly for early surgical menopause (<= 45 years), while analyses across all ages are null.

Why some studies weigh more

Age-specific evidence is most relevant to the claim, which concerns premenopausal surgery and an age gradient.

Is a causal relationship established? Possible, not established Plausible estrogen mechanism, age gradient; observational and inconsistent.

Remaining uncertainty

Role of estrogen therapy; replication.

Justified conclusion

Supported with conditions (early surgery), low certainty.

Why do studies seem to disagree?

Fu 2026 pooled bilateral oophorectomy across ages (often postmenopausal), whereas Georgakis 2019 and Rocca 2007 isolate early premenopausal surgery; they answer different questions.

Does this depend on the country?
General biological effects
Universal.
Eating habits
Not relevant to this claim.
Origin of the food
Not applicable.
Contaminants
Not applicable.
National production conditions
Not applicable.
Legal rules
Not applicable.
Actual monitoring data
No Egypt-specific monitoring data identified.

A regional difference that changes the conclusion is not supported by robust data.

Statistical re-check
  • CI symmetry and significance – Early menopause HR 1.70 significant; any-age HR 1.16 not recalculated
  • Does the CI support the authors' 'associated' wording? – aRR CI 0.89-1.56 includes 1: wording overstates recalculated
Certainty of the overall evidence (GRADE, simplified)
Main outcome
Dementia after early surgical menopause
Starting level
low (observational studies)
Reasons for downgrading
  • inconsistency
  • imprecision
Reasons for upgrading
  • dose-response (age at surgery)
Result
low

Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.

Clinical guidelines and official statements checked
  • ACOG: Committee Opinion No. 774: Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention (reaffirmed 2024) (2019) · Original publication
    BSO causing surgical menopause reduces ovarian cancer risk but may increase the risk of cardiovascular disease, other cancers, osteoporosis, cognitive impairment and all-cause mortality; counselling should include oophorectomy (I-ORG-142).
Search strategy

Documented literature searches for this review (search strings in the original database syntax).

DatabaseDateSearchLooking forHitsIncluded
Europe PMC26 October 2026(TITLE:"surgical menopause" OR TITLE:oophorectomy) AND (TITLE:dementia OR TITLE:cognitive OR TITLE:"cognitive decline" OR TITLE:"Alzheimer") AND (TITLE:"meta-analysis" OR TITLE:"systematic review" OR cohort OR "UK Biobank")both directions18

Open questions

Age-stratified pooled analyses.

How deeply was this checked?

6 linked studies: 1 checked in full text (1 of them with a structured risk-of-bias assessment), 5 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.

Last scientific review: 26 October 2026

History of the verdict
  1. 25 October 2026 · Phase 1 · Initial assessment: Mostly true (low)
  2. 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: Mostly true (low)
    Unchanged (“Mostly true”, low). The new null meta-analysis does not stratify by early premenopausal surgery and therefore does not overturn the age-specific evidence; certainty stays low.
    New sources: I-ORG-138 I-ORG-142 I-ORG-139 I-ORG-140

In plain language

The archive says that removing the ovaries before menopause increases the risk of dementia. A US study found a 46% higher risk of memory problems or dementia, higher with younger age at surgery, and a later meta-analysis found similar results. These are associations from observational studies, but they are consistent.

Studies on this claim

Studies supporting the claim (3)

  • Ovary removal before menopause and dementia

    Rocca WA et al.. Neurology 2007 · PMID 17761551 · DOI 10.1212/01.wnl.0000276984.19542.e6
    Cohort studycited by the Tayebat archiveabstract checked★ key study

    Women who had ovaries removed before menopause had 46% higher risk of cognitive impairment or dementia later.

    Oophorectomy before menopause raises the risk of cognitive impairment or dementia (HR 1.46), more so the younger the age at surgery (Rocca 2

    Does the study support the specific claim? Yes · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Dementia

    How was the study done?

    Cohort

    How many people, animals or samples were studied?

    2961

    What was actually found?

    Higher risk

    How large was the observed effect?

    HR 1.46

    What do the results mean in everyday life?

    Possible brain cost of early ovary removal

    What are the study's limitations?

    Observational

    What does it say about Elawady's specific claim?

    Supports association

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Causation

    Scientific details →

  • Early surgical menopause and dementia

    Georgakis MK et al.. Psychoneuroendocrinology 2019 · PMID 30928686 · DOI 10.1016/j.psyneuen.2019.03.013
    Meta-analysisindependent cross-checkabstract checked★ key study

    Removing both ovaries at 45 or younger was linked to a higher risk of dementia; surgery at any age was not clearly linked.

    Early surgical menopause (<= 45) HR 1.70; no association at any age.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Pool studies on surgical menopause and cognition

    How was the study done?

    Systematic review and meta-analysis

    How many people, animals or samples were studied?

    11 studies, 18,867 women

    What was actually found?

    Higher dementia risk only with surgery at <= 45

    How large was the observed effect?

    HR 1.70 (1.07-2.69)

    What do the results mean in everyday life?

    Age at surgery matters

    What are the study's limitations?

    Only 2 studies for main estimate

    What does it say about Elawady's specific claim?

    Supports the claim's age condition

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Cannot prove causation

    Scientific details →

  • US gynaecologists on removing ovaries

    American College of Obstetricians and Gynecologists (ACOG). ACOG Committee Opinion 2019
    Guideline / position statementindependent cross-checkabstract checked

    Removing both ovaries before menopause may raise risks of heart disease, bone loss, memory problems and death, so it should be discussed carefully.

    ACOG lists possible increase in cognitive impairment after surgical menopause.

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Guide salpingectomy and oophorectomy counselling

    How was the study done?

    Committee opinion

    How many people, animals or samples were studied?

    n/a

    What was actually found?

    BSO may increase several long-term risks

    How large was the observed effect?

    n/a

    What do the results mean in everyday life?

    Keeping healthy ovaries is often preferred before menopause

    What are the study's limitations?

    Only abstract read

    What does it say about Elawady's specific claim?

    Supports the direction of the claim

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Not quantitative

    Scientific details →

Studies contradicting or limiting the claim (1)

  • Gynaecological surgery and dementia: newest pooled analysis

    Fu X et al.. J Clin Med 2026 · PMID 42796018 · DOI 10.3390/jcm15187247
    Meta-analysisindependent cross-checkabstract checked

    Across all ages, removing the uterus or ovaries was not clearly linked to dementia.

    No clear association across ages; the claim's age-specific effect is not tested here.

    Does the study support the specific claim? No · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Pool procedure-specific dementia data

    How was the study done?

    Meta-analysis

    How many people, animals or samples were studied?

    Nearly 2.7 million women

    What was actually found?

    No clear associations

    How large was the observed effect?

    BO alone 0.99 (0.88-1.12)

    What do the results mean in everyday life?

    Any risk is probably confined to early surgery, if real

    What are the study's limitations?

    High heterogeneity

    What does it say about Elawady's specific claim?

    Limits the claim

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Cannot address oophorectomy before 45 specifically

    Scientific details →

Studies with mixed or unclear results (2)

  • Meta-analysis: removing ovaries at hysterectomy

    Hassan H et al.. Am J Obstet Gynecol 2024 · PMID 37364803 · DOI 10.1016/j.ajog.2023.06.043
    Meta-analysisindependent cross-checkfull text, structured risk-of-bias assessment★ key study

    Linked to less breast cancer but more heart disease, dementia and other conditions in younger women; effect on death was inconsistent.

    Oophorectomy before menopause raises the risk of cognitive impairment or dementia (HR 1.46), more so the younger the age at surgery (Rocca 2

    Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    BSO outcomes

    How was the study done?

    Meta-analysis

    How many people, animals or samples were studied?

    n/a

    What was actually found?

    Trade-offs

    How large was the observed effect?

    CVD HR 1.18; dementia HR 1.70

    What do the results mean in everyday life?

    Removing healthy ovaries in young women has costs and some benefits

    What are the study's limitations?

    Observational studies, few per outcome, fixed-effect pooling, no study-level risk-of-bias assessment

    What does it say about Elawady's specific claim?

    Supports risks; mortality unclear

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Causation; harm after age 50; absolute risk

    Scientific details →

  • Ovary removal and dementia in Danish nurses

    Uldbjerg CS et al.. Menopause 2022 · PMID 35102101 · DOI 10.1097/GME.0000000000001943
    Cohort studyindependent cross-checkabstract checked

    Nurses who had both ovaries removed had a slightly higher dementia rate, but the result could be due to chance.

    aRR 1.18 (0.89-1.56): direction consistent, not statistically significant.

    Does the study support the specific claim? Unclear · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim

    Original publication · Scientific details

    Study explained simply
    What did the researchers want to find out?

    Test oophorectomy and dementia

    How was the study done?

    Prospective cohort

    How many people, animals or samples were studied?

    24,851 nurses

    What was actually found?

    aRR 1.18, not significant

    How large was the observed effect?

    aRR 1.18 (0.89-1.56)

    What do the results mean in everyday life?

    Possible small risk, not proven

    What are the study's limitations?

    Limited power

    What does it say about Elawady's specific claim?

    Inconclusive for the claim

    Do the results apply to Germany and Europe?

    Applicable

    What can explicitly not be concluded from this study?

    Cannot confirm or exclude an effect

    Scientific details →

Regional context

Germany / EU

Most cited cohorts are Scandinavian (Denmark, Sweden) and directly European; RCTs from the UK and Finland are directly transferable. Guidelines in Europe also emphasize defined indications (not verified here in detail).

Egypt

No Egypt-specific data on rates or outcomes of tonsillectomy, cholecystectomy, hysterectomy, splenectomy or thyroid surgery were identified in this review.

What applies in my country?

General scientific assessment

Mostly true Association correctly reported and consistent.

This statement concerns biological or medical relationships. The scientific assessment above applies regardless of the country; country-specific food data do not change it.

References

  1. Increased risk of cognitive impairment or dementia in women who underwent oophorectomy before menopause.. Rocca WA et al.. Neurology 2007 · PMID 17761551 · DOI 10.1212/01.wnl.0000276984.19542.e6
  2. Surgical menopause in association with cognitive function and risk of dementia: A systematic review and meta-analysis.. Georgakis MK et al.. Psychoneuroendocrinology 2019 · PMID 30928686 · DOI 10.1016/j.psyneuen.2019.03.013
  3. Opportunistic Salpingectomy as a Strategy for Epithelial Ovarian Cancer Prevention (ACOG Committee Opinion No. 774; reaffirmed 2024). American College of Obstetricians and Gynecologists (ACOG). ACOG Committee Opinion 2019
  4. Associations of Hysterectomy and Oophorectomy with Dementia Risk: A Systematic Review and Meta-Analysis of Observational Studies.. Fu X et al.. J Clin Med 2026 · PMID 42796018 · DOI 10.3390/jcm15187247
  5. Long-term outcomes of hysterectomy with bilateral salpingo-oophorectomy: a systematic review and meta-analysis.. Hassan H et al.. Am J Obstet Gynecol 2024 · PMID 37364803 · DOI 10.1016/j.ajog.2023.06.043
  6. Oophorectomy and rate of dementia: a prospective cohort study.. Uldbjerg CS et al.. Menopause 2022 · PMID 35102101 · DOI 10.1097/GME.0000000000001943

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