Is there a link between gynecologic surgeries and Alzheimer disease?

In 2001, an Institute of Medicine report concluded that “being male or female is an important fundamental variable that should be considered when designing and analyzing basic and clinical research.”1 The extent to which gender- and sex-specific factors influence the risk of Alzheimer disease (AD) is a matter of profound importance.2 Sex refers to biological characteristics of men and women such as chromosomal differences (e.g., XX vs XY chromosomes), hormonal differences (e.g., effects of estrogen), or reproductive differences (e.g., pregnancy or breastfeeding). By contrast, gender refers to social, political, and cultural differences (e.g., access to education or to certain jobs). The burden of AD is particularly great in women, and gender-associated differences in educational attainment may explain part of the differences in AD risk. In addition, exposures to gonadal steroids are linked to differences in Alzheimer-related pathology in animal models, although implications for human disease remain controversial.3