In an age when so many once private topics are out in the open, many women are still very reluctant to talk about hysterectomies, perhaps because of the potential emotional implications of losing the womb, the organ that in some ways defines feminine identity. But it is a surprisingly common operation. By the time they reach age 60, nearly a third of all American women will have had their uteruses removed, making hysterectomy the second most frequently performed major surgical procedure (after Caesareans) for women of reproductive age.

Although it's commonly thought of as an operation for older women, the average age of women getting hysterectomies is actually 42, which means that many younger women have the procedure. That can be particularly devastating if they haven't yet had but want children. In the past, doctors have been divided over whether to also remove a woman's ovaries if she hasn't reached menopause, especially if the reason for the hysterectomy is endometrial cancer that is confined to the inside of the uterus.

But two recent studies indicate that there are good reasons to keep the ovaries. A study published earlier this month by researchers at Columbia University College of Physicians and Surgeons found similar five-year survival rates in 402 women age 45 and younger with stage one endometrial cancer whose ovaries were preserved and 3,269 similar women whose ovaries were removed.

Keeping the ovaries may have long-term health benefits as well. Until women reach natural menopause (the average age is 51), estrogen produced by the ovaries protects against heart disease and thinning bones. A 2007 study also found that women who have their ovaries removed before menopause are at increased risk of developing dementia and other memory problems.

Nearly 600,000 hysterectomies are performed annually in the United States, according to the Centers for Disease Control (CDC), a rate that is down from a peak of 740,000 in 1975. The U.S. still has one of world's highest hysterectomy rates, however, and in recent years, major medical organizations have worked hard to educate both doctors and patients on alternatives to surgery, as well as ways to minimize the surgery's long-term effects.

A total hysterectomy means that the uterus and cervix are removed. In a partial hysterectomy, only the portion of the uterus above the cervix is taken out. In both cases, the ovaries and fallopian tubes may or may not remain. Some doctors believe that saving the cervix reduces the risk of future sexual or urinary problems, but recent studies suggest that's not the case. Still, the issue remains somewhat controversial.

Besides cancer, other problems that can lead to hysterectomies include fibroids, benign growths in the uterus that can cause pain and heavy bleeding; endometriosis, a condition in which the tissue lining the inside of the uterus grows outside on the ovaries or other organs in the abdominal cavity; and uterine prolapse, when the uterus moves down into the vagina.