Heart disease was once thought to be less of a problem for women than for men. Research now indicates that heart disease is the No. 1 cause of death among women in the US (Centers for Disease Control and Prevention, Heart Disease Facts and Statistics, 2008), while confirming that women with an intact uterus have a lower incidence of heart disease because they benefit from the uterine advantage.

    In his article, "Prostacyclin From The Uterus And Woman's Cardiovascular Advantage," James D. Shelton writes, "Prostacyclin emanating from the uterus is proposed as a major contributor to the reduced risk of coronary disease among women." He refers to the uterus as a "systemically active organ whose removal significantly increases subsequent risk of myocardial infarction" (Prostaglandins Leukotrienes and Medicine, 1982).

    The American Heart Association reports that in 2006 there were 16.8 million cases of coronary heart disease in the US. About one in 18 Americans suffers from heart disease. This number would be much lower, if not for hysterectomy.

    Studies reveal that premenopausal removal of the uterus is associated with a three-times-greater incidence and prevalence of heart disease (Brandon S. Centerwall, "Premenopausal Hysterectomy and Cardiovascular Disease," American Journal of Obstetrics and Gynecology, 1981) and that women who undergo a bilateral oophorectomy (surgical removal of the ovaries, castration) have a 5.5 times greater cardiovascular risk (Jacqueline C.M. Witteman et al, "Increased Risk of Atherosclerosis in Women After The Menopause," British Medical Journal, 1989). Other studies demonstrate that women who are castrated before age 35 are hospitalized for myocardial infarction 7.2 times more often than intact women (Lynn Rosenberg et al, "Early Menopause and the Risk of Myocardial Infarction," American Journal of Obstetrics and Gynecology, 1981).

    Hysterectomy is the most commonly performed non-obstetric surgery in the US, and there is general consensus even among the medical community that a majority of hysterectomies are unnecessary. Hysterectomy rates are subject to variations that do not necessarily correlate with health factors. Statistics from the Centers for Disease Control and Prevention (CDC), for example, tell us that women in the South are 50 percent more likely to be hysterectomized than in the Northeast. And the hysterectomy rate among black women is 20 percent higher than among white women.

    Some researchers and medical writers attempt to explain the higher incidence of hysterectomy and removal of the ovaries in black women by demonstrating that they have a higher incidence of fibroids. As the Hysterectomy Educational Resources and Services (HERS) Foundation makes clear in the online educational video, "Female Anatomy: the Functions of the Female Organs," fibroids are benign growths that rarely cause problems, until a doctor spots them incidentally during a routine exam.

    Although less than 1 percent of fibroids are cancer (William Parker et al, Obstetrics and Gynecology, 1994), fibroids are the leading indication for hysterectomy. But women who are told they need a hysterectomy for fibroids may merely have the wrong doctor. Not surprisingly, not only are black women more likely to be hysterectomized, heart disease is the No. 1 cause of death among black women.

    The CDC's Division for Heart Disease and Stroke Prevention reports that 870,000 people died in 2008 - 2,400 each day - from heart disease. "The cost of heart disease and stroke in the United States," the CDC concluded, "is projected to be more than $448 billion in 2008, including health care expenditures and lost productivity from death and disability." The financial burden and tragedy of heart disease as a result of hysterectomy is largely avoidable.

    According to the US Department of Health and Human Services, one of every three women is hysterectomized before the age of 60, while the American Heart Association reports that nearly one out of every three women dies of heart disease.

    Visitors to the "Go Red For Women" web site are encouraged to tell the American Heart Association "about the choices you've made to improve your well being." Women can avoid the risk of heart disease by retaining their uterine advantage - cardiovascular well-being that depends on the lifelong functions of the uterus.

    Drastically reducing cardiovascular risk, circumventing much of the staggering cost of heart disease charged to Medicaid and Medicare, and avoiding the tragic toll of thousands of strokes and deaths may be achieved by helping women avoid hysterectomy.

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    Nora W. Coffey is president of the Hysterectomy Educational Resources and Services (HERS) Foundation. She has been a guest lecturer at medical schools, nursing schools and conferences, has been interviewed in most major publications, including The New York Times, Wall Street Journal, USA Today, New York Magazine, Vogue and Harpers, and has appeared on numerous television and radio shows, including 20/20, Oprah Winfrey, National Public Radio's Fresh Air, and The Today Show. Her most recent article,"Paying For the Bailout: How Unnecessary Medical Procedures are Taxing the System," was published in The Women's International Perspective, February 4, 2009.

    An international nonprofit organization, HERS was established in 1982 to meet the need for accurate information about alternatives to and consequences of hysterectomy by addressing the multiplicity of physical, social, economic and political issues surrounding the surgery. HERS is the only independent organization solely dedicated to the issue of hysterectomy, and it has counseled over 850,000 women, while providing information to millions more throughout the world. Ninety-eight percent of the women HERS has referred to board-certified gynecologists after being told they needed hysterectomies discovered that, in fact, they did not need surgery.