I am 55 & have had dysmenorrea for about 6 yrs, have had 2 d & c's, and am on norethindrone and prempro (conjugated estrogens and medroxyprogesterone). when would a hysterectomy be indicated?

Meds working?: If the hormonal treatment is working-no surgery necessary. However, at 55, menopause should be happening soon. Do you have periods off the hormones? Certainly, hysterectomy could be a option if meds are not working or considering risk/benefits. Talk to doctor.

Maybe, but Options: 1st would you be open to a trial off hormones? Since the estrogen grows the inner uterine lining that often creates the period and cramps. While not as effective as estrogen, there are other medications for relief of menopausal symptoms. Otherwise if your pain is debilitating then a hysterectomy should work. If you proceed find a gynecologist who can do it either vaginally or laparoscopically.