Why might one require a total hysterectomy?

Misnomer: "total hysterectomy" in the past used to mean ovaries and uterus. Typically a strong family history of personal history of estrogen dependent cancers would be a reason to take out uterus/tubes/ovaries. Total hysterectomy now typically means uterus. Some women have hysterectomies because of pain, bleeding and fibroids, and pre-cancer or cancerous lesions.