Hysterectomy or no? AUB with no clear cause

Hi, I'm 40, and am wondering if I should take my (brand new) gyn's somewhat offhand recommendation for a hyster seriously.

History:
Period were always fairly long (6-7 days) from start, but not at all heavy, and super regular 28 days. After my 2nd child I got Mirena IUD, and my body DID NOT like it -- gave my migraines daily by the time I figured out what was causing them (used to get 1-2 a year). Had it in for 4 months, then replaced it with the copper IUD instead. Had absurdly heavy bleeding -- super tampon + pad in an hour. Discovered my thyroid had crapped out, suspected Hashimoto's, got on thyroid. Discovered my iron & Vitamin D were low, got those up. No change. Got the IUD out after 10 months, couldn't take the bleeding any more, only to discover it was not the IUD causing the bleeding. Had another baby, some time off from periods during pregnancy and breastfeeding, but after that my periods continued to get worse, with increasing flooding. Also started to get irregular, often with a "short month-long month" pattern but not always consistent, periods coming anywhere from 22-30 days. 2 years ago finally got an ablation via cryo, but never had great results. I no longer flood, but I am still bleeding 7-10 days with 2-4 of them being "super tampon lasts less than 4 hours" heavy and even what I consider "spotting" days now being similar to my "heavy" flow pre-children. The last 3-4 years I have also gotten increasingly irregular, with shorter cycles being more often, sometimes as short as 16 days (even after 10 days bleeding from the cycle before!). The last few months, have started having night sweats. Iron was good at last check 9 months ago, thyroid has been stable with supplementation for a few years.

Changed insurance, saw new doc. She was somewhat dismissive. I am not supposed to take hormones given the migraine with aura and poor response to even the (supposedly!) localized progestins in Mirena. Said a repeat (this time thermal) ablation was unlikely to make much difference, but we could try. Felt it was unlikely that menopause was approaching anytime soon given my age. Suggested I try ibuprofen for a few days before and a few days into my period to reduce bleeding. Said only alternative was hysterectomy but didn't really talk to me about what that would entail.

Questions:
1. What could be causing this heavy bleeding? Ultrasound 2 years ago showed nothing abnormal, no fibroids, no polyps. Standard bloodwork shows no issues. Doc perked up when I indicated that I never clot, just flood, but felt a bleeding disorder was unlikely after 3 births with no issues. I have no pain, just mild cramping and some heaviness.
2. Am I nuts to consider a hyster given that I am not in pain and these issues are more "significant inconvenience" than "huge barrier to life"? If I knew I would have menopause in 2 years I'd suffer through, but it could be 10+ years. I am afraid that the unknown issues potentially caused by hyst would be worse than what I am dealing with now. I am assuming a LSH or possibly vaginal, not sure if cervix would be taken or not, would definitely try to keep ovaries.
3. Should the doc be doing more to do diagnostics before offering major surgery? At least check my hormone levels and maybe another ultrasound given its been a few years?
4. Are there other treatments that I should have been offered first? Tranexamic acid, say? Or would that also be contradindicated with my issues with hormones?
5. The risks of taking estrogen containing hormones means a doubled stroke risk given my migraine with aura. However, that is still a tiny percentage chance. Is the risk of surgery worse than trying that? I took the pill in college with a first generation progestin and did not have an increase in migraine -- would that be a reasonable risk to try, in an effort to avoid surgery?

I am really wavering on this decision. I feel somewhat pushed for time because I have already mostly met my deductible for this year, so if I do the surgery before Dec 31 it will save me a lot of money, which is important since I am a full time student and single parent, so not a lot of income. I would also need to do the surgery just before Christmas or wait till summer for recovery time. Any thoughts from you smart ladies?