Re: Perimenopause and constant bleeding
Before considering an ablation, look into having a D & C procedure (dilation and curettage). This sometimes takes care of the problem. If this does not work, then you can consider the Novasure technique.
I assume that the bleeding is not coming from uterine fibroids, right ? Oftentimes fibroids are the cause of heavy bleeding and these can be taken care of either through surgical removal or through starving off their blood supply (a day procedure which does not require general anaesthesia).
You do have other choices besides a hysterectomy and your doctor should be discussing these with you before recommending such a radical procedure. Oh and by the way, the Mirena IUD, as far as I know, releases hormones, just like the birth control pill so you may not do so well on this either (you said that your body does not tolerate hormones well).
Hang in there and I am sure that you will find a solution to this problem soon.
All the best.