Weighing options: hysterectomy or no?

Hi all. I've always had pretty even moods around my periods up until I needed to remove an ovary due to a large tumor (wound up being a borderline tumor, which has a chance at turning malignant). So now, I have PMDD. I'd been taking continuous birth control to handle both my PMDD and my ADHD and was surprised when my gynecologist prescribed me a combined pill despite knowing I have migraine with aura. I figured she knew what she was doing, so here I am a year later with even moods, but more frequent migraines. On top of that, I still have to have my period every couple of months because I have extremely heavy flows.

I've recently talked to my PCP about my migraines, and she had me see another gynecologist who said that she would not have prescribed me a combined pill. Instead, she recommended either an IUD or a hysterectomy (with emphasis on hysterectomy). Unfortunately, she was leaving the practice and referred me to another gyno. This new gyno is amazing, but she is also strongly recommending a complete hysterectomy and oophrectomy of my remaining ovary. These are her reasons:

*History of borderline tumor on one ovary (a large tumor despite my young age, 32 at the time, 35 now)

*Borderline tumors can reappear on the other ovary and if I don't get this ovary removed, I'll need yearly exams or ultrasounds

*I have fibroids that cause extremely painful cramps (one fibroid is actually pressed against my colon and I have "period cramps" whenever a bowel movement moves by it, so basically daily cramps)

*I am not having kids

*I have a history of extremely heavy periods (I have a bleeding disorder and need to change super tampons every 1-2 hours, same with cups)

*I can't be on synthetic estrogen because of my migraine with aura, so that excludes all estrogen-inclusive birth control

*IUDs aren't as great for PMDD and ADHD since the hormones stick around the uterus

*I can have HRT if everything is removed because it uses a bio estrogen that is safe to use with migraine with aura

*I have some indication that I may have endo, so she would also search for and treat that during surgery

I guess I'm just worried about undertaking another major surgery that has permanent ramifications. For those of you with a complete hysterectomy and oophrectomy pre-menopause, how has it worked out for you? What should I be taking into account, including prolapse risk, osteoporosis, brain health, etc?