This does happen during peri menopause, you can go for months with nothing and I would imagine the lining becomes very thick, then you have the period from hell with clots like lumps of liver then spotting for a couple of weeks while your hormones try to do what they used to do! The remedy years ago was a D&C under GA where the lining was scraped away. I had this a couple of times and it usually gave me a couple of years of reasonable periods. Progesterone or the mini pill would be a better option now or the coil if you don't want to bother with a daily pill. Usually this stops the periods all together eventually as the lining thins and you can continue with this until you're through menopause.
I've had a hysteroscopy without anaesthetic and it was uncomfortable as in a bad period pain but the procedure wasn't long. However, I did nearly faint afterwards, not through pain but this can happen when the cervix is opened anyway even with anesthetic. Just don't get up too quick after the procedure.