I had my tubes tied at 30 (I took after my parents, didn't want kids). I started getting hot flashes from about age 35 onward. I don't think that's particularly abnormal actually, the hormones start to decline around that age, faster for some than others. Anyone taking birth control pills will be insulated from their actual cycles, so if and when you do get the tubes tied and get off the pill, you may be in for a menstrual surprise. I sure was.

I can't tell you how joyful I felt (sarcasm) to be experiencing mind-frying, stomach-hurling, gut-clenching cramps, with the added bonus of hot flashes all at the same time. Doc finally put me back on birth control pills at age 45 (!) which helped a bunch -- I no longer needed Vicodin for cramps not that it really helped much, and as long as I took a Pill every single day with no break, and never ever missed a pill by more than half a day, EVER, I didn't need adult diapers to cope with the flow either, which was nice, and I was no longer too anemic for the local blood bank.

I am now 54 and 1 year post-hysterectomy, got the job done during my Last Period Ever!!! Yay!!!. Path report said adenomyosis which accounts for the monthly labor pains to pass the clots and the Exodus-plague-level bleeding. I take 1/4 of a 1 mg estrace pill daily and still get the occasional hot flash, but they really don't bother me much any more.