Large Fibroid: 50-Year-Old Woman Worries About Irregular Menstruation and Subserosal Fibroid

Ans: Subserosal fibroid does not cause much problem except that it can undergo torsion if it has a long stalk. If it is not, not to worry about it

Ans: Kindly check with a Gynec to rule out Endometriosis.
Until then have iron supplementation to help with sustaining the hemoglobin level

Ans: If you are losing a, lot of blood with the menstrual cycle then the RBC counts go down which could be a reason for your high ESR

Hydrate yourself well and take supplement of Iron resourcing through food
You repeat ESR after 2 months after your cycle

Ans: Hello
You are 51 with fibroids, with menorrhagia
Firstly,
1) We Need to get usg 3 D pelvis done with fibroid mapping.
2) Blood test to see for CBC, tsh , prolactin, tsh level
Since you are 51 and if your hemoglobin is maintained and bleeding controlled, we can wait and observe with regular usg monitoring for fibroids
Since you are 51, there are chances of you being in perimenopause and menopause, so there are chances fibroids reduce in size, and you become asymptomatic because post menopause estrogen level drops and fibroids are estrogen dependent.
If wish to go for conservative management:
a) Cyclic Oc pills or continuous Oc pills to create pseudoamennorhoea which will control dysmenorrhea and bleeding
B) Lupron Depot is a synthetic hormone that reduces the body's production of estrogen and progesterone, causing a temporary menopause-like state. This can shrink fibroids, stop menstrual periods, and improve anemia.
Uterine fibroid embolization:
This minimally invasive procedure involves injecting small particles into the uterine artery to block blood flow to the fibroids.
Radiofrequency ablation (RFA):
This treatment uses microwave energy to treat smaller fibroids in people who haven't reached menopause.
Progestin-releasing intrauterine device (IUD)
This option is for women with fibroids that don't distort the uterus. It can reduce heavy bleeding but doesn't treat the fibroids.
But if symptoms like
Heavy periods
Pain
Frequent periods
Drop in hemoglobin
Disturbed quality of life
Then best option will be removal of uterus keeping ovaries intact if ovaries are healthy to maintain hormones.