Presence of a fibroid
itself is not risky at all. It is present in many women and they even don't notice unless they were told after an ultrasound
examination is done for any reason. The incidence of it being malignant or converting to malignancy is very rare.
But in some cases, the fibroid may cause troubles which necessitate treatment such as: pain, bleeding, infertility
or reaching a large size causing cosmetic disfigurement.
In this case the fibroid is causing bleeding, also it's size is apparently big so I think it should be treated.
There are many modalities of treatment, I recommend one of these according to feasibility.
1- Insertion of a progesterone
medicated intrauterine device: it will help reduce bleeding, pain and even the size of the fibroid, but it is not suitable if you are willing to get pregnant.
2- Ultrasound guided embolization of the feeding vessel: success not guaranteed and needs well trained and experienced personelle.
3- Surgical removal may be the best option if the bleeding is heavy. It has the advantage of obtaining a specimen for histopathological examination in order to confirm the diagnosis.
It is very important to mention that before doing any of these solutions, you should have a sample from your endometrium and examine to exclude a hidden carcinoma.
I hope these words were usefull to you. Good luck.
Dr. Ahmed Bahaa.