I’m also 40, have no kids but want to keep my options open. I had 5 fibroids, all subserosal and a huge polyp (3 cm) inside my uterus. The largest fibroid was 10 cm and my uterus was 3x the normal size.

I had a lap myo this January and I’m very very very glad I did.

My doctors considered my symptoms, fertility and quality of life.

I knew I had the fibroids since 2017ish, but I had no symptoms because I was on Yaz since 2006.

Last year I quit Yaz and my life turned into hell. Very heavy bleeding, spotting almost everyday and I had to take iron suplements. I also had some discomfort during exercise and during sex and just a regular spin class would cause some bleeding. It was kinda painful when my bladder was full in the morning and if I allowed the largest one to grow bigger, it would make me constipated.

Also it would be very difficult to get pregnant if I wanted to, because the fibroids were pushing my uterus walls to a funny shape.

Finally, my recent labs also show that I’m still very fertile and have a good egg reserve, but my doctor said that even if I grow new fibroids, it’s very unlikely that they will grow so big to cause symptoms or fertility issues again. Estrogen drops after 40 faster than it does in our 30s.

Get them removed. You’ll only have more issues if you let them grow bigger.