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Symptoms you should look out for is severe pain, fever, diarrhea, or heavy vaginal bleeding. I generally recommend my ladies have a hysterectomy as symptoms worsen with continued growth. We generally expect it to no longer grow and actually shrink after menopause, but if your periods are still regular, menopause is not imminent and it will just continue growing. The larger the uterus is, the more difficult the surgery is. Generally, it is best to perform an operation like this before you have developed any major issues as a consequence--meaning the healthier you are, the faster your recovery will be. Even though fibroids are commonly benign, the problems they cause lead me to recommend hysterectomy--especially when growth is obvious. As far as the risks of keeping it vs the risks of the operation--no one can say you will develop serious complications without having a hysterectomy or with a hysterectomy. Hysterectomy is one of the most common surgeries performed in the U.S. and is commonly performed for fibroids. Most often, it is a major surgery that has no complications. However, the risks of complications increases as the uterus continues to grow. If your discomfort is leading you to consider hysterectomy, I would recommend having surgery now instead of waiting or risking the development of other medical problems that can make your surgery imminent, increase the risk of complications, and negatively impact your recovery.