49yo, submucosal and subserosal fibroids/ovarian cyst

I started spotting between periods over 2 years ago and my doctor assumed I'd started perimenopause. The bleeding/cramping/pain got worse over time to where I bleed many days out of the month with a main period lasting about 10 days. The heaviest part used to last 1 day and now it lasts 4 or 5 days with much gushing and clots. I have GI issues from food intolerances, but I think some of those symptoms might be from my gyn issues. Bloating, cramping, gassy, intermittent pain in lower abdomen (thought it was gas), heavy feeling (like bowling ball). I have one fibroid completely within the uterus, the other 2 are subserosal, ranging from 3 to 5 cm. One ovarian cyst less than 3 cm (I think I can feel this hurting from front to back at times-thought it was gas).
My doctor would like to do a vaginal resection of the submucosal fibroid and then use Lupron if the other fibroids are still bothering me. I will have a followup US in 2 mo to check on the cyst. He thinks I'm close to menopause, although my mom didn't start perimenopause until she was 52-53. I have never skipped a period and have no other symptoms of menopause.
1. I don't like the thought of Lupron, especially since it won't help long term.
2. If I have the hysteroscopic myomectomy and then still have problems, will I be looking at a possible 2nd surgery?
3. Has anyone else dealt with these two types of fibroids at this age?
4. Any suggestions/comments/things to ask the doctor?
5. I'm leaning toward doing the HSM, but not the Lupron, and taking my chances with the cyst and other fibroids. I do think my doctor will want me to tough it out until menopause, but if I'm still in pain and still having bloating issues I'd almost rather just have a partial hysterectomy instead of risking 10 more years of this stuff.
Thanks for all your advice/sharing experiences/etc!

Hi Hockey28, I'm also 49, had TAH vertical incision due to multiple very large fibroids which enlarged and elevated my uterus. Kept both ovaries, tubes and cervix removed. I was hoping to hold out till menopause, but the women in my family menopause late. The fibroids grew more rapidly in the last couple of years. My periods were regular, but very heavy.
Two gynos suggested Lupron, but there was no way I was risk my body with unknown longer term side effects, for only a possibility of shrinking the fibroids. For me, the purpose would have been to avoid a vertical incision.
My third, oncology gyno agreed with me on the Lupron. I'm not sure I understand the purpose of Lupron in your case?

Fibroids do grow back, but if I had the option of a myoectomy, I would have seriously considered it. My fibroids were too large and numerous.
I was not in pain, except during my periods, which is probably the reason I waited so long. But I am so incredibly glad I did it.

My understanding is that he thinks the Lupron will shrink the fibroids long enough to get me to menopause, but I think that's quite a gamble considering I have no perimenopause symptoms and Lupron should only be given for 3 months. And like you, I don't want to take something with long term side effects.
I'm still leaning toward a hysteroscopic myomectomy the submucosal fibroid, and then seeing how I feel and watching the cyst. If the cyst doesn't go away, I'd prefer he just remove it along with the other two fibroids. I'd get to keep everything and maybe the fibroids won't grow back before I hit menopause.

Sounds like you have a good plan, if your doctor agrees.
Gynos suggest Lupron like it's aspirin. That really bothers me.
Btw, I had fibroids everywhere, submucosal, subserosal, all over the place.
Good luck to you, hope it all works out well.