### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, I was having lower abdominal pains since long time. I have gone to my GP as I knew that in 2 years before ultrasound of Pelvis they found 3 fibroids in my uterus but they very small in size. Now I started being very lethargic in past few months. The doctor has done my blood tests and found my iron levels down which was decreasing every month. I had extreme painful periods and very heavy bleeding. I asked my doctors for another pelvis ultrasound and the final results are:Uterus is anteverted with a volume of 255ccwith at least 5 fibroids up to 36mm in diameter including sub mucosal fibroids. Endometrial thickness is 16mm and is distorted due to fibroids. Ovarian volumes are 8.5cc on the right and 14cc on the left.Blood results:Iron 6 unfolded/LTRF 4.1 HTRF. SAT. 6 LFerritin 8 LI am 35 and has no. Kids.Please reply. Thanks in advance.

### output:

HelloThanks for writing to us. You are having severe anemia due to extremely heavy menstrual bleeding (hemorrhagic)This is due to the uterine fibroid, which are multiple, and are submucosal, hence disrupting the lining of the uterus. Frankly speaking in my opinion, the best option for you is to go for surgical mastectomy (removal of the fibroid) surgically. As the fibroid are many and scattered all over, you do run the unfortunate risk of the need for hysterectomy (removal of the uterus). Before surgery, you would need blood transfusions to stabilize your hemoglobin levels. All the best.