Does my sister need to get her uterus removed?

Q: My sister-in-law, aged 48, has a fibroid in her uterus measuring 3 cm x 4 cm. She is under menopause but does not have a heavy flow. She has normal bleeding for a day and a half and there is no white discharge or any pain. But, if the doctor examines her abdomen by pressing the lower abdomen, she has a little pain. Is it necessary to have her uterus removed on an emergency basis or she can wait for some time. Can she lead a normal life with this size of the fibroid in her uterus?

A:The fibroid is causing problem while pressing. Though she is close to her menopause, I would recommend hysterectomy. Reason is she will require some hormone replacement therapy for first few years after menopause, and the fibroid can grow again while on HRT. I suggest an endometrial aspiration biopsy be done. If that does not show any abnormal pathology she can wait for few months to get herself operated.