46 with large/multiple fibroids: meds to shrink for lap vs just doing an open hysterectomy?

Hi everyone, I'm looking for some advice and real experiences.

I'm 46, live in Canada, and in 2018, an MRI for an unrelated injury unexpectedly showed I had multiple fibroids, with the largest at 8 cm. I'd never been told I had fibroids before and that came as a huge shock, but I had always had painful, heavy periods so it all made sense.

At the time of diagnosis I was considering my options-- then the pandemic hit and all surgeries were off the table anyway. I then opted to just leave it all alone, but I am now experiencing uterine prolapse and chronic constipation and difficult urination due to the location of the largest fibroid, which appears to be causing pelvic floor issues. I don't have children and don't plan to at this age, so my gyn and I agreed that a hysterectomy makes sense.

Because I have a chronic illness and limited help at home (plus a cat with medical needs), I really want a laparoscopic hysterectomy if possible, since recovery and hospital time would be much shorter. The problem is that my surgeon says the largest fibroid needs to be under 6 cm to do it laparoscopically.

My most recent ultrasound (last week) showed it's now about 7.6 cm. Two years ago it was still 8 cm, so it has shrunk slightly on its own, but not enough.

We talked about trying meds to shrink it:

1. Myfembree, but everything I'm reading says side effects can be rough, and it may not shrink fibroids much.

2. Lupron, it's effective, but I'm scared of the side effects since once you get the shot, you're stuck with them for a month.

I already deal with chronic health issues and don't want to make myself feel worse with meds that might not even work. At the same time, an open abdominal hysterectomy would mean a longer hospital stay and harder recovery, which worries me too.

So I'm stuck and would love input:

• Has Myfembree actually shrunk fibroids for anyone here?
• Was it worth it?
• How was Lupron, if you've tried it?
• For those who've had laparoscopic vs open hysterectomy, how did recovery compare?
• If you were in my position, would you try to shrink it, or just go straight to the open surgery?

I know everyone's experience is different, but I’m feeling pretty torn and overwhelmed. Any insight would be really appreciated. Thanks.