Hello
Thanks for writing to DoctorSpring.com with your health concern.

See , even if you are asymptomatic , the fibroid of the specified dimensions mandates removal. It is not going to regress on its own.

Now, the complicating factor is the term - sarcomatous degeneration. Fibroids can undergo lots of internal changes - vascularization, degneration, cystic changes etc. Sarcomatous changes are those that are suggestive of a malignancy - these are very rare, only 1 in 1000.

Your sonogram is suggestive of that, not diagnostic.
The only confirmatory proof would be removal of the said fibroid and then a formal histopathology ( biopsy ) which would tell you for sure if malignant changes had set in.

There is nothing to worry about, since in any case, the fibroid would be removed by then. So please plan for surgical removal.

All the best. Would be glad to answer any follow-ups.
Take care.

Yes, fibroids can shrink with menopause, but not one of this size, and especially one showing suspicion of sarcomatous degeneration.

You can wait a few days but not months.
Yes, laparoscopic minimally invasive surgery can be tried.

Since this is one single fibroid, you can opt for myomectomy done laparoscopically ( removal of the fibroid only ) instead of a complete hysterectomy.

The recovery time, in expert hands, would be a few days in the hospital, and full resumption of normal functions in 4 - 6 weeks time.

Take care.

Yes, you can take two or three weeks time for sure.
Wish you good health.

That must be because you are so reluctant to have a hysterectomy.
When sarcomatous change is indicated in a fibroid, he / she is right to insist on an endometrial biopsy to ensure that the rest of the uterus is alright.