Could Heavy Vaginal Bleeding Be Due To Fibroid In Uterus?

I have a fibroid growing in the wall of the uterus that is causing very heavy periods. I am 49, perimenopausal and have been told the ablation probably will not work to stop the bleeding. A hysterectomy is the definitive way. I cannot take hormones due to migraines with aura. My question is....what are the risks of allowing these heavy periods to continue? And also, I have international travel plans ahead...will this effect the bleeding? Elevation, jet-lag, exhaustion etc...?