I would want another scan, a lot can happen in 18 months. Oestrogen can make fibroids grow. Utro is a different progestin so perhaps it'll stop it (though probably not) but increasing the dose is a known strategy, there's no medical reason not to take 200mg a day. You may find 25mcg isn't enough to control your symptoms. Utro isn't the best for stopping problem bleeding, I know you don't want a mirena It's usually the most effective option. Could you see a more knowledgeable gp?