Has anyone offered a progestin only birth control pill? This would be similar to Mirena hormonally, but at least if it's problematic you wouldn't have to go through having it removed. Low iron can actually cause heavy bleeding, as well as resulting from it, so it's important to be sure you're getting a good source of iron through food and supplements. The tablets prescribed to me didn't work as well as a liquid supplement, Floridix/Floravital, I can't remember exactly what it was called. Also, you might ask to try a very low dose of thyroid hormone. Underactive thyroid can also cause heavy or irregular bleeds. Personally, I would try to get the ferritin levels up first, then perhaps try the birth control, and lastly thyroid. Once you begin on the thyroid med, it's likely a lifetime thing, worth it if you need it, but ideally you won't need it. Of course at age 49, all of these bleeding issues are not unusual. Support your body the best you can, it gets better! I opted not to have the ablation, I'm assuming that's the balloon?, due to friends' negative experiences with it. I understand it's either a blessing or a curse, nothing in between. When I reached the point of considering it after a couple years of battling anemia and always bleeding, my periods finally quit. I hope this helps!