### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am 45years old. Two weeks ago I went for a vaginal ultrasound due to heavy periods with large clotting. For the past 6+ months my periods came with bad headaches and severe cramping. My last period even caused nausea and vomiting. I am extremely fatigued. Within the past few months I even have pain with urination (which is frequent) and bowel movements (which alternate between diarrhea and constipation). Some of the recent pains remind me of labor pains... The result of the ultra sound says: Bulky and heterogeneous uterus measuring 9.6x5x5 with coarseness echo texture and myometrial cysts measuring 8mm in the anterior body. Endometrial thickness is obscured by this heterogeneity. I am now waiting for my NEW insurance to start in 3 weeks (may 1) before I see the dr. I alternate between being at peace and being fearful. My mom was diagnosed with ovarian cancer at age 48 and died 2 years later. My maternal grandmother had breast cancer at an early age. Just wondering what that medical jargon means and what the issues might be. Thank you.

### output:

Hi, Thanks for asking. Based on your query, my opinion is as follows.1. The uterus contains multiple adenomyosis loci. 2. This adenomyosis causes severe cramp pains, particularly during periods, when the uterus contracts.3. Check hemoglobin levels. It could be low due to heavy periods. Will required It B12 and iron therapy to improve levels. 4. No ovarian problem at present. You might need hormonal therapy at present, however, if uncontrolled, hysterectomy will be necessary. Not much of an issue, other than possible low hemoglobin and cramps due to adenomyosis. Hope it helps. Any further queries, happy to help again.