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

### input:
I recently had a pelvic ultrasound with endovaginal scan and it showed there is an apparent focal thickening of the endometrium measuring 5 mm (non-vascular)  It might represent unusual polyp or focal endometrial growth associated with a small amount of hemorrhage in the canal above it.  I am 60 years old, on biest and progesterone for 4 years; with lower abodominal pain (like low grade menstrual cramps at times) frequent urination and weight gain.  Should I be doing something else?

### output:

Hi. Thanks for your query and an elucidated history. To consider your history one by one:The cause of the lower abdominal pain can be many. This can be due to PID, due to the mass in the uterus as per your ultrasonography. It is possible that there is a prolapse of the uterus giving you typical pains of the type of menstrual cramps. In addition, taking the best and progesterone as a hormone replacement therapy can have its own effect on not only the uterus but also on the body and can give wright gain and all associated symptoms. Frequent urination can be due to urinary tract infection or prolapse of the uterus as has been mentioned above. I would advise you the following::Blood tests, particularly of the hormonal status including the Thyroid function tests. Urine routine, microscopy, culture and sensitivity. Ultrasonography of abdomen. Physical examination by a Gynecologist to rule out any prolapse and so. Currating and biopsy of the endometrium to rule of the cancer. All these tests will lead to a proper diagnosis and plan for a proper treatment