I am 38 year old woman have two kids. I have very heavy bleeding and very painful periods every month. So my family physician referred me to do an ultrasound. My ultra sound results are like this.

A routine trans-abdominal trans-vaginal pelvic ultrasound was performed. It was performed after a week of having my first day of menstrual periods.

Results: Endometrial echoes thickntess measuring 1.5 cm in greatest diameter near the fundus. The endometrium otherwise is normal. The uterus is retroverted containing intramural fibroid measuring 4 cm on the left.

There is a 2.5 cm simple cyst within the ovary of doubtful significance. No other adnexal mass persists.

The uterus is 8.8 x 5.8 x 5.3 cm. Right ovary is 3.2 x 3.0 x 2.3 cm. left ovary is 4.0 x 3.3 x 2.9 cm.Minimal free fluid is noted within the cul-de-sac.

What are the risks having endometrial thickness 1.5 cm and 4 cm fibroid? What would be the next steps.

Thanks,

Sara