Hi, Here are your answers: 1. Thickened endometrium is usually not present in a regular menstrual cycle even during the peri-menopausal age; if present it is suggestive of excessive estrogen action. 2. Cancer of the uterus is not an usual finding in such a situation; predisposing factors like infertility, excessive estrogen action as in PCOD, prolonged pill usage etc., chronic endometritis and so on. A biopsy of the endometrium, pap smear and test for tumor markers can help. 3. Primolut N does have gastrointestinal side effects like nausea and vomiting. In fact, such symptoms are caused by any female hormone supplement. 4. The recommended course of action is observation, using the hormone prescribed to see if the bleeding gets controlled, since the sonogram has revealed only endometrial hyperplasia, exclusion of endometrial cause of the bleeding through a dilatation and curettage and a biopsy in addition to a pap smear. Improvement of the general condition also is necessary as is the testing for any bleeding disorders. Hope this helps.