Soru

A 57-year-old woman presents to the gynecology clinic for evaluation of blood-tinged vaginal discharge. She first noticed the discharge on her undergarments three days ago. The patient underwent natural menopause at age 51. Her past medical history is significant for type 2 diabetes mellitus, hypertension, and hyperlipidemia. Current medications include metformin, lisinopril, and atorvastatin. She does not use hormone replacement therapy. Vital signs are within normal limits, and her body mass index is 34 kg/m². Speculum examination shows pale, thinned vaginal walls with a small amount of dark red blood pooled in the posterior fornix. The cervix appears flush with the vaginal vault and has no gross lesions. A transvaginal ultrasound is performed and demonstrates a heterogeneous endometrial stripe with a thickness of 9 mm. The adnexa are unremarkable bilaterally. Which of the following is the most appropriate next step in management?