Soru

A 46-year-old woman is evaluated in the outpatient clinic for a 5-month history of heavy and irregular vaginal bleeding. She states that her menstrual cycles were previously regular, occurring every 28 days and lasting 5 days, but they now occur at random intervals with heavy flow and the passage of large blood clots. Her medical history includes type 2 diabetes mellitus, hypertension, and obesity. Current medications are metformin and lisinopril. Her body mass index is $36 \text{ kg/m}^2$. Vital signs are within normal limits. Pelvic examination demonstrates a normal-appearing vagina and cervix, with a normal-sized, non-tender uterus and no palpable adnexal masses. A point-of-care urine beta-hCG test is negative. Which of the following is the most appropriate next step in management?