A 45 year old post menopausal woman presents with vaginal bleeding. Transvaginal ultrasound reveals an endometrial thickness of 8.0 mm. The next step in the management should be:
Postmenopausal women with endometrial thickness > 5mm require histopathological examination of the endometrium which can he performed by 'Hysteroscopy and Endometrial biopsy' or after Dilatation and Curettage. Ref: Danfoh's Obstetrics and Gynaecology, 10th Edition, Pages 542-43; Ultrasound: A Practical Approach to Clinical Problems By Bluth, 2000, Pages 238-39; Gynaecological Ultrasound in Clinical Practice: Ultrasound Imaging By D. Jurkovic, Lil Valentin, Sanjay Vyas, Page 14
Hysterectomy
Sta progesterone therapy
Histopathological examination of curettage
Follow up sonogaphy