Question of the Week

For September 26, 2023

A 66-year-old woman with obesity, hypertension, and type 2 diabetes reports two episodes of vaginal bleeding during the past 6 months. On each occasion, light spotting lasted for approximately 3 days. She experienced natural menopause at age 53.

The remainder of her review of systems is negative. Physical examination is unremarkable. A transvaginal ultrasound shows a 7-mm endometrial stripe.

Which one of the following diagnostic approaches is most appropriate in this case?

Progesterone challenge test
CT of the abdomen and pelvis
Endometrial biopsy
Repeat transvaginal ultrasound in 6 months

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