input: The following are multiple choice questions (with answers) about medical knowledge.   **Question:** A 55-year-old nulligravid woman comes to the physician because of a 3-day history of heavy vaginal bleeding, requiring more than 5 pads per day. Menopause occurred 1 year ago. She attained menarche at 10 years of age. She has a history of hypothyroidism and type 2 diabetes mellitus. She has smoked 1 pack of cigarettes daily for 20 years but quit 5 years ago. Current medications include levothyroxine and metformin. She is 165 cm (5 ft 5 in) tall and weighs 86 kg (190 lb); BMI is 32 kg/m2. Physical examination shows mild vaginal atrophy and a normal cervix. The uterus and adnexa are nontender to palpation. Transvaginal ultrasonography shows an endometrial thickness of 6 mm. Endometrial biopsy shows non-invasive proliferation of endometrial glands with no nuclear or cytological atypia. Which of the following is the most appropriate next step in management?   (A) Total hysterectomy   (B) Estrogen vaginal cream   (C) Reassurance and follow-up   (D) Progestin therapy
output: ['(D) Progestin therapy <> answer', 'The following are multiple choice questions (with answers) about medical knowledge. <> instruction', '(A) Total hysterectomy  (B) Estrogen vaginal cream  (C) Reassurance and follow-up  (D) Progestin therapy <> possible answers', '  A 55-year-old nulligravid woman comes to the physician because of a 3-day history of heavy vaginal bleeding, requiring more than 5 pads per day. Menopause occurred 1 year ago. She attained menarche at 10 years of age. She has a history of hypothyroidism and type 2 diabetes mellitus. She has smoked 1 pack of cigarettes daily for 20 years but quit 5 years ago. Current medications include levothyroxine and metformin. She is 165 cm (5 ft 5 in) tall and weighs 86 kg (190 lb); BMI is 32 kg/m2. Physical examination shows mild vaginal atrophy and a normal cervix. The uterus and adnexa are nontender to palpation. Transvaginal ultrasonography shows an endometrial thickness of 6 mm. Endometrial biopsy shows non-invasive proliferation of endometrial glands with no nuclear or cytological atypia. Which of the following is the most appropriate next step in management? <> context']