Guidance on Endometrial Biopsy for Perimenopausal Bleeding and Sensitive Tissue - #10172

I am almost 53 and have been under very high stress for the past five years due to grief after losing my father and ongoing worry because my mother is very ill. I am currently alone without close support, and I became extremely distressed after a gynecologist told me that there was nothing else to test except an endometrial biopsy. I understand this test is mainly used to rule out cancer, which is why I became very afraid. I have never been sexually active and have never used any form of contraception for pregnancy prevention. I only take medication for stomach acidity and daily vitamins. Because of my age, I may have more sensitive or thinner vaginal tissue, and I am concerned that an invasive biopsy would be extremely painful. I had a Pap smear last year, which was negative. The referral described my bleeding as heavy and postmenopausal, but this is incorrect. I have not reached postmenopause. Last month I had a regular period lasting 4 days with mild discomfort during the first days, similar to what I have experienced since my first period at age 13. This month, after 30 days, I had the same light 4-day period. An external pelvic ultrasound done a few weeks ago showed a normal endometrial lining and only small fibroids. No other abnormalities were found. Based on this complete and accurate history, is an endometrial biopsy medically indicated at this time, or would observation be appropriate unless true postmenopausal or heavy/prolonged bleeding develops?