Inclusion Criteria:  women ≥40 years with pre- or perimenopausal AUB or PMB presenting to Women's Health Hospital, Department of Obstetrics and Gynecology, Faculty of medicine, Assiut University, Assiut, Egypt.  Exclusion Criteria:  Women with a vaginal bleeding arising from a cervical, vaginal or vulvar disease. Patients with cervical cancer or uterine metastases. History of prior hysterectomy, prior pelvic radiation, endometrial sampling within the past 3 months. Presence of existing pregnancy. Women with inadequate endometrial sampling or with no histopathological diagnosis.