What Causes Vaginal Bleeding With Pain During Intercourse?

I have been bleeding for 20 days. I had pelvis and transvaginal ultrasounds which shows that my uterus measures 9x4.8x5.7cm, the myometrium is heterogeneous, there is an apparent elliptical polyp in the fundal portion of the endometrium, 7mmx3mm. A small amount of fluid is present in the endometrial canal. I have pain during intercourse, deep pain.I am 43 and have delivered 4.children. I have the option of a D&C or a hystertcomy. any advice