The first thing to do is to determine if the menstrual cycle is a normal one, and to find out how this cycle is different from the previous ones. If the menstrual cycle is much earlier or later than before, be alert to the possibility of ectopic pregnancy and suggest a urine pregnancy test to rule out abnormal uterine bleeding caused by pregnancy. If this cause is ruled out, anovulatory abnormal uterine bleeding may have occurred. It is possible that ovulation did not occur in this cycle, the estrogen level in the body is not normal, and the lack of progesterone does not allow the uterine lining to shed regularly.