In the current scenario, I would ask for a proper clinical evaluation followed by a trans-vaginal sonogram and also a hormone profile, if pregnancy
has been excluded as the source of the bleeding. Hormonal
imbalance can occur with weight disturbances, infections, stress
of any sort, certain medications and hormone disorders like polycystic ovaries
. So, proper management would need exclusion of these causes. Also, pain could be related or unrelated to the menstrual cycles and hence, should be evaluated properly. Hope this helps.