The first investigation for abnormal uterine bleeding is Urine Beta HCG to rule ouut pregnancy. Abnormal Uterine Bleeding(AUB): is a common and debilitating condition. Chronic AUB was defined as &;bleeding from the uterine corpus that is abnormal in volume, regularity and/or timing that has been present for the majority of the last 6 months. AUB may affect females of all ages. Factors that influence incidence most greatly are age and reproductive status. A structured approach for establishing the cause using the FIGO PALM COEIN classification system will facilitate accurate diagnosis and inform treatment options. In the reproductive age group , the hypothalamic-pituitary-ovarian (HPO) axis matures, and anovulatory uterine bleeding is encountered less often. The diagnostic goal is exclusion of pregnancy and identification of the underlying pathology to allow optimal treatment. Miscarriage, ectopic pregnancies, and hydatidiform moles may cause life-threatening hemorrhage. Pregnancy complications are quickly excluded with determination of urine and serum Beta-human chorionic gonadotrophin (hCG levels). This is typically obtained on all reproductive-aged women. Other options: Pap smear evaluation is usually done for cervical and endometrial cancers which are commonly seen in peri and post menopausal women. Transvaginal sonography (TVS) typically offers greater patient comfo and suitable detection of postmenopausal endometrial hyperplasia and cancer compared to transabdominal ultrasonography. Ref: Shaw&;s textbook of Gynaecology 17th edition Pgno: 139