Please ask if this spotting is menstruation or miscarriage?

Patient's question:

My last menstrual period started on December 4th. Because my menstrual cycle has been a bit irregular for the past six months, I went to the hospital to get Chinese herbal medicine to regulate my period. On January 9th, I took a pregnancy test, which showed negative. On January 11th, I started bleeding. I'm wondering if this bleeding is my period or a miscarriage?
Medical history: Irregular menstrual cycle for the past six months
Other: Taken eight courses of Chinese herbal medicine to regulate the period
Auxiliary tests: Pregnancy test on January 9th showed negative

Doctor's answer:

Because the urine test is negative, the possibility of pregnancy is not high. However, it is necessary to identify the cause of the bleeding. It is recommended to have an ultrasound examination at the hospital to check for uterine fibroids. If there are none, the vaginal bleeding is likely caused by endocrine disorders.

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