45 years old menstruation comes for 20 days and does not go away, consider related to pregnancy-related, ovarian hypoplasia, cervical polyps or endometrial polyps, cervical or endometrial malignant lesions, and so on. 1.45 years old has not yet menopausal, if there is menstruation 20 days does not go, first of all to exclude whether it is pregnancy-related caused by bleeding. 2. Ovarian hypogonadism related dysfunctional bleeding: if the patient has a combination of ovarian hypogonadism, the body’s level of estrogen and progesterone is low, and can not make the endothelium completely peeled off, and the prolongation of the menstrual period, menstrual bleeding and other manifestations. 2. 2. For patients with cervical polyps or endometrial polyps, irregular vaginal bleeding and prolonged menstrual period are the main clinical manifestations. 3. Organic lesions: If there are uterine fibroids, cervical lesions, endometrial lesions and other organic lesions lead to changes in the menstrual cycle. For the 45-year-old patients whose menstruation does not go away for 20 days, it is recommended to go to the gynecology department of regular hospitals, improve the urine HCG or blood β-HCG, ultrasound, cervical cancer screening and other related examinations, to clarify the cause of the disease, and then under the guidance of the doctor to actively treat.