The large blood clots in menstruation of 46-year-old women are considered to be related to endocrine disorders, uterine fibroids, adenomyosis, endometrial cancer and so on. 1. Endocrine disorders: for 46-year-old women, their ovarian function has been reduced to different degrees, if women have irregular ovulation, the lack of progesterone in the body will lead to menstruation can not come on schedule, and at the same time, the endothelium continues to proliferate under the action of estrogen, leading to endothelial thickening, which will lead to increased volume of menstruation, clip clots, prolonged menstruation and other manifestations during menstruation. 2. Uterine fibroids and adenomyosis: for patients with uterine fibroids or adenomyosis, as the size of uterus and the area of uterine lining increase to different degrees, women will have heavy menstrual flow and blood clots, and in serious cases, dizziness, fatigue and other anemia manifestations will be combined. 3. Endometrial cancer: for endometrial cancer patients, due to the rapid growth of cancerous tissues, if the cancerous tissues invade the local blood vessels, it will lead to heavy vaginal bleeding, and if the blood accumulates in the vagina and can not be discharged in time, it will form big blood clots. For 46-year-old women with large blood clots during menstruation, it is recommended to go to the gynecology department of regular hospitals to improve ultrasound, sex hormone and other related examinations, so as to clarify the cause of the disease and then actively treat it under the guidance of doctors.