Perimenopausal menstruation has not gone with a large number of blood clots first need to stop the bleeding in time, so as not to lead to hemorrhagic anemia or shock. The first thing you need to do in this case is to determine the cause of the vaginal bleeding, and the common ones are: anovulatory abnormal uterine bleeding, endometrial cancer, and cervical lesions. 1. Anovulatory Abnormal Uterine Bleeding: Perimenopause is the period of time around menopause. At this stage, due to the depletion of follicles, the lack of progesterone antagonism of the endometrium will lead to excessive endometrial hyperplasia, resulting in irregular menstruation, increased menstrual flow, etc. These are common phenomena in the transition period of menopause, but first of all, we should go to the hospital to perform ultrasound examination to exclude organic diseases. When the bleeding is relatively large amount of time to come to the hospital for treatment, so as not to cause hemorrhagic anemia or shock, if necessary, diagnostic scraping should be carried out, scraping out the material sent to the pathological examination, in order to stop bleeding and clear diagnosis. 2. Organic gynecological diseases: such as endometrial cancer patients, abnormal uterine bleeding is also the most common symptom of this disease, which may be related to the continuous stimulation of endometrium by oestrogen and prolonged endometrial hyperplasia. Treatment is mainly surgical, removing the uterus and bilateral adnexa, and clearing the pelvic lymph nodes. Cervical cancer is also a common cause of abnormal bleeding. Cytological and virological examinations for cervical cancer such as TCT (liquid-based cytology) and HPV (human papillomavirus) can be performed in a timely manner and cervical biopsy can be performed in a timely manner if necessary, and standardized treatments can be followed according to the results of the examinations. If the above symptoms occur during perimenopause, it is necessary to go to the gynecology clinic in time to find out the cause of the disease and treat the cause of the disease.