Irregular vaginal bleeding is one of the most common clinical symptoms of gynecological disorders. Many patients associate irregular vaginal bleeding with menstrual disorders as soon as they see it, but, in fact, this is very one-sided. A significant proportion of this bleeding is related to other diseases. The most important clinical differentiation is pregnancy-related diseases, such as ectopic pregnancy (commonly known as ectopic pregnancy) and miscarriage. Ectopic pregnancy often presents as continuous vaginal bleeding after menopause (some patients do not have menopause), usually less than menstrual flow, and is often subjectively considered by patients as irregular menstruation because it is not accompanied by abdominal pain in the early stages. Some patients are very incomprehensible or uncooperative when doctors propose pregnancy tests, especially those who are approaching menopause or have taken contraceptive measures, and reject these tests in the hope of direct treatment. In fact, such patients will take a greater risk. This is because once ectopic pregnancy is treated as a menstrual disorder, it will not only be ineffective, but also delay the condition and miss the best time for treatment, or even cause intra-abdominal bleeding and a more critical situation. Avoiding this risk is actually very simple, namely, a blood HCG test combined with an ultrasound examination. Among the patients treated in my clinic, there was a patient with irregular vaginal bleeding near menopause who was found to have an ectopic pregnancy and was treated with medication, which is still ongoing. Therefore, in individual cases, even if ectopic pregnancy (or miscarriage) is unlikely, it is safer to treat it after ruling out these other diseases.