44 years old vaginal bleeding two months need to timely consultation, may be abortion, uterine fibroids, endometrial hyperplasia, etc., need to be under the guidance of the doctor to carry out targeted treatment, such as medication, surgical treatment. 1. Miscarriage: 44-year-old women should consider the possibility of miscarriage if they have had sex before, and the whole process of early miscarriage is accompanied by vaginal bleeding. If necessary, consider taking scraping surgery to remove the residual tissue in the uterus. 2. Uterine fibroids: can cause irregular vaginal bleeding during the non-menstrual period, consider medications such as gonadotropin-releasing hormone analogs, mifepristone, etc. Surgery includes myomectomy, hysterectomy and so on. 3. Endometrial hyperplasia: Most patients will present with irregular menstruation and abnormal uterine bleeding. For patients with simple endometrial hyperplasia and complex hyperplasia, norethindrone tablets are often used; for patients with atypical endometrial hyperplasia who want to retain their reproductive function, medroxyprogesterone acetate is often used. Drug treatment is ineffective and no fertility requirements of endometrial atypical hyperplasia, the feasibility of total hysterectomy. Patients should consult the doctor in a timely manner to identify the cause of the disease and follow the doctor’s instructions to standardize the treatment, so as not to cause the patient to develop anemia.