Excessive menstruation is a common problem in gynecological clinics. First of all, let’s talk about what is normal menstruation. According to the textbook definition, excessive menstruation is defined as menstrual flow exceeding 80ml per month, but 80ml is a rather abstract concept. If you use the amount of sanitary napkins or tampons to assess, about every 1-2 hours you wet a large sanitary napkin or tampon, it indicates excessive menstrual flow. Of course, you can also compare it with your past menstrual flow. If there is a combination of decreased hematocrit or anemia such as weakness or ringing in the ears, it can indicate excessive menstrual flow and you need to seek medical help. There are many reasons for excessive menstruation and the causes need to be examined. In terms of etiology, excessive menstrual flow may be due to systemic coagulation problems, such as reduced platelets or prothrombin problems, or if you are taking some oral anticoagulant medications, such as aspirin. In addition, uterine diseases such as myometriosis, endometrial polyps and endometrial hyperplasia can also cause excessive menstruation. The IUD may also be a local factor that causes an increase in menstrual flow, and sometimes an undetected miscarriage is also a cause of excessive menstruation. In addition, the presence of hypothyroidism (low thyroid) may also be a cause of increased menstruation. After excluding systemic or uterine pathologies, the rest of the problem is functional ovarian problems that cause excessive menstruation. When you come to the clinic with excessive menstruation, you will need to undergo a gynecological examination and a general physical examination, including routine blood tests, ultrasound of both uterine adnexa, and sometimes coagulation and sex hormone levels, if necessary. For example, if the excessive menstruation is caused by fibroids, it is usually necessary to remove the fibroids or hysterectomy to achieve the purpose of treatment; if the excessive menstruation is suspected to be caused by IUD, it is usually necessary to try to remove the IUD first; if the problem is low A or coagulation function, it is necessary to treat For these systemic diseases. For functional problems, it is usually possible to reduce menstrual flow through hormonal regulation. Taking oral short-acting contraceptives is an easy way to try whether hormonal treatment is effective. In the case of perimenopausal hematemesis, the general principle is to treat what is lacking by supplementation, usually with progestin. Antifibrinolytic drugs can also be used to reduce bleeding during menstruation. Patients with combined anemia are usually treated with iron supplements. In addition to the above-mentioned etiology, there are also general treatment options, such as intrauterine placement of a slow-releasing progestin ring (Mannorrhea), which is also effective in reducing bleeding; hysteroscopic endometrial resection, which is a relatively traditional procedure to remove the endometrium that causes excessive menstruation; and more recent treatment options, including endometrial microwave therapy (Nosur), which has the advantage of is fast (90 seconds) and minimally invasive; uterine artery embolization is also a more minimally invasive approach, which reduces blood flow by blocking the blood vessels in the uterus, which has the effect of reducing blood flow. However, any method of preserving the uterus is likely to fail because the cause of the excessive menstruation is not removed. These methods are certainly not suitable for patients with fertility requirements. In conclusion, the first thing to do is to find the cause of excessive menstruation, and then to choose a treatment plan on an individual basis, taking into account age, fertility requirements, and previous treatment.