The main causes of irregular menstruation at 48 years old include perimenopause, submucous fibroid, cervical polyp, endometrial cancer, cervical cancer, etc. Patients should clarify the causes and then treat the causes.1. Perimenopause: 48-year-old women have entered the perimenopause, and with the decline in ovarian function, the level of estrogen and progesterone decreases, which can be characterized by a gradual shortening of menstrual cycles and a decrease in menstrual flow, accompanied by anxiety, Uncontrolled emotions, lack of concentration, sleep disorders and so on. Menopause is a normal natural phenomenon, patients in daily life through regular exercise, balanced diet, quit smoking and limiting alcohol, keep the spirit happy, etc. can alleviate the symptoms, and at the same time pay attention to the prevention of osteoporosis, avoid bone fracture; 2, uterine submucosal fibroids: uterine fibroids are common gynecological benign tumors, due to the fact that the submucosal fibroids can make the uterine cavity larger, affect the contraction of uterus, which can cause the increase of menstruation, prolongation of menstruation, and other symptoms, the patient should Go to the hospital for ultrasound and hysteroscopy in time, after clear diagnosis, hysteroscopic myomectomy or hysterectomy can be carried out under doctor’s guidance; 3. Cervical polyps: when patients have cervical polyps, they will have vaginal bleeding, and some of the patients have postmenopausal vaginal bleeding, which can be mistaken by the patients for menstrual bleeding, at this time, patients should go to the hospital in time and follow the doctor’s instruction to remove the polyps; 4. Endometrial cancer Irregular vaginal bleeding is the main symptom of endometrial cancer, and in advanced stage, there may be rotten meat-like tissue mixed in the bleeding, and some patients have abdominal mass, at this time, patients should go to the hospital for consultation in time, and after clear diagnosis, they can follow the doctor’s instruction to carry out surgery, radiotherapy and chemotherapy. 5. Cervical cancer: patients with cervical cancer may have irregular vaginal bleeding, and patients should go to the hospital for examination in time, such as cytological examination of cervical scraping and colposcopic examination to make a clear diagnosis, colposcopy, etc. After clear diagnosis, surgical treatment or radiotherapy can be carried out under the guidance of doctors.