Some patients with postmenopausal bleeding, especially elderly patients, often do not understand the tests prescribed by doctors. Of course, postmenopausal bleeding is often caused by benign diseases such as senile vaginitis and endometritis, but cervical cancer and endometrial cancer and ovarian tumors need to be excluded, so the corresponding tests are cervical cytology and gynecologic ultrasound. 1.Hysteroscopy: The diagnostic accuracy of fiber hysteroscopy is higher than that of TVS, which can miss local hyperplastic lesions and adenocarcinoma, and even the endometrium seen in TVS and SHSG probes needs to be biopsied directly under hysteroscopy, so to check the lesions of perimenopausal and postmenopausal uterine bleeding, fiber hysteroscopy is better than vaginal ultrasound for four reasons: one, the thickness of the double-layered endometrium without hormone therapy is <4mm as Second, the initial stages of endometrial hyperplasia and endometrial adenocarcinoma are focal, which can be easily missed by vaginal ultrasound, whereas fiberoptic hysteroscopy can detect and take biopsies under direct vision; third, sometimes more than two biopsies are needed to determine the extent of tumor or lesion extension. Fourth, abnormal vaginal ultrasound findings need pathological confirmation, and fiberoptic hysteroscopy can directly perform biopsy. Granberg believes that TVS can be used as a first step in the routine evaluation of PMB, and that hysteroscopy must be applied when the ultrasound image is abnormal or indeterminate, or when the ultrasound image is normal and the patient continues to have symptoms, along with further microscopic biopsies to rule out or show pathology. to exclude or show pathology. Finally, once again: postmenopausal bleeding needs to exclude the possibility of malignant tumors, do not just seek two Chinese herbal medicines, but to investigate the cause to prevent missing the diagnosis of malignant tumors.