Uterine atrophy is divided into physiological uterine atrophy and pathological uterine atrophy. Uterine atrophy should be judged in the context of age and menstrual flow, as well as the size of the congenital uterus. Generally, physiological uterine atrophy is normal and can be treated with estrogen and progesterone if necessary, while pathological uterine atrophy needs to be actively treated. If a woman is around 50 years old and is close to menopause or has a shrinking uterus after menopause, it is normal and not harmful. However, congenital small uterus, sometimes combined with low menstrual flow, is a sign of dysplasia, which often affects fertility and even causes infertility, and should be treated with estrogen and progesterone supplementation as prescribed by the doctor. If the menstrual flow is normal, the effect is usually minimal and does not affect conception. If a woman is very young and has shrunken uterus and uterine atrophy before she is 40 years old, it is an abnormal phenomenon and is pathological uterine atrophy, which is often a manifestation of declining ovarian function and premature ovarian failure, resulting in declining estrogen and progesterone, shrinking uterus and early menopause. Patients usually find it difficult to have children again and will have severe menopausal syndromes such as insomnia, agitation, hot flashes and excessive sweating, as well as reduced vaginal discharge, difficulties in sexual life and sometimes osteoporosis. For this condition, estrogen and progesterone replacement therapy is required as prescribed by the doctor.