In the clinic, we are often asked whether it hurts to scrape the uterus or not, and some postmenopausal friends are often delayed because they are afraid of scraping the uterus. Not long ago, I met a patient who had been menopausal for 10 years and had very little vaginal bleeding for 1 month, and went to the hospital because she was afraid of it. ultrasound suggested that the endometrium was thickened by about 30px, and the doctor suggested that the patient should undergo diagnostic scraping in order to find out the reason for the thickening of the endometrium, but the patient refused to do it because of her fear, and she was treated according to the treatment of vaginitis, and the bleeding still did not get better, and finally, she had to undergo diagnostic scraping three months later, and her test result was: Endometrial cancer. Cancer. In fact, many perimenopausal women and some postmenopausal women have experienced vaginal bleeding, which cannot be diagnosed simply by a “vaginitis” or a “dysfunctional uterine bleeding”, for perimenopausal and postmenopausal women, abnormal vaginal bleeding requires gynecological examination. For perimenopausal and menopausal women with abnormal vaginal bleeding, a gynecologic examination is needed to clarify the cervix and uterus and, if necessary, cervical cytology and ultrasonography to determine the presence of cervical disease and the condition of the lining of the uterus. If the results of cervical cytology screening are abnormal, colposcopy and microscopic biopsy are needed to clarify the presence of benign cervical diseases and malignant tumors; if the endometrium is thickened, segmental scraping is needed to clarify the presence of benign or malignant endometrial lesions. Although some women are afraid of these tests, they are necessary to diagnose dysfunctional uterine bleeding only after cervical and endometrial lesions are excluded.