A 49 year old woman who has stopped menstruating for three months needs to be checked for pregnancy and then have an ultrasound. When a 49-year-old woman stops menstruating for three months, it could be caused by pregnancy, or it could be ovarian failure, which is a more common symptom in perimenopausal women. But in the case of menopause for three months, you need to go to the hospital first to check. 1. Do a urine pregnancy test or take a blood test for HCG. 49-year-old women who have stopped menstruating for three months and do not use contraception during intercourse need to check if they are pregnant. You can do a urine pregnancy test, or use a pregnancy test stick, pregnancy test paper to test the urine, you can also directly draw blood to check HCG. 2. Ultrasound examination, three months without menstruation, to determine that there is no pregnancy, you need to do ultrasound examination. If the lining of the uterus is thin, it means that the ovarian function has declined, and the level of estrogen in the body is relatively low, that is, it is about to be menopausal. If the lining of the uterus is thicker, it means that menstruation is imminent, and you can take progesterone and other medications under the guidance of your doctor.