If you are 45 years old and your menstruation is dark and scanty, besides considering age-related ovarian recession, you should also consider endometrial dysfunction, hereditary or life-related causes. 1. Age-related ovarian dysfunction: mainly refers to the normal decline of ovarian organ function due to aging, which may cause dark and scanty menstruation. 2. Endometrial abnormality: The formation of menstruation is caused by the cyclic exfoliation of the endometrium, so endometrial abnormality may also cause menstrual darkness and scanty menstruation. Endometrial abnormalities are usually associated with intrauterine surgery such as curettage and birth control device placement. 3. Heredity: If there is a history of gynecological disease in the patient’s family, such as oligomenorrhea or polycystic, it may also cause dark and scanty menstruation. 4. Lifestyle reasons: excessive stress, irregular work and rest habits can also lead to the appearance of menstruation in the dark and low volume of the situation. At the age of 45, the darkening of the menstrual cycle is generally not a serious situation, but does not rule out the possibility of other malignant diseases, it is recommended that patients encounter similar symptoms in a timely manner to go to the hospital for medical confirmation, so as not to delay the best time for treatment.