Perimenopause begins 4 till 10 years prior to menopause. For that period deep fluctuations in hormone levels are characheristic, which are very gravious to women. The most common reason to visit the doctor gynecologist, for them is irregular bleeding. That bleedings are charachterized by increasd freaquency as well as heavier flow. This is an unwelcome and unexpected change becouse many women, as they approach menopause, are expecting their cycles to decrease in flow and frequency. It is very important to make good diagnostic and to make sure these bleedings are connected only with the state of perimenopause and not with some pathology. Main diagnostic includes tranvaginal ultrasonography to assess for uterine polyps and fibroids, hysterioscopy and endometrial biopsy to exclude uterine cancer, MRI as most expensive diagnostic method but a very good one for evaluation of adenomyosis. If the bleeding is interfering with a woman ˈs ability to make all her regular activities, treatment is desired. Medications are first line of treatment and as a second option there is surgical options. Medications for abnormal uterine bleeding are divided into two main groups, hormonal therapy which includes oral contraceptives, LNG-IUS, gestagens , AG GnRH and non-hormonal therapy which includes NSAID and antifibrinolitics. Surgical treatment includes endometrial ablation and curettage, polypectomy, myomectomy, embolisation of arteria uterine and hysteroctomy as last option.