In this module, we will provide a comprehensive overview of the approach to a patient presenting with abnormal/ excessive vaginal bleeding. Critical questions to ask in history, including date of last menstrual period and whether the patient is pregnant, and their significance will be reviewed. Additionally, you will learn about specific signs to look for on physical exam, including vital signs and pooling of blood on speculum exam, and will gain an understanding about the special tests used to aid diagnosis, such as pelvic ultrasound and endometrial/cervical biopsies. Lastly, you will gain an understanding of the approach and management of some conditions causing abnormal vaginal bleeding, such as endometrial hyperplasia and uterine fibroids.