In some cases, the cause of heavy menstrual bleeding is unknown, but there are certainly a number of conditions that may be the underlying cause of menorrhagia. Because the causes of menorrhagia vary greatly, it is vitally important to have open and honest communication with your physician in order to accurately diagnose the problem.
Common causes may include the following:
- Hormonal imbalance: In a normal menstrual cycle, a balance between the hormones estrogen and progesterone regulates the buildup of the lining of the uterus (endometrium), which is shed during menstruation. If a hormonal imbalance occurs, the endometrium develops in excess and eventually sheds by way of heavy menstrual bleeding. Hormonal imbalance occurs most often in adolescent girls and in women approaching menopause. If menorrhagia is caused by a specific hormonal imbalance, such as thyroid disease, the heavy menstrual flow often can be controlled with hormone medications. However, improper use of hormone medications can also be a direct cause of menorrhagia.
- Uterine fibroids: Uterine fibroids typically occur during the childbearing years and are non-cancerous (benign) tumors of the uterus. They also can cause heavier than normal or prolonged menstrual bleeding.
- Polyps Small: Benign growths on the lining of the uterine wall (uterine polyps) may cause heavy or prolonged menstrual bleeding. Polyps of the uterus most commonly occur in women of reproductive age as the result of high hormone levels.
- Dysfunction of the ovaries: Lack of ovulation (anovulation) may cause hormonal imbalance and result in menorrhagia
- Adenomyosis: This condition occurs when glands from the endometrium become embedded in the uterine muscle, often causing heavy bleeding and pain. Adenomyosis is most likely to develop if you're a middle-aged woman who has had many children.
- Intrauterine device (IUD): Menorrhagia is a well-known side effect of using a non-hormonal intrauterine device for birth control. When an IUD is the cause of excessive menstrual bleeding, you'll often need to remove it.
- Pregnancy complications: A single, heavy, late period may be due to a miscarriage. If bleeding occurs at the usual time of menstruation, however, miscarriage is unlikely to be the cause. An ectopic pregnancy — implantation of a fertilized egg within the fallopian tube instead of the uterus — also may cause menorrhagia.
- Cancer: Rarely, uterine cancer, ovarian cancer and cervical cancer can cause excessive menstrual bleeding.
- Medications: Certain drugs, including anti-inflammatory medications and anticoagulants (to prevent blood clots), can contribute to heavy or prolonged menstrual bleeding.
- Other medical conditions: A number of other medical conditions, including pelvic inflammatory disease (PID), thyroid problems, endometriosis, and liver or kidney disease, may cause menorrhagia.
This information is not intended to substitute the recommendations of your healthcare providers. Women’s Health Foundation disclaims any liability for the decisions you make based on this information.
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