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Causes of Menorrhagia. There are many possible causes of heavy menstrual bleeding. They include: 1  Hormonal imbalance, particularly in estrogen and progesterone; this is most common in adolescents who recently began their periods and women who are getting close to menopause.
However, there are a number of conditions and some treatments that can cause heavy menstrual bleeding. Conditions that can cause heavy bleeding include: polycystic ovary syndrome (PCOS) â a common condition that affects how the ovaries work; it causes irregular periods and when periods return they can be heavy.