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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.
Diagnosing what causes heavy periods can sometimes be difficult. However, some physical condition affecting the uterus, such as fibroids and polyps, may cause heavy menstrual bleeding. The more common reasons for heavy periods are: 1  fibroids.  polyps.