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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.
The whole process then repeats again. Heavy menstrual bleeding can occur when there is some imbalance in these hormones. This imbalance prevents the release of the egg from the ovary, causes a buildup of the lining of the uterus, and results in an instability of the lining which makes it more prone to shedding.