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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.
Irregular and heavy periods can be successfully treated with hormonal therapy in the setting of overweight, underweight or normal weight women. Heavy and irregular bleeding may also be the result of an abnormal pregnancy. A miscarriage or a pregnancy outside of the uterus may cause abnormal or heavy bleeding.