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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 following can all be causes of heavy menstrual bleeding: 1  Uterine cancer: This is a cancer that begins in the uterus and is usually characterized with abnormal bleeding, along with urinary pain or pain during intercourse. 2  Uterine fibroids: These are noncancerous tumors that grow on or in the muscular wall of the uterus.