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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.
Abnormal uterine bleeding may also be related to other causes unrelated to the natural cycle or ovulation: 1  Uterine Fibroids. 2  Von Willebrand Disease and Other Bleeding Disorders . Bleeding disorders that stop blood from clotting can cause heavy menstrual bleeding. 3  Abnormalities in the Uterus .