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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.
Determining the cause of long periods begins with a visit to the doctor. During a typical monthly menstrual cycle, a woman ovulates and her uterine lining thickens to prepare for conception. If pregnancy does not occur, the built-up tissue of the uterine lining is shed with the menstrual flow and a new cycle begins. Periods typically occur approximately every 4 weeks and last no more than 7 days. Sometimes, periods become especially heavy and last an unusually long time. Several things can cause heavy or prolonged menstrual bleeding. Possibilities include reproductive system problems and some nonreproductive disorders.