Menorrhagia / Heavy Menstrual Bleeding / Heavy Periods - Causes

Causes

The cause of menorrhagia may be within the uterus or outside the uterus.

In many cases, the cause of menorrhagia is not known. Some conditions that lead to menorrhagia are:

• Absence of ovulation- If the ovary does not release the egg every month, there could be hormonal imbalances leading to excessive or irregular menstrual bleeding. Ovulation is often absent in early puberty or just before menopause. It is also absent in patients with polycystic ovarian syndrome
• Polyps or fibroids in the uterus
• Presence of an intrauterine contraceptive device
• Infections of the uterus
• Bleeding

  or clotting problems - Patients with less platelets or abnormalities in platelet function or clotting factors in the blood could experience menorrhagia

• Liver problems
• Kidney problems
• Tumors of the pituitary gland - The pituitary gland secretes hormones and controls the menstrual cycle. Pituitary tumors may secrete some hormones in excess leading to menorrhagia
• Anticoagulant drugs such as warfarin - warfarin prevents blood from clotting and could lead to excessive bleeding
• Miscarriage - A miscarriage could lead to excessive or irregular bleeding
• Thyroid disease

References

1. Apgar BS, Kaufman AH, George � Nwogu U, Kittendorf A. Treatment of Menorrhagia. American Family Physician 2007; 75 (12): 1813-19.
2. Joanne Protheroe. Modern management of menorrhagia. Journal of Family Planning and Reproductive Health Care 2004; 30(2): 118�122
3. Ely JW, Kennedy CM, Clark EC, Bowdler NC. Abnormal Uterine Bleeding: A Management Algorithm. JABFM 2006;19 (6): 590 - 602

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