Menorrhagia

Abnormally profuse or prolonged menstrual bleeding occurring at regular menstrual intervals, resulting from excessive endometrial shedding or impaired hemostasis and potentially causing iron-deficiency anemia or, in severe cases, hemodynamic compromise.

Causes

• Endometriosis

• Hormonal and endocrine causes

  • Polycystic ovary syndrome (PCOS)

  • Hypothyroidism

  • Hyperthyroidism

  • Estrogen–progesterone imbalance

  • Anovulatory cycles

  • Perimenopause-related hormonal changes

• Structural uterine causes

  • Uterine fibroids (leiomyomas)

  • Endometrial polyps

  • Adenomyosis

  • Uterine malformations

  • Endometrial hyperplasia

• Pregnancy-related causes

  • Miscarriage

  • Ectopic pregnancy

  • Retained products of conception

• Bleeding disorders

  • Von Willebrand disease

  • Platelet disorders

  • Coagulation factor deficiencies

• Medication-related causes

  • Anticoagulants

  • Antiplatelet medications

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Hormonal medications affecting endometrial stability

• Systemic causes

  • Liver failure causing impaired coagulation factor synthesis

  • Kidney failure causing platelet dysfunction

• Infectious and inflammatory causes

  • Pelvic inflammatory disease

  • Chronic endometritis

• Malignant causes

  • Endometrial cancer

  • Cervical cancer