Menorrhagia

Causes of menorrhagia include :

• Dysfunctional uterine bleeding (excessive bleeding with no identifiable cause): 20-40 percent.
• Anovulatory cycles (more common at extremes of reproductive age): 20 percent.
  • This means that the ovaries do not release the egg at each cycle. This is due to hormonal imbalance.
  • In adolescents, the most common cause is an immature hypothalamus-pituitary-ovarian axis. (i.e. the chemical signalling process between the brain and the ovaries).
  • In perimenopausal women, it can be due to the depletion of ovarian function.
• Organic causes. Fibroids, endometrial polyps, adenomyosis, endometritis, pelvic inflammatory disease.
• Endometrial hyperplasia and carcinoma. This is a consideration especially in patients above 40 years old or with risk factors such as polycystic ovarian syndrome, obesity, nulliparity, early menarche, diabetes mellitus, excessive oestrogen (female hormones) either produced by the body or supplemented externally.
• Systemic disease. Including hypothyroidism, liver or kidney failure and bleeding disorders.