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Risk factors
By Mayo Clinic staffMenorrhagia is most often due to a hormonal imbalance that causes menstrual cycles without ovulation. In a normal cycle, the release of an egg from the ovaries stimulates the body's production of progesterone, the female hormone most responsible for keeping periods regular. When no egg is released, insufficient progesterone can cause heavy menstrual bleeding.
Menstrual cycles without ovulation (anovulatory cycles) are most common among two age groups:
- Adolescent girls who have recently started menstruating. Girls are especially prone to anovulatory cycles in the first year and a half after they have their first menstrual period (menarche).
- Older women approaching menopause. Women ages 40 to 50 are at increased risk of hormonal changes that lead to anovulatory cycles.
- Jurema M, et al. Menorrhagia. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- Excessive menstrual bleeding: Quick primer. National Women's Health Information Center. http://www.healthywomen.org/aub/pg1.html. Accessed April 25, 2009.
- Women and anemia — Heavy menstrual bleeding and fibroids. National Anemia Action Council. http://www.anemia.org/patients/featurearticles/content.php?contentid=000242§ionid=00015. Accessed April 25, 2009.
- Vaginal bleeding. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec18/ch242/ch242e.html. Accessed April 25, 2009.
- Abnormal uterine bleeding. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp095.cfm. Accessed April 25, 2009.
- Questions to ask about excessive menstrual bleeding. National Women's Health Information Center. http://www.healthywomen.org/aub/pg3.html. Accessed April 25, 2009.
- Menstrual periods fact sheet. The American College of Obstetricians and Gynecologists. Accessed April 25, 2009.
- Goodman A. Terminology and evaluation of abnormal uterine bleeding in premenopausal women. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- de Silva NK, et al. Definition and evaluation of abnormal uterine bleeding in adolescents. http://www.uptodate.com/home/index.html. Accessed April 25, 2009.
- Lobo RA. Abnormal uterine bleeding: Ovulatory and anovulatory dysfunctional uterine bleeding, management of acute and chronic excessive bleeding. In: Katz VL, et al., eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa.: Mosby; 2007. http://www.mdconsult.com/das/book/body/133793247-3/834086474/1524/248.html#4-u1.0-B978-0-323-02951-3..50040-6_1192. Accessed April 25, 2009.
- Cervical cancer screening. Centers for Disease Control and Prevention. http://www.cdc.gov/cancer/cervical/basic_info/screening/. Accessed April 25, 2009.
- Gallenberg MM (expert opinion). Mayo Clinic, Rochester, Minn. April 29, 2009.
