Causes of Heavy Menstrual Bleeding

There are many causes of heavy menstrual bleeding, primarily categorized into functional and organic factors. In terms of functional factors, hormonal imbalances are the main cause; for example, insufficient progesterone or ovulation disorders may lead to excessive endometrial hyperplasia, thereby causing increased menstrual flow. Mental stress, fatigue, and environmental changes may also affect hormonal balance and indirectly lead to abnormal menstrual volume. Organic factors mainly involve issues with the uterus itself, such as uterine fibroids, endometrial polyps, and endometriosis. These conditions may cause thickening of the uterine wall, increased vascularity, or enlargement of the uterine volume, resulting in heavier menstrual bleeding. Hematologic disorders such as leukemia and thrombocytopenia, as well as iatrogenic factors like the insertion of an intrauterine device or oral contraceptive use, can also affect menstrual volume. Heavy menstrual bleeding should be analyzed according to individual circumstances, and medical evaluation should be sought promptly if physical discomfort occurs.