Menorrhagia: Causes

Pathogenesis (development of disease)

Bleeding is prolonged (>6 days) and increased in menorrhagia. In most cases, organic changes that limit uterine contraction (contraction of the uterine muscles) are causative.

Etiology (causes)

Biographic causes

• Hormonal factors
  • Puberty
  • Perimenopause – transitional phase between premenopause and postmenopause; varying lengths of years before menopause (about five years) and after menopause (1 year).

Causes related to disease

Blood, blood-forming organs – immune system (D50-D90).

• Coagulation disorders

Endocrine, nutritional and metabolic disorders (E00-E90).

• Hypothyroidism (underactive thyroid gland).
• Premenstrual progestin deficit – deficiency of luteal hormone before the onset of menstruation.

Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

• Cirrhosis of the liver (liver shrinkage).

Neoplasms – tumor diseases (C00-D48)

• Endometrial carcinoma (cancer of the uterus).

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

• Adnexitis (ovarian inflammation), chronic.
• Endometritis (inflammation of the uterus); including tuberculous endometritis.
• Endometriosis – disease in which the endometrium grows outside the uterus such as in the ovary (ovary) or the vesica urinaria (urinary bladder).
• Glandular-cystic hyperplasia of the endometrium – pathological thickening of the endometrium due to increased estrogen action (eg, follicular persistence).
• Polyps (mucosal growths) of the cervix (cervix) or endometrium (endometrium).
• Uterine hyperplasia – proliferation of the endometrium.
• Uterine fibroids – benign tumors in the uterus.

Medication

• Hormonal contraceptives (birth control pills), hormone replacement therapy.
• Intrauterine device (“IUD”).