2: Possible causes of menorrhagia

Organic

Biochemical (prostaglandins)

Fibroids

Adenomyosis

Polyps

Endometriosis

Pelvic infection

Pelvic cancer

Bleeding disorders (e.g., Von Willebrand's disease; leukaemia)

Endocrine dysfunction (e.g., polycystic ovarian syndrome; oestrogen- producing ovarian tumours)

Iatrogenic

Intrauterine devices

Anticoagulants

Other

Number of children (menorrhagia is associated with more children)

Obesity (associated with increased oestrogen levels)

Psychosocial factors (e.g., depression, heavy smoking, excessive alcohol intake)

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