Abnormal menstrual bleeding can be caused by a variety of factors, including: - Hormonal imbalances: Imbalances in estrogen and progesterone can affect the menstrual cycle. - Uterine fibroids: Noncancerous growths in the uterus that can cause heavy or prolonged bleeding. - Polycystic Ovary Syndrome (PCOS): A hormonal disorder that can cause irregular periods and excessive bleeding. - Endometriosis: A condition where the tissue that normally lines the uterus grows outside of it, leading to painful and heavy periods. - Thyroid disorders: Both hypothyroidism and hyperthyroidism can affect the menstrual cycle.