At some point, all women may experience menorrhagia, or heavy menstrual bleeding during their periods. However, what women often think is abnormally heavy bleeding is not excessive enough to be diagnosed as menorrhagia. The best way to know if you are experiencing menorrhagia is by monitoring how often you change your pad or tampon. If you change more often than every one to two hours, or your period lasts more than 7 days, you may be experiencing menorrhagia and should consult a doctor. There are 3 common causes of heavy menstrual bleeding, hormonal imbalance, fibroids and polyps and Pelvic Inflammatory Disease (PID). Hormonal Imbalance The most common cause of heavy menstrual bleeding is hormonal imbalance. From the time a young girl begins menstruation to when menstruation ends during menopause, a woman’s hormone levels are continuously fluctuating. These drastic hormonal changes can cause the heavy menstrual bleeding that some women experience. This can often be controlled by the use of birth control pills or other hormone therapy. Fibroids and Polyps Fibroids and polyps are another common cause of heavy menstrual bleeding. Fibroids are typically benign (non-cancerous) growths that occur in the uterus and will present in women in their thirties and forties. The exact cause of fibroids is still unclear, however, it is known that they are estrogen-dependent, which means estrogen needs to be present in the body for them to grow. Most fibroids will shrink and disappear after menopause. However, if they become an issue before then, fibroids can be treated by a simple outpatient surgery to remove them or by the use of oral contraceptives. Polyps are small growths that can occur on or around the cervix or on the lining of the uterus. The causes of polyps are unclear, but are most often associated with an excess amount of estrogen in the body. In most cases, polyps are non-cancerous. However, once removed the doctor will send them to the lab to be tested for cancer cells. Polyps will commonly present in women over the age of 20 that have had children. Most polyps can be removed by an outpatient procedure. In severe cases of fibroids or polyps, a full hysterectomy may be necessary. Pelvic Inflammatory Disease Heavy menstrual bleeding can also be caused by a condition called Pelvic Inflammatory Disease, or PID. PID is an infection that affects the uterus, fallopian tubes and cervix and will typically follow childbirth or other gynecological procedures. Pelvic Inflammatory Disease is most commonly treated with antibiotics.