What causes heavy menstrual bleeding?
The history is complicated. There can be several possibilities. At age 26, the reasons for menstrual irregularities can be either pathological or hormonal. Both causes have be identified with blood tests and ultrasound. Ultrasound can rule out ovarian cysts,fibroids polyp, adenomyosis. Hormone tests can rule out pcos, thyroid dysfunction, DUB etc.
In her case, since she is diabetic and over weight i would like to rule out thyroid and polycystic ovaries first. Endometrioisis is a definite possibility since it can run in families. She may need a D/C and hormonal medication.
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