What are the common causes of heavy excessive menstrual cycles?

Could perimenopause be the culprit?

Good day ladies, I’m very concerned for my mom who has been bleeding for 16 days. She says her bleeding is nonstop after browning during the first few days of her current cycle. Now, her period blood turned red, and she continues to bleed and has the occasional blood clots the size of a penny. She has never used menstrual cups nor tampons nor period underwear nor flow free. She prefers pads exclusively. She told me her doctor diagnosed her with fibroids and said she has small grape sized cysts. The doctor told her not to worry as they’re noncancerous. She does have a family history of cancer, mostly breast cancer and colon cancer related. That diagnosis was a few years ago, approximately 2 years ago. This year, as her periods have recently been irregular since the pandemic, has been persistent more than before. She has had long menstrual blood flow for several days longer than usual ever since she hit her 40s. This was also during the pandemic. Because it has been 16 days now, she is freaking out. I’m not sure what to do. I’ve already tried comforting her. I’ve even helped her around the house. She is still very worried. She has insomnia and frequent neck pain and back pain and calf and thigh pain especially during changing weather patterns. She was in the hospital twice. She was low on vitamin D and Iron. She was diagnosed with pre diabetes as well. She worked tirelessly to get back in shape for her own health and for her children. Her health has increased for the better. . . However, she has relapsed this time around (late 2024 and early 2025). Her weight slightly increased, and she has exercised less. Her body is sort of giving out. She has even developed anxiety. These are her current symptoms. I forgot to mention that she had hot flashes before but not recently. Her mom told her that she had menopause at 50 years. My mom will turn 50 in 5 more years. Could these be common symptoms of perimenopause? Could it be something bigger? My mom’s due for an OBGYN appointment this month. They just need more tests to run. I believe a biopsy or a PAP smear. But I’m afraid she will miss her appointment due to her being temporary blind. She hasn’t had prescribed glasses in a while and uses contacts, but her new pair comes in a week or so. She hasn’t been able to see another doctor. She can’t operate a vehicle at this time. Yes, someone in the family needs to take her, I’m aware. But we’re also tight on money. We’ve been waiting in a sense. In the meantime, please tell me the possible diagnoses. It’s better if you mention the symptoms. If you’ve dealt with similar, I’m really sorry you’ve gone through that, but I hope you’re doing better. Thanks. ❤️‍🩹