As a female fetus develops in the womb, a few million immature eggs are produced but most of these will degrade before puberty. When menstruation commences during puberty, one egg is released approximately every 28 days. During each of these menstrual cycles, the lining of the uterus (womb) thickens, to prepare for implantation of an embryo, if fertilization occurs. If the woman does not become pregnant, the thickened lining is useless and starts to shed along with the egg. It is discharged through the vagina in approximately 5 days and is referred to as a period or menses. Hormonal changes will allow this cycle to be repeated monthly. Normal menstrual cycles are a result of proper functioning and synchronization of the hypothalamus, pituitary gland and ovaries. Normally, women do not menstruate before puberty, during pregnancy and after menopause.

Amenorrhea is a fairly common disorder, affecting between 2 - 5% of women in North America. It is a menstrual condition characterized by absent menstrual periods for more than three monthly menstrual cycles. Amenorrhea is often associated with infertility, and can cause long-term problems when it comes to conception. It often indicates reproductive health problems including polycystic ovarian syndrome (PCOS), in which tiny cysts form over the ovaries, uterine fibroids, a condition where wart-like growths form in the uterine cavity and hirsutism, whereby the pituitary gland produces too much of one hormone.

Amenorrhea is not a disease, but is usually a symptom of another condition and may be classified as primary or secondary. Primary amenorrhea occurs when a woman has not started to menstruate by the age of 16, while secondary amenorrhea refers to the abnormal cessation of menstruation in a woman who previously had menstrual cycles.

Primary amenorrhea may be caused by developmental problems such as the congenital absence of the uterus, or failure of the ovary to receive or maintain egg cells. Delay in pubertal development will also lead to primary amenorrhea. In fact, any abnormalities in the organs, glands, and receptors involved in menstruation may result in failure of the production of the correct proportions of hormones and may lead to primary amenorrhea.

Poor diet, excessive exercise and stress are the most common causes of secondary amenorrhea. Hormonal disturbances from the hypothalamus and the pituitary gland, premature menopause, and intrauterine scar formation may also lead to secondary amenorrhea.

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