ABSTRACT
The normal developmental progression from a prepubertal stage to ovulatory menstruation requires an intact hypothalamic-pituitary-ovarian axis. In addition, normal female reproductive structures and adequate nutritional status are necessary for normal menses to occur. Central, gonadal, structural, or systemic abnormalities can lead to menstrual dysfunction. Menstrual abnormalities can be defined as lack of menstruation (primary or secondary amenorrhea), irregular menstruation (oligomenorrhea or dysfunctional uterine bleeding (DUB)) or abnormalities associated with menstruation (dysmenorrhea). Therefore, a discussion of menstrual abnormalities must begin with a description of the current knowledge regarding normal female pubertal development and menarche.
