Menstruation
Most female mammals have an estrous cycle, yet only ten primates species, four bats species, the elephant shrew, and the spiny mouse have a menstrual cycle. The relatedness of these groups suggests that four distinct evolutionary events have caused menstruation to arise.
Leptin
In mice, and to a lesser extent in humans, leptin is required for male and female fertility. Ovulatory cycles in females are linked to energy balance (positive or negative depending on whether a female is losing or gaining weight) and energy flux (how much energy is consumed and expended) much more than energy status (fat levels). When energy balance is highly negative (meaning the woman is starving) or energy flux is very high (meaning the woman is exercising at extreme levels, but still consuming enough calories), the ovarian cycle stops and females stop menstruating. Only if a female has an extremely low body fat percentage does energy status affect menstruation. Leptin levels outside an ideal range may have a negative effect on egg quality and outcome during "in vitro" fertilization. Leptin is involved in reproduction by stimulating gonadotropin-releasing hormone from the hypothalamus.