MENOPAUSE SOCIETY CERTIFIED
PRACTITIONER (MSCP) EXAM| NAMS
MENOPAUSE EXAM BANK| REAL EXAM
CURRENTLY TESTING | EXPERT VERIFIED FOR
GUARANTEED PASS 2026
1. At what average age does natural menopause occur?
A. 45 years
B. 51 years
C. 55 years
D. 60 years
Answer: 51 years
Rationale: The mean age of menopause in the U.S. is approximately 51 years.
2. Menopause is defined retrospectively after how many months of amenorrhea?
A. 3 months
B. 6 months
C. 12 months
D. 18 months
Answer: 12 months
Rationale: Menopause is the absence of menstruation for 12 consecutive months.
3. The main source of estrogen in postmenopausal women is:
A. Ovarian follicles
B. Adrenal glands
C. Peripheral aromatization of androgens
D. Pituitary gland
Answer: Peripheral aromatization of androgens
Rationale: Estrone is formed via conversion of androstenedione in adipose tissue.
4. Estrogen’s most potent form in premenopausal women is:
A. Estrone (E1)
B. Estradiol (E2)
C. Estriol (E3)
D. Estrone sulfate
Answer: Estradiol (E2)
Rationale: 17β-estradiol (E2) is the most potent estrogen.
5. The most consistent symptom of early perimenopause is:
A. Night sweats
B. Vasomotor instability (hot flashes)
C. Vaginal dryness
D. Bone loss
, Answer: Vasomotor instability (hot flashes)
Rationale: Hot flashes and night sweats are hallmark symptoms.
Section 2: Vasomotor Symptom Management
6. Which medication is the first-line therapy for moderate to severe hot flashes in
healthy women <60 years and <10 years post-menopause?
A. Clonidine
B. Estrogen therapy
C. Venlafaxine
D. Gabapentin
Answer: Estrogen therapy
Rationale: Estrogen therapy is the gold standard for vasomotor symptoms.
7. Nonhormonal therapy best supported by evidence for hot flashes includes:
A. SSRIs/SNRIs
B. Progesterone
C. Testosterone
D. DHEA
Answer: SSRIs/SNRIs
Rationale: SSRIs and SNRIs (e.g., paroxetine, venlafaxine) effectively reduce VMS.
8. Clonidine is limited in use due to:
A. Limited efficacy
B. Weight gain
C. Improved sleep
D. Increased libido
Answer: Limited efficacy
Rationale: Clonidine provides limited VMS relief and causes side effects such as
hypotension.
9. A woman with a history of breast cancer should be advised to use:
A. Systemic estrogen
B. Tibolone
C. Nonhormonal options such as venlafaxine
D. Conjugated equine estrogen
Answer: Nonhormonal options such as venlafaxine
Rationale: Hormone therapy is contraindicated; nonhormonal agents are preferred.
10. FDA-approved nonhormonal medication for moderate-severe VMS (as of 2023):
A. Oxybutynin
B. Fezolinetant
C. Gabapentin
D. Paroxetine
Answer: Fezolinetant
Rationale: Fezolinetant is a neurokinin 3 receptor antagonist approved for hot flashes.
Section 3: Hormone Therapy (HT) Principles
, 11. Estrogen therapy alone increases the risk of:
A. Endometrial hyperplasia
B. Breast cancer
C. Ovarian cysts
D. Vitamin D deficiency
Answer: Endometrial hyperplasia
Rationale: Unopposed estrogen stimulates endometrial proliferation.
12. Progestogen is added to systemic estrogen therapy to prevent:
A. Bone loss
B. Endometrial hyperplasia and cancer
C. Vasomotor symptoms
D. Cardiovascular disease
Answer: Endometrial hyperplasia and cancer
Rationale: Progestogen protects the uterine lining from unopposed estrogen.
13. Which statement about route of estrogen administration is correct?
A. Oral estrogen increases VTE risk more than transdermal
B. All forms have equivalent liver effects
C. Transdermal estrogen increases triglycerides
D. Oral and transdermal forms have equal risk for hypertension
Answer: Oral estrogen increases VTE risk more than transdermal
Rationale: Transdermal estrogen bypasses first-pass liver metabolism.
14. The “timing hypothesis” suggests menopausal HT is safer when started:
A. >15 years post-menopause
B. <10 years post-menopause
C. Age >70 years
D. Immediately at menopause regardless of age
Answer: <10 years post-menopause
Rationale: Cardiovascular risk is lowest when HT starts early after menopause.
15. Absolute contraindication to estrogen therapy:
A. Controlled hypertension
B. Past thromboembolic event
C. Osteoporosis
D. Hypothyroidism
Answer: Past thromboembolic event
Rationale: VTE or estrogen-dependent cancers are absolute contraindications.
16. Which of the following best describes Genitourinary Syndrome of Menopause
(GSM)?
A. Condition limited to vaginal dryness
B. Combination of genital, sexual, and urinary symptoms due to estrogen deficiency
C. Disorder of excess testosterone
D. Premenstrual-related disorder
Answer: Combination of genital, sexual, and urinary symptoms due to estrogen
deficiency
Rationale: GSM is a chronic syndrome involving vulvovaginal atrophy, dryness, and
urinary changes.
PRACTITIONER (MSCP) EXAM| NAMS
MENOPAUSE EXAM BANK| REAL EXAM
CURRENTLY TESTING | EXPERT VERIFIED FOR
GUARANTEED PASS 2026
1. At what average age does natural menopause occur?
A. 45 years
B. 51 years
C. 55 years
D. 60 years
Answer: 51 years
Rationale: The mean age of menopause in the U.S. is approximately 51 years.
2. Menopause is defined retrospectively after how many months of amenorrhea?
A. 3 months
B. 6 months
C. 12 months
D. 18 months
Answer: 12 months
Rationale: Menopause is the absence of menstruation for 12 consecutive months.
3. The main source of estrogen in postmenopausal women is:
A. Ovarian follicles
B. Adrenal glands
C. Peripheral aromatization of androgens
D. Pituitary gland
Answer: Peripheral aromatization of androgens
Rationale: Estrone is formed via conversion of androstenedione in adipose tissue.
4. Estrogen’s most potent form in premenopausal women is:
A. Estrone (E1)
B. Estradiol (E2)
C. Estriol (E3)
D. Estrone sulfate
Answer: Estradiol (E2)
Rationale: 17β-estradiol (E2) is the most potent estrogen.
5. The most consistent symptom of early perimenopause is:
A. Night sweats
B. Vasomotor instability (hot flashes)
C. Vaginal dryness
D. Bone loss
, Answer: Vasomotor instability (hot flashes)
Rationale: Hot flashes and night sweats are hallmark symptoms.
Section 2: Vasomotor Symptom Management
6. Which medication is the first-line therapy for moderate to severe hot flashes in
healthy women <60 years and <10 years post-menopause?
A. Clonidine
B. Estrogen therapy
C. Venlafaxine
D. Gabapentin
Answer: Estrogen therapy
Rationale: Estrogen therapy is the gold standard for vasomotor symptoms.
7. Nonhormonal therapy best supported by evidence for hot flashes includes:
A. SSRIs/SNRIs
B. Progesterone
C. Testosterone
D. DHEA
Answer: SSRIs/SNRIs
Rationale: SSRIs and SNRIs (e.g., paroxetine, venlafaxine) effectively reduce VMS.
8. Clonidine is limited in use due to:
A. Limited efficacy
B. Weight gain
C. Improved sleep
D. Increased libido
Answer: Limited efficacy
Rationale: Clonidine provides limited VMS relief and causes side effects such as
hypotension.
9. A woman with a history of breast cancer should be advised to use:
A. Systemic estrogen
B. Tibolone
C. Nonhormonal options such as venlafaxine
D. Conjugated equine estrogen
Answer: Nonhormonal options such as venlafaxine
Rationale: Hormone therapy is contraindicated; nonhormonal agents are preferred.
10. FDA-approved nonhormonal medication for moderate-severe VMS (as of 2023):
A. Oxybutynin
B. Fezolinetant
C. Gabapentin
D. Paroxetine
Answer: Fezolinetant
Rationale: Fezolinetant is a neurokinin 3 receptor antagonist approved for hot flashes.
Section 3: Hormone Therapy (HT) Principles
, 11. Estrogen therapy alone increases the risk of:
A. Endometrial hyperplasia
B. Breast cancer
C. Ovarian cysts
D. Vitamin D deficiency
Answer: Endometrial hyperplasia
Rationale: Unopposed estrogen stimulates endometrial proliferation.
12. Progestogen is added to systemic estrogen therapy to prevent:
A. Bone loss
B. Endometrial hyperplasia and cancer
C. Vasomotor symptoms
D. Cardiovascular disease
Answer: Endometrial hyperplasia and cancer
Rationale: Progestogen protects the uterine lining from unopposed estrogen.
13. Which statement about route of estrogen administration is correct?
A. Oral estrogen increases VTE risk more than transdermal
B. All forms have equivalent liver effects
C. Transdermal estrogen increases triglycerides
D. Oral and transdermal forms have equal risk for hypertension
Answer: Oral estrogen increases VTE risk more than transdermal
Rationale: Transdermal estrogen bypasses first-pass liver metabolism.
14. The “timing hypothesis” suggests menopausal HT is safer when started:
A. >15 years post-menopause
B. <10 years post-menopause
C. Age >70 years
D. Immediately at menopause regardless of age
Answer: <10 years post-menopause
Rationale: Cardiovascular risk is lowest when HT starts early after menopause.
15. Absolute contraindication to estrogen therapy:
A. Controlled hypertension
B. Past thromboembolic event
C. Osteoporosis
D. Hypothyroidism
Answer: Past thromboembolic event
Rationale: VTE or estrogen-dependent cancers are absolute contraindications.
16. Which of the following best describes Genitourinary Syndrome of Menopause
(GSM)?
A. Condition limited to vaginal dryness
B. Combination of genital, sexual, and urinary symptoms due to estrogen deficiency
C. Disorder of excess testosterone
D. Premenstrual-related disorder
Answer: Combination of genital, sexual, and urinary symptoms due to estrogen
deficiency
Rationale: GSM is a chronic syndrome involving vulvovaginal atrophy, dryness, and
urinary changes.
