NAMS MENOPAUSE CERTIFICATION EXAM| QUESTIONS AND
CORRECT ANSWERS| NEWEST EXAM UPDATE 2025/2026
Climacteric phase -CORRECT ANSWERThe period of endrocrinologic,
somatic, and transitory psychologic changes that occur around the time of
menopause.
Early menopause -CORRECT ANSWERLMP before age 45
Late menopause -CORRECT ANSWERLMP after age 54
Primary ovarian insufficiency -CORRECT ANSWERMenopause that occurs
before age 40
Early menopause transition (stage -2) -CORRECT ANSWERPersistent
difference of 7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) -CORRECT ANSWER60 or more
consecutive days of amenorrhea
Luteal out of phase event (LOOP) -CORRECT ANSWERExplains why some
perimenopausal women have elevated estrogen level sometimes...In the early
menopause transition, elevated FSH levels are adequate to recruit a second
follicle which results in a follicular phase-like rise in estradiol secretion
superimposed on the mid-to-late luteal phase of the ongoing ovulatory cycle.
Obese women and estradiol levels during menopause -CORRECT
ANSWERObese women are more likely to have anovulatory cycles with high
estradiol levels. They are also more likely to have lower premenopause yet
,higher postmenopause estradiol levels compared with women of normal weight.
(why they are at higher risk of endometrial cancer)
Chinese and Japanese women -CORRECT ANSWERThese ethnic groups
have lower estradiol levels then white, black and hispanic women.
stage +2 -CORRECT ANSWERlate menopause stage: 5-8 years after FMP.
Somatic aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c -CORRECT ANSWERearly post menopause: 2 years
after FMP. FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH -CORRECT ANSWEREndocrine labs after menopause
AMH, inhibin B -CORRECT ANSWERThese hormones work during
reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms -CORRECT
ANSWERMenstrual cycle shortenes, follicular phase compresses, women
spend more time in luteal phase.. meaning more premenstrual symptoms and
more frequent menstrual periods.
How to respond if a patient requests FSH lab? -CORRECT ANSWERmany
pitfalls, variable depending on the day of the cycle you draw the lab, normal or
low FSH is not helpful.
The potentially superior marker of menopause, a lab. -CORRECT
ANSWERAMH
, DHEA (dehydroepiandrosterone) -CORRECT ANSWERAdrenal androgens:
precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
Location of estrogen receptors -CORRECT ANSWERVagina, vulva, urethra,
trigone of the bladder
Effects of estrogen on tissue -CORRECT ANSWERmaintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome and
protects tissue from pathogens.
Vaginal changes with menopause -CORRECT ANSWERThinning, loss of
elasticity, loss or absence or rugae.
Vagina and urethra in menopause -CORRECT ANSWERvagina narrows,
urethra moves closer to the introitus.
Stress urinary incontinence -CORRECT ANSWERVaginal estrogen and
urinary incontinence: what type does it help with?
Treatment for FPHL -CORRECT ANSWERMinoxidil, spironolactone,
finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles,
FSH, AMH, AFC, inhibin? -CORRECT ANSWER-3b: menstrual cycles
normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
CORRECT ANSWERS| NEWEST EXAM UPDATE 2025/2026
Climacteric phase -CORRECT ANSWERThe period of endrocrinologic,
somatic, and transitory psychologic changes that occur around the time of
menopause.
Early menopause -CORRECT ANSWERLMP before age 45
Late menopause -CORRECT ANSWERLMP after age 54
Primary ovarian insufficiency -CORRECT ANSWERMenopause that occurs
before age 40
Early menopause transition (stage -2) -CORRECT ANSWERPersistent
difference of 7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) -CORRECT ANSWER60 or more
consecutive days of amenorrhea
Luteal out of phase event (LOOP) -CORRECT ANSWERExplains why some
perimenopausal women have elevated estrogen level sometimes...In the early
menopause transition, elevated FSH levels are adequate to recruit a second
follicle which results in a follicular phase-like rise in estradiol secretion
superimposed on the mid-to-late luteal phase of the ongoing ovulatory cycle.
Obese women and estradiol levels during menopause -CORRECT
ANSWERObese women are more likely to have anovulatory cycles with high
estradiol levels. They are also more likely to have lower premenopause yet
,higher postmenopause estradiol levels compared with women of normal weight.
(why they are at higher risk of endometrial cancer)
Chinese and Japanese women -CORRECT ANSWERThese ethnic groups
have lower estradiol levels then white, black and hispanic women.
stage +2 -CORRECT ANSWERlate menopause stage: 5-8 years after FMP.
Somatic aging predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c -CORRECT ANSWERearly post menopause: 2 years
after FMP. FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH -CORRECT ANSWEREndocrine labs after menopause
AMH, inhibin B -CORRECT ANSWERThese hormones work during
reproductive years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms -CORRECT
ANSWERMenstrual cycle shortenes, follicular phase compresses, women
spend more time in luteal phase.. meaning more premenstrual symptoms and
more frequent menstrual periods.
How to respond if a patient requests FSH lab? -CORRECT ANSWERmany
pitfalls, variable depending on the day of the cycle you draw the lab, normal or
low FSH is not helpful.
The potentially superior marker of menopause, a lab. -CORRECT
ANSWERAMH
, DHEA (dehydroepiandrosterone) -CORRECT ANSWERAdrenal androgens:
precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
Location of estrogen receptors -CORRECT ANSWERVagina, vulva, urethra,
trigone of the bladder
Effects of estrogen on tissue -CORRECT ANSWERmaintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome and
protects tissue from pathogens.
Vaginal changes with menopause -CORRECT ANSWERThinning, loss of
elasticity, loss or absence or rugae.
Vagina and urethra in menopause -CORRECT ANSWERvagina narrows,
urethra moves closer to the introitus.
Stress urinary incontinence -CORRECT ANSWERVaginal estrogen and
urinary incontinence: what type does it help with?
Treatment for FPHL -CORRECT ANSWERMinoxidil, spironolactone,
finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles,
FSH, AMH, AFC, inhibin? -CORRECT ANSWER-3b: menstrual cycles
normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
