NAMs Menopause Certification Exam
Questions and Answers
1. Climacteric phase
Answer The period of endrocrinologic, somatic, and transitory psychologic changes that occur
around the time of menopause.
2. Early menopause
Answer LMP before age 45
3. Late menopause
Answer LMP after age 54
4. Primary ovarian insufficiency
Answer Menopause that occurs before age 40
5. Early menopause transition (stage -2)
Answer Persistent difference of 7 days or more in the length of consecutive cycles.
6. Late menopause transition (stage -1)
Answer 60 or more consecutive days of amenorrhea
7. Luteal out of phase event (LOOP)
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20
,Answer Explains 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.
8. Obese women and estradiol levels during menopause
Answer Obese 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)
9. Chinese and Japanese women
Answer These ethnic groups have lower estradiol levels then white, black and hispanic
women.
10. stage +2 late menopause stage
Answer 5-8 years after FMP. Somatic aging predominates. Increased genitourinary symptoms.
11. Stages +1a, +1b, +1c
Answer early post menopause
Answer 2 years after FMP. FSH rises, estradiol decreases. VMS predominate.
12. Elevated FSH, LH
Answer Endocrine labs after menopause
13. AMH, inhibin B
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20
, Answer These hormones work during reproductive years to not deplete follicle pool too quickly.
14. Phases during menopause transition and PMS symptoms
Answer Menstrual cycle shortenes, follicular phase compresses, women spend more time in
luteal phase.. meaning more premenstrual symptoms and more frequent menstrual periods.
15. How to respond if a patient requests FSH lab?
Answer many pitfalls, variable depending on the day of the cycle you draw the lab, normal
or low FSH is not helpful.
16. The potentially superior marker of menopause, a lab.
Answer AMH
17. DHEA (dehydroepiandrosterone)
Answer Adrenal androgens
Answer precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
18. Location of estrogen receptors
Answer Vagina, vulva, urethra, trigone of the bladder
19. Effects of estrogen on tissue
Answer maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports
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20
Questions and Answers
1. Climacteric phase
Answer The period of endrocrinologic, somatic, and transitory psychologic changes that occur
around the time of menopause.
2. Early menopause
Answer LMP before age 45
3. Late menopause
Answer LMP after age 54
4. Primary ovarian insufficiency
Answer Menopause that occurs before age 40
5. Early menopause transition (stage -2)
Answer Persistent difference of 7 days or more in the length of consecutive cycles.
6. Late menopause transition (stage -1)
Answer 60 or more consecutive days of amenorrhea
7. Luteal out of phase event (LOOP)
1/
20
,Answer Explains 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.
8. Obese women and estradiol levels during menopause
Answer Obese 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)
9. Chinese and Japanese women
Answer These ethnic groups have lower estradiol levels then white, black and hispanic
women.
10. stage +2 late menopause stage
Answer 5-8 years after FMP. Somatic aging predominates. Increased genitourinary symptoms.
11. Stages +1a, +1b, +1c
Answer early post menopause
Answer 2 years after FMP. FSH rises, estradiol decreases. VMS predominate.
12. Elevated FSH, LH
Answer Endocrine labs after menopause
13. AMH, inhibin B
2/
20
, Answer These hormones work during reproductive years to not deplete follicle pool too quickly.
14. Phases during menopause transition and PMS symptoms
Answer Menstrual cycle shortenes, follicular phase compresses, women spend more time in
luteal phase.. meaning more premenstrual symptoms and more frequent menstrual periods.
15. How to respond if a patient requests FSH lab?
Answer many pitfalls, variable depending on the day of the cycle you draw the lab, normal
or low FSH is not helpful.
16. The potentially superior marker of menopause, a lab.
Answer AMH
17. DHEA (dehydroepiandrosterone)
Answer Adrenal androgens
Answer precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
18. Location of estrogen receptors
Answer Vagina, vulva, urethra, trigone of the bladder
19. Effects of estrogen on tissue
Answer maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports
3/
20
