NAMS MENOPAUSE CERTIFICATION
EXAM QUESTIONS AND ANSWERS 100%
PASS 2026/2027
Climacteric phase - ANS The period of endrocrinologic, somatic, and transitory psychologic
changes that occur around the time of menopause.
Early menopause - ANS LMP before age 45
Late menopause - ANS LMP after age 54
Primary ovarian insufficiency - ANS Menopause that occurs before age 40
Early menopause transition (stage -2) - ANS Persistent difference of 7 days or more in the
length of consecutive cycles.
Late menopause transition (stage -1) - ANS 60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) - ANS 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.
Obese women and estradiol levels during menopause - ANS Obese women are more likely to
have anovulatory cycles with high estradiol levels. They are also more likely to have lower
2026/2027 ALLRIGHTS RESERVED
1
, 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 - ANS These ethnic groups have lower estradiol levels then
white, black and hispanic women.
stage +2 - ANS late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms.
Stages +1a, +1b, +1c - ANS early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.
Elevated FSH, LH - ANS Endocrine labs after menopause
AMH, inhibin B - ANS These hormones work during reproductive years to not deplete follicle
pool too quickly.
Phases during menopause transition and PMS symptoms - ANS Menstrual 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? - ANS many 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. - ANS AMH
DHEA (dehydroepiandrosterone) - ANS Adrenal androgens: precursor hromones produced by
the adrenal gland that are enzymatically converted to active androgens or estrogens in
peripheral tissues.
Location of estrogen receptors - ANS Vagina, vulva, urethra, trigone of the bladder
2026/2027 ALLRIGHTS RESERVED
2
EXAM QUESTIONS AND ANSWERS 100%
PASS 2026/2027
Climacteric phase - ANS The period of endrocrinologic, somatic, and transitory psychologic
changes that occur around the time of menopause.
Early menopause - ANS LMP before age 45
Late menopause - ANS LMP after age 54
Primary ovarian insufficiency - ANS Menopause that occurs before age 40
Early menopause transition (stage -2) - ANS Persistent difference of 7 days or more in the
length of consecutive cycles.
Late menopause transition (stage -1) - ANS 60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) - ANS 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.
Obese women and estradiol levels during menopause - ANS Obese women are more likely to
have anovulatory cycles with high estradiol levels. They are also more likely to have lower
2026/2027 ALLRIGHTS RESERVED
1
, 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 - ANS These ethnic groups have lower estradiol levels then
white, black and hispanic women.
stage +2 - ANS late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms.
Stages +1a, +1b, +1c - ANS early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.
Elevated FSH, LH - ANS Endocrine labs after menopause
AMH, inhibin B - ANS These hormones work during reproductive years to not deplete follicle
pool too quickly.
Phases during menopause transition and PMS symptoms - ANS Menstrual 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? - ANS many 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. - ANS AMH
DHEA (dehydroepiandrosterone) - ANS Adrenal androgens: precursor hromones produced by
the adrenal gland that are enzymatically converted to active androgens or estrogens in
peripheral tissues.
Location of estrogen receptors - ANS Vagina, vulva, urethra, trigone of the bladder
2026/2027 ALLRIGHTS RESERVED
2
