Page 1 of 73
NAMS MENOPAUSE CERTIFICATION EXAM |
{LATEST 2026/ 2027 UPDATE} COMPLETE
ACTUAL AND AUTHENTIC EXAM | BRAND NEW!
Androgenetic Alopecia
Female pattern thinning, genetic predisposition, hormonal factors, a
slow miniaturization over time, characterized by follicular
miniaturization, shorter growth cycle, and longer latent period; NOT
AN ABRUPT SHED.
Female Pattern Thinning
Can begin in teens, usually NOT androgen excess; first notice smaller
ponytail, wider part, see scalp.
Labs to Obtain in Female Pattern Thinning
TSH, CBC, ferritin, consider PCOS.
Topical treatment for female pattern thinning
,Page 2 of 73
minoxidil 5% once daily
Systemic treatment for female pattern hair thinning
Younger women - OCP w/ drospirenon, spironolactone 100-200 mg
daily
Minoxidil dosage
2.5mg daily
Finasteride dosage
5mg daily
Dutasteride dosage
.5mg daily
Telogen effluvium
,Page 3 of 73
Premature shedding of hair in the resting phase
Causes of telogen effluvium
Thyroid, Rapid weight loss, Significant illness, Anesthesia,
Malnutrition, Pregnancy, Heparin, β-blockers, IFN, lithium, retinoids,
OCP discontinuation, antidepressants, anticonvulsants, ACE inhibitors,
colchicine, NSAIDs
Testosterone estrogen level trend in menopause
Testosterone levels decrease but not as significantly as estrogen levels
therefore leading to a hypoestrogenemic and relative hyperandrogenic
state that may lead to patterned hair loss
Role of estrogen on urogenital health
Vasoactive hormone, increases blood flow, increases transductive
lubrication, supplies glycogen to superficial and intermediate layers
maintaining acidic pH, supports collagen content of the vagina,
maintains thickness and elasticity of the vaginal walls, supports
epithelium, connective tissue, and smooth muscle of the vulva,
vagina, urethra and bladder trigone
, Page 4 of 73
Non-pharmacologic vaginal moisturizer
Long term aid to vaginal dryness attaches to mucin and epithelial cells
on vaginal wall, carries up to 60x its weight in water, holds water in
place, requires maintenance 2-3x week
Topical estrogen use in uterine cancer
Can: Type I and II, Carcinosarcoma; Cannot: Leiomyosarcoma, Stromal
sarcoma
Topical estrogen use in ovarian cancer
Can: HGSOC, Germ cell, Granulosa cell; Cannot: Endometrioid
Topical estrogen use in cervical cancer
All
Dosing of vaginal estrogen
Daily for 2 weeks then 2x weekly
NAMS MENOPAUSE CERTIFICATION EXAM |
{LATEST 2026/ 2027 UPDATE} COMPLETE
ACTUAL AND AUTHENTIC EXAM | BRAND NEW!
Androgenetic Alopecia
Female pattern thinning, genetic predisposition, hormonal factors, a
slow miniaturization over time, characterized by follicular
miniaturization, shorter growth cycle, and longer latent period; NOT
AN ABRUPT SHED.
Female Pattern Thinning
Can begin in teens, usually NOT androgen excess; first notice smaller
ponytail, wider part, see scalp.
Labs to Obtain in Female Pattern Thinning
TSH, CBC, ferritin, consider PCOS.
Topical treatment for female pattern thinning
,Page 2 of 73
minoxidil 5% once daily
Systemic treatment for female pattern hair thinning
Younger women - OCP w/ drospirenon, spironolactone 100-200 mg
daily
Minoxidil dosage
2.5mg daily
Finasteride dosage
5mg daily
Dutasteride dosage
.5mg daily
Telogen effluvium
,Page 3 of 73
Premature shedding of hair in the resting phase
Causes of telogen effluvium
Thyroid, Rapid weight loss, Significant illness, Anesthesia,
Malnutrition, Pregnancy, Heparin, β-blockers, IFN, lithium, retinoids,
OCP discontinuation, antidepressants, anticonvulsants, ACE inhibitors,
colchicine, NSAIDs
Testosterone estrogen level trend in menopause
Testosterone levels decrease but not as significantly as estrogen levels
therefore leading to a hypoestrogenemic and relative hyperandrogenic
state that may lead to patterned hair loss
Role of estrogen on urogenital health
Vasoactive hormone, increases blood flow, increases transductive
lubrication, supplies glycogen to superficial and intermediate layers
maintaining acidic pH, supports collagen content of the vagina,
maintains thickness and elasticity of the vaginal walls, supports
epithelium, connective tissue, and smooth muscle of the vulva,
vagina, urethra and bladder trigone
, Page 4 of 73
Non-pharmacologic vaginal moisturizer
Long term aid to vaginal dryness attaches to mucin and epithelial cells
on vaginal wall, carries up to 60x its weight in water, holds water in
place, requires maintenance 2-3x week
Topical estrogen use in uterine cancer
Can: Type I and II, Carcinosarcoma; Cannot: Leiomyosarcoma, Stromal
sarcoma
Topical estrogen use in ovarian cancer
Can: HGSOC, Germ cell, Granulosa cell; Cannot: Endometrioid
Topical estrogen use in cervical cancer
All
Dosing of vaginal estrogen
Daily for 2 weeks then 2x weekly
