NAMS MENOPAUSE CERTIFICATION EXAM WITH QUESTIONS AND VERIFIED ANSWERS 2026/27 SERIES

NAMS MENOPAUSE CERTIFICATION EXAM
WITH QUESTIONS AND VERIFIED ANSWERS
2026/27 SERIES
1. Which hormonal change is most directly responsible for the onset of menopause?
A. Increased progesterone secretion
B. Decreased ovarian follicular activity
C. Increased LH suppression
D. Increased estrogen production
Correct Answer: B
Explanation: Menopause is primarily caused by depletion of ovarian follicles, leading to
decreased estrogen production. The other options are incorrect because LH typically
increases, not decreases, and estrogen production declines rather than increases.



2. The average age of natural menopause in most populations is:
A. 40 years
B. 45 years
C. 51 years
D. 60 years
Correct Answer: C
Explanation: The average age of natural menopause is approximately 51 years. The
other options are outside the typical physiologic range.



3. The most common vasomotor symptom of menopause is:
A. Vaginal dryness
B. Hot flashes
C. Osteoporosis
D. Weight loss
Correct Answer: B
Explanation: Hot flashes are the hallmark vasomotor symptom. Vaginal dryness is
genitourinary, not vasomotor.



4. Which hormone level is most consistently elevated in postmenopausal women?
A. Estrogen
B. Progesterone
C. Follicle-stimulating hormone (FSH)
D. Oxytocin
Correct Answer: C

, Explanation: FSH rises due to loss of negative feedback from ovarian estrogen
production.



5. The most appropriate first-line therapy for moderate to severe vasomotor symptoms in
healthy women under 60 is:
A. Calcium supplements
B. Hormone therapy
C. Antibiotics
D. Anticoagulants
Correct Answer: B
Explanation: Systemic hormone therapy is the most effective treatment for vasomotor
symptoms in appropriate candidates.



6. A major contraindication to estrogen therapy is:
A. Osteopenia
B. History of breast cancer
C. Mild hot flashes
D. Age over 50
Correct Answer: B
Explanation: Estrogen therapy is contraindicated in women with a history of estrogen-
sensitive breast cancer.



7. Which symptom is most associated with genitourinary syndrome of menopause (GSM)?
A. Headache
B. Vaginal dryness and dyspareunia
C. Hypertension
D. Insomnia
Correct Answer: B
Explanation: GSM includes vaginal dryness, irritation, and painful intercourse due to
estrogen deficiency.



8. Non-hormonal first-line therapy for vasomotor symptoms includes:
A. SSRIs and SNRIs
B. Antibiotics
C. Diuretics
D. Antipsychotics only
Correct Answer: A

, Explanation: SSRIs/SNRIs such as paroxetine and venlafaxine are effective non-
hormonal options.



9. The primary mechanism of bone loss in menopause is:
A. Increased calcium intake
B. Decreased estrogen leading to increased bone resorption
C. Increased testosterone
D. Increased calcitonin
Correct Answer: B
Explanation: Estrogen deficiency increases osteoclast activity, accelerating bone loss.



10. Which screening test is recommended for osteoporosis in postmenopausal women?
A. ECG
B. DEXA scan
C. MRI brain
D. Chest X-ray
Correct Answer: B
Explanation: DEXA scan is the gold standard for bone mineral density assessment.



11. The most common sleep disturbance during menopause is:
A. Sleep apnea only
B. Insomnia
C. Narcolepsy
D. REM disorder exclusively
Correct Answer: B
Explanation: Insomnia is commonly associated with hormonal fluctuations and
vasomotor symptoms.



12. Which factor increases risk for early menopause?
A. High calcium diet
B. Smoking
C. Regular exercise
D. High estrogen therapy
Correct Answer: B
Explanation: Smoking is associated with earlier onset of menopause due to ovarian
toxicity.