NAMS LATEST 2026 EXAM MANUAL QUESTIONS AND
ANSWERS GRADED A+
✔✔Japanese - ✔✔What ethnicity has the least likely chance of having bad hot flashes?
✔✔black
more frequent, longer duration. - ✔✔What ethnicity is the most likely to have bad hot
flashes?
✔✔10 years, early menopause transition women have them the longest. - ✔✔Median
length of hot flashes
✔✔lower ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction. - ✔✔Theories about etiology of hot flashes (6)
✔✔low grade is not precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma. - ✔✔VIN
low grade-what to do
high grade-what to do
differentiated VIN-what to do
✔✔squamous cell carcinoma - ✔✔most common type of vulvar cancer
✔✔paget's disease
will not improve on steroids
screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time. -
✔✔Vulvar disorder commonly misdiagnosed as eczema or dermatitis?
✔✔<100mL - ✔✔Normal PVR
✔✔will NOT help with stress incontinence. - ✔✔systemic and vaginal estrogen will not
help with this type of urinary incontinence?
✔✔the vaginal rings
FEMRING IS THE HIGHEST - ✔✔Which topical vaginal estrogen has the highest dose?
✔✔BV - ✔✔Most common cause of vulvovaginitis?
,✔✔desquamative inflammatory vaginitis. treat different with clindamycin or
hydrocortisone+ET - ✔✔post menopause burning and diffuse yellow/brown discharge
and dyspareunia that does not respond to local ET?
✔✔circulating androgens - ✔✔What hormones are associated with sexual desire in
women?
✔✔circulating androgen levels - ✔✔Women who have had a BSO experience an abrupt
and persistent decline in what hormone?
✔✔female sexual interest/arousal disorder - ✔✔HSDD and FSAD were combined into a
single dysrunction called
✔✔flibanserin and bremelanotide - ✔✔HSDD treatments
✔✔L-arginine, topical alprostadil, wellbutrin, oxytosin.
phosphodiesterase inhibitors-lacking in efficacy
Eros therapy device $300- vaccum-like the penis pump - ✔✔FGAD treatments (genital
arousal disorder)
✔✔directed masturbation is most researched behavioral treatment. - ✔✔FOD (orgasmic
disorder) treatments
✔✔Rarely. They often shrink after menopause. - ✔✔Does systemic ET cause fibroids to
resume growth?
✔✔Difficulty concentrating and remembering are common. - ✔✔What is true about
cognition and menopause?
✔✔memory for verbal information can be compromised immediately after surgical
menopause, especially if it is before the typical age of mesopause. - ✔✔What is true
about cognition and surgical menopause
✔✔Mediterranean diet with olive oil and tai chi exercise helps with global cognition
Mediterranean diet with olive oil and isoflavone supplements helps with memory. -
✔✔Meta analysis of RCTs have shown small benefit of what diet/exercise for global
cognition and memory?
✔✔small or no overall effect on cognition - ✔✔effect of HRT on cognition
✔✔EPT replacement was shown to double the risk of developing dementia.
, There was no significant increased risk in ET alone.
this is why HRT is not recommended after 65 for primary prevention of dementia -
✔✔What HRT can increase your risk for dementia based on the WHIMS study in 65+
year old healthy women?
✔✔1. Observational studies imply it
2. Clinical trial of transdermal estradiol during the early postmenopause stage is
associated with reductions in AD pathology.
3. 18 year cumulative follow up data from WHI found that women randomized to ET had
significantly lower risk of dying from AD or dementia compared with women randomized
to receive placebo. - ✔✔3 reasons supporting the idea that HRT in early menopause
may decrease a woman's chance of developing alzheimer's disease?
✔✔typically migraines improve-estrogen levels stabilize - ✔✔Migraine headache and
pregnancy
✔✔usually decrease with natural menopause - ✔✔Migraine without aura after
menopause
✔✔should resolve completely - ✔✔menstrual migraine after menopause
✔✔>2 times per week or severe and effecting QOL - ✔✔When to consider preventative
medication for migraines
✔✔patients with cardiovascular disease, as are NSAIDs - ✔✔Triptans are
contraindicated in what?
✔✔NSAID or triptan 2 days before expected to get your period, and take for 5-7 days. -
✔✔Menstrual migraine treatment
✔✔migraine with aura-advise to not use combined hormone contraception
caution in women with migraine without aura - ✔✔cdc and who guidelines for migraine
treatment
✔✔it can take several months. - ✔✔How long can it take for arthralgia from vitamin d
deficiency or hypothyroidism to fully resolve?
✔✔osteoarthritis - ✔✔what is th emost common form of arthritis?
✔✔hippocampus and prefrontal cortex - ✔✔what areas of th ebrain have th emost
estrogen receptors?
ANSWERS GRADED A+
✔✔Japanese - ✔✔What ethnicity has the least likely chance of having bad hot flashes?
✔✔black
more frequent, longer duration. - ✔✔What ethnicity is the most likely to have bad hot
flashes?
✔✔10 years, early menopause transition women have them the longest. - ✔✔Median
length of hot flashes
✔✔lower ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction. - ✔✔Theories about etiology of hot flashes (6)
✔✔low grade is not precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma. - ✔✔VIN
low grade-what to do
high grade-what to do
differentiated VIN-what to do
✔✔squamous cell carcinoma - ✔✔most common type of vulvar cancer
✔✔paget's disease
will not improve on steroids
screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time. -
✔✔Vulvar disorder commonly misdiagnosed as eczema or dermatitis?
✔✔<100mL - ✔✔Normal PVR
✔✔will NOT help with stress incontinence. - ✔✔systemic and vaginal estrogen will not
help with this type of urinary incontinence?
✔✔the vaginal rings
FEMRING IS THE HIGHEST - ✔✔Which topical vaginal estrogen has the highest dose?
✔✔BV - ✔✔Most common cause of vulvovaginitis?
,✔✔desquamative inflammatory vaginitis. treat different with clindamycin or
hydrocortisone+ET - ✔✔post menopause burning and diffuse yellow/brown discharge
and dyspareunia that does not respond to local ET?
✔✔circulating androgens - ✔✔What hormones are associated with sexual desire in
women?
✔✔circulating androgen levels - ✔✔Women who have had a BSO experience an abrupt
and persistent decline in what hormone?
✔✔female sexual interest/arousal disorder - ✔✔HSDD and FSAD were combined into a
single dysrunction called
✔✔flibanserin and bremelanotide - ✔✔HSDD treatments
✔✔L-arginine, topical alprostadil, wellbutrin, oxytosin.
phosphodiesterase inhibitors-lacking in efficacy
Eros therapy device $300- vaccum-like the penis pump - ✔✔FGAD treatments (genital
arousal disorder)
✔✔directed masturbation is most researched behavioral treatment. - ✔✔FOD (orgasmic
disorder) treatments
✔✔Rarely. They often shrink after menopause. - ✔✔Does systemic ET cause fibroids to
resume growth?
✔✔Difficulty concentrating and remembering are common. - ✔✔What is true about
cognition and menopause?
✔✔memory for verbal information can be compromised immediately after surgical
menopause, especially if it is before the typical age of mesopause. - ✔✔What is true
about cognition and surgical menopause
✔✔Mediterranean diet with olive oil and tai chi exercise helps with global cognition
Mediterranean diet with olive oil and isoflavone supplements helps with memory. -
✔✔Meta analysis of RCTs have shown small benefit of what diet/exercise for global
cognition and memory?
✔✔small or no overall effect on cognition - ✔✔effect of HRT on cognition
✔✔EPT replacement was shown to double the risk of developing dementia.
, There was no significant increased risk in ET alone.
this is why HRT is not recommended after 65 for primary prevention of dementia -
✔✔What HRT can increase your risk for dementia based on the WHIMS study in 65+
year old healthy women?
✔✔1. Observational studies imply it
2. Clinical trial of transdermal estradiol during the early postmenopause stage is
associated with reductions in AD pathology.
3. 18 year cumulative follow up data from WHI found that women randomized to ET had
significantly lower risk of dying from AD or dementia compared with women randomized
to receive placebo. - ✔✔3 reasons supporting the idea that HRT in early menopause
may decrease a woman's chance of developing alzheimer's disease?
✔✔typically migraines improve-estrogen levels stabilize - ✔✔Migraine headache and
pregnancy
✔✔usually decrease with natural menopause - ✔✔Migraine without aura after
menopause
✔✔should resolve completely - ✔✔menstrual migraine after menopause
✔✔>2 times per week or severe and effecting QOL - ✔✔When to consider preventative
medication for migraines
✔✔patients with cardiovascular disease, as are NSAIDs - ✔✔Triptans are
contraindicated in what?
✔✔NSAID or triptan 2 days before expected to get your period, and take for 5-7 days. -
✔✔Menstrual migraine treatment
✔✔migraine with aura-advise to not use combined hormone contraception
caution in women with migraine without aura - ✔✔cdc and who guidelines for migraine
treatment
✔✔it can take several months. - ✔✔How long can it take for arthralgia from vitamin d
deficiency or hypothyroidism to fully resolve?
✔✔osteoarthritis - ✔✔what is th emost common form of arthritis?
✔✔hippocampus and prefrontal cortex - ✔✔what areas of th ebrain have th emost
estrogen receptors?
