Menopause Society Certification Exam
Study online at https://quizlet.com/_hp8us5
1. STRAW+10 -5, -4, -3b, -3a
Reproductive
Stages
2. Early reproduc- Starts at menarche and cycles are typically irregular for several years
tive stage -5
3. Reproductive Peak stage
stage -4 Cycles are regular
Ranging from 21-35 days
4. Late Reproduc- Fecundability (the chance of becoming pregnant) declines
tive stage: -3 (-3a cycles may start to change
& -3b)
5. Late reproduc- FSH and cycle length are normal, but AFC and AMH decline
tive stage: -3b
6. Late reproduc- Subtle changes in menstrual cycle length and flow
tive stage: -3a often increasing frequency of shorter cycles
Variable FSH levels
AMH and AFC are low
7. AMH Produced by the granulosa cells of preantral and small antral follicles (unmea-
sured by ultrasound)
Not a screening tool in women without a diagnosis of infertility because it does
not correlate with time to pregnancy
8. Peak AMH 24.5 years old
Not reliable before 25
Slight fluctuation during cycles
9.
, Menopause Society Certification Exam
Study online at https://quizlet.com/_hp8us5
When not to before 25 y.o.
check AMH when pregnant
when on contraceptive as it may 25-50% lower
10. AMH by race higher in white
lower in black and Hispanic
11. AFC Ultrasound detected follicles 2mm-10mm
represent primordial follicles
are considered available pool of follicles
Follicles are decreasing in their ability to produce AMH
12. Menopause tran- Menstrual cycle irregularity
sition: Stages -2 ends with menopause
& -1 Changing hormone levels
inconsistent ovulation
13. Early menopause 7 day difference in cycle length
transition: Stage Elevated FSH (variables still)
-2 low AMH and AFC
Lasting for 10 + cycles
14. Late menopause 60 or more consecutive days of amenorrhea
transition: Stage only one episode is needed to define this stage in women over 45 yo
-1 2 or more episodes between age 40-44 is more predictive of this transition
Increased variability in length
extreme fluctuations is hormones
increased anovulation
FSH >25 in random blood draw
lasts 1-3 years on average
15. LOOP Cycles Elevated estradiol lelves
luteal out of phase event
, Menopause Society Certification Exam
Study online at https://quizlet.com/_hp8us5
one in every four cycles in early menopause transition and 1/3 of cycles in late
High FSH recruits a follicle in the luteal phase
superimposed estradiol from each follicular phase - high levels
Ovulation 50% of time, with shorter cycle <21 days if not ovulation, you will have
a long cycle >36 days
16. LOOP Cycles high estradiol = mastalgia, menorrhagia, uterine fibroid growth, endometrial
symptoms hyperplasia
17. Androgen arom- increase with age to compensate for low estradiol levels
atization in increases with body weight
menopause tran- increase estradiol levels
sition
18. Longer longer exposure to unopposed estradiol = increase risk for reproductive cancers
menopause
transition risk
19. Anovulatory cy- low progesterone levels
cles increase in the menopause transition
40-60% of cycles are anovulatory in late menopause transition
More common in obese women
20. Post- Initiated by FMP
menopausal:
+1a, b, c and +2
21. Early post- 2 years after FMP
menopausal: +1 FSH increases
a, b, c Estradiol decreases
22. Stage +1a postmenopausal year 1
the 12 months after FMP
Study online at https://quizlet.com/_hp8us5
1. STRAW+10 -5, -4, -3b, -3a
Reproductive
Stages
2. Early reproduc- Starts at menarche and cycles are typically irregular for several years
tive stage -5
3. Reproductive Peak stage
stage -4 Cycles are regular
Ranging from 21-35 days
4. Late Reproduc- Fecundability (the chance of becoming pregnant) declines
tive stage: -3 (-3a cycles may start to change
& -3b)
5. Late reproduc- FSH and cycle length are normal, but AFC and AMH decline
tive stage: -3b
6. Late reproduc- Subtle changes in menstrual cycle length and flow
tive stage: -3a often increasing frequency of shorter cycles
Variable FSH levels
AMH and AFC are low
7. AMH Produced by the granulosa cells of preantral and small antral follicles (unmea-
sured by ultrasound)
Not a screening tool in women without a diagnosis of infertility because it does
not correlate with time to pregnancy
8. Peak AMH 24.5 years old
Not reliable before 25
Slight fluctuation during cycles
9.
, Menopause Society Certification Exam
Study online at https://quizlet.com/_hp8us5
When not to before 25 y.o.
check AMH when pregnant
when on contraceptive as it may 25-50% lower
10. AMH by race higher in white
lower in black and Hispanic
11. AFC Ultrasound detected follicles 2mm-10mm
represent primordial follicles
are considered available pool of follicles
Follicles are decreasing in their ability to produce AMH
12. Menopause tran- Menstrual cycle irregularity
sition: Stages -2 ends with menopause
& -1 Changing hormone levels
inconsistent ovulation
13. Early menopause 7 day difference in cycle length
transition: Stage Elevated FSH (variables still)
-2 low AMH and AFC
Lasting for 10 + cycles
14. Late menopause 60 or more consecutive days of amenorrhea
transition: Stage only one episode is needed to define this stage in women over 45 yo
-1 2 or more episodes between age 40-44 is more predictive of this transition
Increased variability in length
extreme fluctuations is hormones
increased anovulation
FSH >25 in random blood draw
lasts 1-3 years on average
15. LOOP Cycles Elevated estradiol lelves
luteal out of phase event
, Menopause Society Certification Exam
Study online at https://quizlet.com/_hp8us5
one in every four cycles in early menopause transition and 1/3 of cycles in late
High FSH recruits a follicle in the luteal phase
superimposed estradiol from each follicular phase - high levels
Ovulation 50% of time, with shorter cycle <21 days if not ovulation, you will have
a long cycle >36 days
16. LOOP Cycles high estradiol = mastalgia, menorrhagia, uterine fibroid growth, endometrial
symptoms hyperplasia
17. Androgen arom- increase with age to compensate for low estradiol levels
atization in increases with body weight
menopause tran- increase estradiol levels
sition
18. Longer longer exposure to unopposed estradiol = increase risk for reproductive cancers
menopause
transition risk
19. Anovulatory cy- low progesterone levels
cles increase in the menopause transition
40-60% of cycles are anovulatory in late menopause transition
More common in obese women
20. Post- Initiated by FMP
menopausal:
+1a, b, c and +2
21. Early post- 2 years after FMP
menopausal: +1 FSH increases
a, b, c Estradiol decreases
22. Stage +1a postmenopausal year 1
the 12 months after FMP
