NAMS MENOPAUSE CERTIFICATION
EXAM 2026/2027 PRACTICE TEST
1. According to the STRAW+10 staging system, which stage is characterized by a persistent
change of 7 days or more in the length of consecutive menstrual cycles?
A. Stage -2 (Late Reproductive)
B. Stage -1 (Early Menopausal Transition)
C. Stage -3 (Early Reproductive)
D. Stage 0 (Postmenopause)
Answer: B
Conceptual Explanation: Stage -1, the early menopausal transition, is defined by
increased variability in cycle length, specifically a persistent difference of 7 or more days in
consecutive cycles.
2. Which of the following non-hormonal treatments is a neurokinin 3 (NK3) receptor
antagonist specifically FDA-approved for moderate to severe vasomotor symptoms?
A. Oxybutynin
B. Venlafaxine
,C. Gabapentin
D. Fezolinetant
Answer: D
Conceptual Explanation: Fezolinetant is a selective NK3 receptor antagonist that targets
the KNDy neurons in the hypothalamus to treat vasomotor symptoms without using
estrogen.
3. The ‘timing hypothesis’ suggested by the ELITE trial results indicates that hormone therapy
has a more favorable effect on subclinical atherosclerosis when started:
A. Only after age 65
B. More than 10 years after menopause onset
C. Within 10 years of menopause onset
D. During the early reproductive years
Answer: C
Conceptual Explanation: The ELITE trial found that oral estradiol slowed the progression
of carotid artery intima-media thickness when started within 6 years of menopause, but
not when started 10 or more years after menopause.
, 4. For a postmenopausal woman with an intact uterus, what is the minimum number of days
per month that a progestogen should be administered in a sequential regimen to provide
adequate endometrial protection?
A. 12 to 14 days
B. 5 to 7 days
C. 20 to 22 days
D. Every other day
Answer: A
Conceptual Explanation: Clinical evidence suggests that at least 12 to 14 days of
progestogen per month is necessary to prevent endometrial hyperplasia in women using
sequential systemic estrogen therapy.
5. A 52-year-old woman reports painful intercourse and vaginal dryness. Physical exam shows
pale, thin vaginal mucosa. Which of the following is considered a first-line non-hormonal
treatment?
A. Vaginal estrogen cream
B. Prasterone (DHEA)
C. Ospemifene
D. Vaginal lubricants and moisturizers
Answer: D
EXAM 2026/2027 PRACTICE TEST
1. According to the STRAW+10 staging system, which stage is characterized by a persistent
change of 7 days or more in the length of consecutive menstrual cycles?
A. Stage -2 (Late Reproductive)
B. Stage -1 (Early Menopausal Transition)
C. Stage -3 (Early Reproductive)
D. Stage 0 (Postmenopause)
Answer: B
Conceptual Explanation: Stage -1, the early menopausal transition, is defined by
increased variability in cycle length, specifically a persistent difference of 7 or more days in
consecutive cycles.
2. Which of the following non-hormonal treatments is a neurokinin 3 (NK3) receptor
antagonist specifically FDA-approved for moderate to severe vasomotor symptoms?
A. Oxybutynin
B. Venlafaxine
,C. Gabapentin
D. Fezolinetant
Answer: D
Conceptual Explanation: Fezolinetant is a selective NK3 receptor antagonist that targets
the KNDy neurons in the hypothalamus to treat vasomotor symptoms without using
estrogen.
3. The ‘timing hypothesis’ suggested by the ELITE trial results indicates that hormone therapy
has a more favorable effect on subclinical atherosclerosis when started:
A. Only after age 65
B. More than 10 years after menopause onset
C. Within 10 years of menopause onset
D. During the early reproductive years
Answer: C
Conceptual Explanation: The ELITE trial found that oral estradiol slowed the progression
of carotid artery intima-media thickness when started within 6 years of menopause, but
not when started 10 or more years after menopause.
, 4. For a postmenopausal woman with an intact uterus, what is the minimum number of days
per month that a progestogen should be administered in a sequential regimen to provide
adequate endometrial protection?
A. 12 to 14 days
B. 5 to 7 days
C. 20 to 22 days
D. Every other day
Answer: A
Conceptual Explanation: Clinical evidence suggests that at least 12 to 14 days of
progestogen per month is necessary to prevent endometrial hyperplasia in women using
sequential systemic estrogen therapy.
5. A 52-year-old woman reports painful intercourse and vaginal dryness. Physical exam shows
pale, thin vaginal mucosa. Which of the following is considered a first-line non-hormonal
treatment?
A. Vaginal estrogen cream
B. Prasterone (DHEA)
C. Ospemifene
D. Vaginal lubricants and moisturizers
Answer: D
