NAMS MENOPAUSE CERTIFICATION
PRACTICE EXAM 2026/2027 QUESTIONS
AND ANSWERS
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 (Early Menopausal Transition)
B. Stage -1 (Late Menopausal Transition)
C. Stage +1 (Early Postmenopause)
D. Stage -3 (Late Reproductive)
Answer: A
Conceptual Explanation: Stage -2, the early menopausal transition, is defined by a
persistent change of 7 days or more in cycle length. Stage -1 is characterized by intervals of
amenorrhea of 60 days or more.
,2. Which of the following is the most appropriate first-line treatment for a 52-year-old
woman with moderate Genitourinary Syndrome of Menopause (GSM) who failed to respond
to lubricants and moisturizers?
A. Oral Conjugated Equine Estrogens (CEE)
B. Systemic transdermal estradiol patch
C. Low-dose vaginal estrogen therapy
D. Testosterone cream applied to the clitoris
Answer: C
Conceptual Explanation: For isolated GSM symptoms, low-dose vaginal estrogen is
preferred over systemic therapy due to its localized effect and minimal systemic
absorption.
3. The Women’s Health Initiative (WHI) found that the risk of which of the following
decreased in women taking Estrogen plus Progestogen (E+P)?
A. Venous Thromboembolism (VTE)
B. Breast Cancer
C. Colorectal Cancer
D. Ischemic Stroke
Answer: C
, Conceptual Explanation: The WHI study reported a statistically significant reduction in
the risk of colorectal cancer among women using E+P therapy compared to the placebo
group.
4. Which medication is currently the only FDA-approved non-hormonal SSRI specifically
indicated for the treatment of moderate-to-severe vasomotor symptoms?
A. Venlafaxine 75mg
B. Paroxetine Mesylate 7.5mg
C. Escitalopram 10mg
D. Fluoxetine 20mg
Answer: B
Conceptual Explanation: Paroxetine mesylate (7.5mg) is the only SSRI with an FDA
indication for VMS; other antidepressants are used off-label for this purpose.
5. A 48-year-old woman presents with hot flashes and has a history of a hysterectomy for
fibroids. Which Hormone Therapy (HT) regimen is most appropriate?
A. Estrogen plus Micronized Progesterone
B. Estrogen plus Medroxyprogesterone Acetate
C. Estrogen therapy alone
D. Bazedoxifene alone
Answer: C
PRACTICE EXAM 2026/2027 QUESTIONS
AND ANSWERS
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 (Early Menopausal Transition)
B. Stage -1 (Late Menopausal Transition)
C. Stage +1 (Early Postmenopause)
D. Stage -3 (Late Reproductive)
Answer: A
Conceptual Explanation: Stage -2, the early menopausal transition, is defined by a
persistent change of 7 days or more in cycle length. Stage -1 is characterized by intervals of
amenorrhea of 60 days or more.
,2. Which of the following is the most appropriate first-line treatment for a 52-year-old
woman with moderate Genitourinary Syndrome of Menopause (GSM) who failed to respond
to lubricants and moisturizers?
A. Oral Conjugated Equine Estrogens (CEE)
B. Systemic transdermal estradiol patch
C. Low-dose vaginal estrogen therapy
D. Testosterone cream applied to the clitoris
Answer: C
Conceptual Explanation: For isolated GSM symptoms, low-dose vaginal estrogen is
preferred over systemic therapy due to its localized effect and minimal systemic
absorption.
3. The Women’s Health Initiative (WHI) found that the risk of which of the following
decreased in women taking Estrogen plus Progestogen (E+P)?
A. Venous Thromboembolism (VTE)
B. Breast Cancer
C. Colorectal Cancer
D. Ischemic Stroke
Answer: C
, Conceptual Explanation: The WHI study reported a statistically significant reduction in
the risk of colorectal cancer among women using E+P therapy compared to the placebo
group.
4. Which medication is currently the only FDA-approved non-hormonal SSRI specifically
indicated for the treatment of moderate-to-severe vasomotor symptoms?
A. Venlafaxine 75mg
B. Paroxetine Mesylate 7.5mg
C. Escitalopram 10mg
D. Fluoxetine 20mg
Answer: B
Conceptual Explanation: Paroxetine mesylate (7.5mg) is the only SSRI with an FDA
indication for VMS; other antidepressants are used off-label for this purpose.
5. A 48-year-old woman presents with hot flashes and has a history of a hysterectomy for
fibroids. Which Hormone Therapy (HT) regimen is most appropriate?
A. Estrogen plus Micronized Progesterone
B. Estrogen plus Medroxyprogesterone Acetate
C. Estrogen therapy alone
D. Bazedoxifene alone
Answer: C
