NAMS Menopause Certification Exam Study Guide | Menopause Certification Exam Prep

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NAMs Menopause Certification Exam

Climacteric phase

The period of endrocrinologic, somatic, and transitory psychologic changes
that occur around the time of menopause.




Early menopause

LMP before age 45




Late menopause

LMP after age 54




Primary ovarian insufficiency


pg. 1

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Menopause that occurs before age 40




Early menopause transition (stage -2)

Persistent difference of 7 days or more in the length of consecutive cycles.




Late menopause transition (stage -1)

60 or more consecutive days of amenorrhea




Luteal out of phase event (LOOP)

Explains why some perimenopausal women have elevated estrogen level
sometimes...In the early menopause transition, elevated FSH levels are
adequate to recruit a second follicle which results in a follicular phase-like
rise in estradiol secretion superimposed on the mid-to-late luteal phase of
the ongoing ovulatory cycle.


pg. 2

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Obese women and estradiol levels during menopause

Obese women are more likely to have anovulatory cycles with high
estradiol levels. They are also more likely to have lower premenopause yet
higher postmenopause estradiol levels compared with women of normal
weight. (why they are at higher risk of endometrial cancer)




Chinese and Japanese women

These ethnic groups have lower estradiol levels then white, black and
hispanic women.




stage +2

late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms.


pg. 3

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Stages +1a, +1b, +1c

early post menopause: 2 years after FMP. FSH rises, estradiol decreases.
VMS predominate.




Elevated FSH, LH

Endocrine labs after menopause




AMH, inhibin B

These hormones work during reproductive years to not deplete follicle pool
too quickly.




pg. 4

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