Menopause Society Certified Practitioner
Competency Examination (MSCP)
2027 | Newly Released
Questions,Answers With Complete Solutions
Guaranteed Pass | Graded A+
Q1. A 51-year-old woman presents with a 4-month history of cycle length variability. Her cycles
have ranged from 24 to 38 days. According to STRAW+10, which stage is she in?
A. Late menopausal transition
B. Early menopausal transition [CORRECT]
C. Postmenopause
Correct Answer: B
Rationale: Correct because persistent cycle length variability of ≥7 days defines Stage -2 (early
transition). Late transition requires ≥60 days of amenorrhea .
Q2. A 58-year-old woman is 6 years past menopause. She has no contraindications and requests
HT for VMS. Based on the timing hypothesis, her cardiovascular risk profile with HT initiation
is:
A. Unfavorable because she is over 55
B. Favorable because she is within 10 years of menopause and under 60 [CORRECT]
C. Neutral because timing has no effect on outcomes
Correct Answer: B
Rationale: Correct because early initiation (<60 years or <10 years since menopause) is
associated with reduced CAD risk (RR 0.52) and all-cause mortality (RR 0.70) .
Q3. A 60-year-old woman with a history of breast cancer treated 5 years ago has moderate-to-
severe dyspareunia. Non-hormonal lubricants have failed. She is not on an aromatase inhibitor.
What is the most appropriate next step?
,A. Systemic estrogen therapy
B. Low-dose vaginal estrogen after oncologist discussion [CORRECT]
C. Oral ospemifene without discussion
Correct Answer: B
Rationale: Correct because low-dose vaginal estrogen may be considered for breast cancer
survivors who fail non-hormonal therapy, after oncologist discussion. Systemic estrogen is
contraindicated.
Q4. A 63-year-old woman has a DEXA T-score of -2.3 at the total hip. This represents:
A. Normal bone density
B. Osteopenia [CORRECT]
C. Osteoporosis
Correct Answer: B
Rationale: Correct because a T-score between -1.0 and -2.5 defines osteopenia. Osteoporosis
requires ≤ -2.5.
Q5. A 55-year-old woman with a history of VTE has severe VMS. She cannot take estrogen.
Which non-hormonal option is FDA-approved for VMS?
A. Venlafaxine
B. Fezolinetant [CORRECT]
C. Gabapentin
Correct Answer: B
Rationale: Correct because fezolinetant is an NK3 receptor antagonist FDA-approved for VMS.
Venlafaxine has evidence but is not FDA-approved for this indication .
Q6. Which route of estrogen administration is associated with no increased VTE risk?
A. Oral conjugated equine estrogen
B. Transdermal estradiol [CORRECT]
C. Oral estradiol
Correct Answer: B
Rationale: Correct because transdermal estrogen bypasses first-pass hepatic metabolism. VTE
risk was increased with oral HT (RR 1.74–1.96), while transdermal showed no increased risk
(OR 0.93) .
, Q7. A 57-year-old woman with premature ovarian insufficiency (POI) is on HT. How long
should she continue?
A. Until symptoms resolve, typically 1–2 years
B. Until at least the average age of natural menopause [CORRECT]
C. Indefinitely
Correct Answer: B
Rationale: Correct because HT in POI is recommended until at least the average age of natural
menopause (approximately 51–52) to protect bone and cardiovascular health.
Q8. A 54-year-old woman has a FRAX 10-year major osteoporotic fracture risk of 17%. She has
no prior fracture. What is the appropriate action?
A. Lifestyle modification only
B. Consider pharmacotherapy [CORRECT]
C. Reassure and reassess in 5 years
Correct Answer: B
Rationale: Correct because FRAX between 15% and 19.9% supports considering
pharmacotherapy.
Q9. Which of the following is an absolute contraindication to systemic hormone therapy?
A. Vasomotor symptoms
B. History of breast cancer [CORRECT]
C. Genitourinary syndrome of menopause
Correct Answer: B
Rationale: Correct because a history of breast cancer is an absolute contraindication to systemic
HT.
Q10. A 52-year-old woman is in the late menopausal transition. Which STRAW+10 criterion
applies?
A. Amenorrhea ≥60 days but <12 months [CORRECT]
B. Cycle variability of ≥7 days
C. 12 months of amenorrhea
Competency Examination (MSCP)
2027 | Newly Released
Questions,Answers With Complete Solutions
Guaranteed Pass | Graded A+
Q1. A 51-year-old woman presents with a 4-month history of cycle length variability. Her cycles
have ranged from 24 to 38 days. According to STRAW+10, which stage is she in?
A. Late menopausal transition
B. Early menopausal transition [CORRECT]
C. Postmenopause
Correct Answer: B
Rationale: Correct because persistent cycle length variability of ≥7 days defines Stage -2 (early
transition). Late transition requires ≥60 days of amenorrhea .
Q2. A 58-year-old woman is 6 years past menopause. She has no contraindications and requests
HT for VMS. Based on the timing hypothesis, her cardiovascular risk profile with HT initiation
is:
A. Unfavorable because she is over 55
B. Favorable because she is within 10 years of menopause and under 60 [CORRECT]
C. Neutral because timing has no effect on outcomes
Correct Answer: B
Rationale: Correct because early initiation (<60 years or <10 years since menopause) is
associated with reduced CAD risk (RR 0.52) and all-cause mortality (RR 0.70) .
Q3. A 60-year-old woman with a history of breast cancer treated 5 years ago has moderate-to-
severe dyspareunia. Non-hormonal lubricants have failed. She is not on an aromatase inhibitor.
What is the most appropriate next step?
,A. Systemic estrogen therapy
B. Low-dose vaginal estrogen after oncologist discussion [CORRECT]
C. Oral ospemifene without discussion
Correct Answer: B
Rationale: Correct because low-dose vaginal estrogen may be considered for breast cancer
survivors who fail non-hormonal therapy, after oncologist discussion. Systemic estrogen is
contraindicated.
Q4. A 63-year-old woman has a DEXA T-score of -2.3 at the total hip. This represents:
A. Normal bone density
B. Osteopenia [CORRECT]
C. Osteoporosis
Correct Answer: B
Rationale: Correct because a T-score between -1.0 and -2.5 defines osteopenia. Osteoporosis
requires ≤ -2.5.
Q5. A 55-year-old woman with a history of VTE has severe VMS. She cannot take estrogen.
Which non-hormonal option is FDA-approved for VMS?
A. Venlafaxine
B. Fezolinetant [CORRECT]
C. Gabapentin
Correct Answer: B
Rationale: Correct because fezolinetant is an NK3 receptor antagonist FDA-approved for VMS.
Venlafaxine has evidence but is not FDA-approved for this indication .
Q6. Which route of estrogen administration is associated with no increased VTE risk?
A. Oral conjugated equine estrogen
B. Transdermal estradiol [CORRECT]
C. Oral estradiol
Correct Answer: B
Rationale: Correct because transdermal estrogen bypasses first-pass hepatic metabolism. VTE
risk was increased with oral HT (RR 1.74–1.96), while transdermal showed no increased risk
(OR 0.93) .
, Q7. A 57-year-old woman with premature ovarian insufficiency (POI) is on HT. How long
should she continue?
A. Until symptoms resolve, typically 1–2 years
B. Until at least the average age of natural menopause [CORRECT]
C. Indefinitely
Correct Answer: B
Rationale: Correct because HT in POI is recommended until at least the average age of natural
menopause (approximately 51–52) to protect bone and cardiovascular health.
Q8. A 54-year-old woman has a FRAX 10-year major osteoporotic fracture risk of 17%. She has
no prior fracture. What is the appropriate action?
A. Lifestyle modification only
B. Consider pharmacotherapy [CORRECT]
C. Reassure and reassess in 5 years
Correct Answer: B
Rationale: Correct because FRAX between 15% and 19.9% supports considering
pharmacotherapy.
Q9. Which of the following is an absolute contraindication to systemic hormone therapy?
A. Vasomotor symptoms
B. History of breast cancer [CORRECT]
C. Genitourinary syndrome of menopause
Correct Answer: B
Rationale: Correct because a history of breast cancer is an absolute contraindication to systemic
HT.
Q10. A 52-year-old woman is in the late menopausal transition. Which STRAW+10 criterion
applies?
A. Amenorrhea ≥60 days but <12 months [CORRECT]
B. Cycle variability of ≥7 days
C. 12 months of amenorrhea
