NAMs Menopause Certification Exam With Complete
Solutions Latest updates
Climacteric phase - Right Ansa -The period of endocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
Early menopause - Right Ansa -LMP before age 45
Late menopause - Right Ansa -LMP after age 54
Primary ovarian insufficiency - Right Ansa -Menopause that occurs before age 40
Early menopause transition (stage -2) - Right Ansa -Persistent difference of 7 days or
more in the length of consecutive cycles.
Late menopause transition (stage -1) - Right Ansa -60 or more consecutive days of
amenorrhea
Luteal out of phase event (LOOP) - Right Ansa -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.
Obese women and estradiol levels during menopause - Right Ansa -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 - Right Ansa -These ethnic groups have lower estradiol
levels then white, black and hispanic women.
stage +2 - Right Ansa -late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c - Right Ansa -early post menopause: 2 years after FMP. FSH
rises, estradiol decreases. VMS predominate.
, Elevated FSH, LH - Right Ansa -Endocrine labs after menopause
AMH, inhibin B - Right Ansa -These hormones work during reproductive years to not
deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - Right Ansa -Menstrual cycle
shortenes, follicular phase compresses, women spend more time in luteal phase..
meaning more premenstrual symptoms and more frequent menstrual periods.
How to respond if a patient requests FSH lab? - Right Ansa -many pitfalls, variable
depending on the day of the cycle you draw the lab, normal or low FSH is not helpful.
The potentially superior marker of menopause, a lab. - Right Ansa -AMH
DHEA (dehydroepiandrosterone) - Right Ansa -Adrenal androgens: precursor hromones
produced by the adrenal gland that are enzymatically converted to active androgens or
estrogens in peripheral tissues.
Location of estrogen receptors - Right Ansa -Vagina, vulva, urethra, trigone of the
bladder
Effects of estrogen on tissue - Right Ansa -maintain blood flow, the collagen, and HA
within the epithelial surfaces. Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause - Right Ansa -Thinning, loss of elasticity, loss or
absence or rugae.
Vagina and urethra in menopause - Right Ansa -vagina narrows, urethra moves closer
to the introitus.
Stress urinary incontinence - Right Ansa -Vaginal estrogen and urinary incontinence:
what type does it help with?
Treatment for FPHL - Right Ansa -Minoxidil, spironolactone, finasteride, estrogen
therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH,
AFC, inhibin? - Right Ansa --3b: menstrual cycles normal, FSH normal, AMH low, AFC
low, inhibin low.
Solutions Latest updates
Climacteric phase - Right Ansa -The period of endocrinologic, somatic, and transitory
psychologic changes that occur around the time of menopause.
Early menopause - Right Ansa -LMP before age 45
Late menopause - Right Ansa -LMP after age 54
Primary ovarian insufficiency - Right Ansa -Menopause that occurs before age 40
Early menopause transition (stage -2) - Right Ansa -Persistent difference of 7 days or
more in the length of consecutive cycles.
Late menopause transition (stage -1) - Right Ansa -60 or more consecutive days of
amenorrhea
Luteal out of phase event (LOOP) - Right Ansa -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.
Obese women and estradiol levels during menopause - Right Ansa -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 - Right Ansa -These ethnic groups have lower estradiol
levels then white, black and hispanic women.
stage +2 - Right Ansa -late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c - Right Ansa -early post menopause: 2 years after FMP. FSH
rises, estradiol decreases. VMS predominate.
, Elevated FSH, LH - Right Ansa -Endocrine labs after menopause
AMH, inhibin B - Right Ansa -These hormones work during reproductive years to not
deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - Right Ansa -Menstrual cycle
shortenes, follicular phase compresses, women spend more time in luteal phase..
meaning more premenstrual symptoms and more frequent menstrual periods.
How to respond if a patient requests FSH lab? - Right Ansa -many pitfalls, variable
depending on the day of the cycle you draw the lab, normal or low FSH is not helpful.
The potentially superior marker of menopause, a lab. - Right Ansa -AMH
DHEA (dehydroepiandrosterone) - Right Ansa -Adrenal androgens: precursor hromones
produced by the adrenal gland that are enzymatically converted to active androgens or
estrogens in peripheral tissues.
Location of estrogen receptors - Right Ansa -Vagina, vulva, urethra, trigone of the
bladder
Effects of estrogen on tissue - Right Ansa -maintain blood flow, the collagen, and HA
within the epithelial surfaces. Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause - Right Ansa -Thinning, loss of elasticity, loss or
absence or rugae.
Vagina and urethra in menopause - Right Ansa -vagina narrows, urethra moves closer
to the introitus.
Stress urinary incontinence - Right Ansa -Vaginal estrogen and urinary incontinence:
what type does it help with?
Treatment for FPHL - Right Ansa -Minoxidil, spironolactone, finasteride, estrogen
therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH,
AFC, inhibin? - Right Ansa --3b: menstrual cycles normal, FSH normal, AMH low, AFC
low, inhibin low.
