2023 NAMS Exam
By 2020, number of women over 50 - Correct Answer ✔✔ - 64 million
By 2060, number of women over 50 - Correct Answer ✔✔ - 90 million
What is the US female life expectancy - Correct Answer ✔✔ - 81.2 years
How many oocytes in the ovary at 20 weeks pregnancy - Correct Answer ✔✔ - 6-7
Million
How many oocytes left at birth - Correct Answer ✔✔ - 1-2 million
How many oocytes left at puberty - Correct Answer ✔✔ - 300,000-500,000
What is the period of change at menopause - Correct Answer ✔✔ - Climacteric or
perimenopause
What is the term for menopause that occurs before age 45 - Correct Answer ✔✔ -
Early menopause
What is the term for menopause that occurs after age 54 - Correct Answer ✔✔ - Late
menopause
What is the timeframe within the first 8 years after FMP (and what numerical SWAN
stages correspond?) - Correct Answer ✔✔ - Early post menopause (+1a, +1b, +1c)
What is the timeframe called after 8 years from FMP (and what numerical SWAN stage
corresponds?) - Correct Answer ✔✔ - Late post menopause (+2)
What is the time before FMP with cycle variability (and what numerical SWAN stages
correspond?) - Correct Answer ✔✔ - Menopause transition (-2, -1)
What is the time of 7 or more days persistent difference in cycle length (and what
numerical SWAN stage corresponds?) - Correct Answer ✔✔ - Early menopause
transition (-2)
What is the time with 60 or more days of amenorrhea at least once (and what numerical
SWAN stage corresponds?) - Correct Answer ✔✔ - Late menopause transition (-1)
What is a retrospective determination of 12 months of amenorrhea - Correct Answer
✔✔ - Natural menopause
What is the timeframe from onset of menstrual cycle irregularity to 1 year after final
menopause transition - Correct Answer ✔✔ - Perimenopause
What is any time frame after FMP - Correct Answer ✔✔ - Post menopause
What is the preferred term for menopause before age 40 - Correct Answer ✔✔ -
Primary ovarian insufficiency (POI)
Preferred since this may not be a permanent state
What term for menopause before age 40 should no longer be used - Correct Answer
✔✔ - Premature ovarian failure
,What percentage of US women experience POI - Correct Answer ✔✔ - 1%
How many total stages in STRAW - Correct Answer ✔✔ - 10 total
Reproductive has 4 (-5 to -3a)
Menopause Transition has 2 (-2 to -1)
Post Menopause has 4 (+1a to +2)
How many reproductive stages in STRAW - Correct Answer ✔✔ - 4 (-5 early
reproductive, -4 Peak reproductive, -3b and -3b late reproductive)
How many stages in menopause transition in STRAW - Correct Answer ✔✔ - 2 (-2
early transition, -1 late transition)
How many stages in postmenopause in STRAW - Correct Answer ✔✔ - 4 (+1a, +1b
and +1c early PM, +2 late PM)
Which STRAW stage is menarche in - Correct Answer ✔✔ - -5 early reproductive
In which STRAW stage are cycles every 21 to 35 days - Correct Answer ✔✔ - -4 Peak
reproductive
What differentiates STRAW stage -3b from -3a - Correct Answer ✔✔ - -3b cycles
normal, FSH wnl, AMH, AFC, inhibit B low
-3a shorter cycles, variable FSH
What effect do inhibin B and AMH have on follicles - Correct Answer ✔✔ - They
prevent too many follicles from growing at once, so the follicle pool is not depleted too
quickly
What happens to inhibin b and AMH levels during menopause transition - Correct
Answer ✔✔ - Decreased number of follicles leads to decreased levels of both of these
products.
This means more follicular atresia
What is a LOOP event - Correct Answer ✔✔ - Luteal Out of Phase event
Explains why some perimenopausal women have elevated estrogen levels sometimes.
In early menopause, transition, elevated FSH is adequate to recruit a second follicle.
This results in a follicular phase-like rise in estradiol during the luteal phase
Compared to normal weight women, how do the pre-menopause and post menopause
estradiol levels of obese women compare - Correct Answer ✔✔ - Lower pre-
menopause estradiol
Higher post menopause estradiol
Which ethnic groups have lower estradiol levels, compared to white/black/Hispanic
women - Correct Answer ✔✔ - Chinese and Japanese women
Where is AMH produced - Correct Answer ✔✔ - Granulosa cells of antral and preantral
follicles
When does AMH peak - Correct Answer ✔✔ - Around 25 yo
(so before age 25, test is not helpful)
How does birth control affect AMH - Correct Answer ✔✔ - Lowers it
What is AFC - Correct Answer ✔✔ - Antral follicle count
Number of follicles 2-10 mm detected with ultrasound
Do African-American women have higher or lower FSH levels - Correct Answer ✔✔ -
Higher
Do Chinese and Japanese women have higher or lower estradiol levels compared to
white women - Correct Answer ✔✔ - Lower
What happens to SHBG at menopause - Correct Answer ✔✔ - Decreases
, (T:SHBG ratio increases by 80%)
What is the Free Androgen Index - Correct Answer ✔✔ - T:SHBG ratio
What hormone is generally higher in obese women and why - Correct Answer ✔✔ -
Estrone
Due to aromatization of estradiol to estrone by excess adipose tissue
What 2 hormones does the postmenopausal ovary continue to produce - Correct
Answer ✔✔ - Testosterone
Androstenedione
Surgical menopause reduces what hormone as compared to natural menopause -
Correct Answer ✔✔ - Testosterone
(40 to 50% lower)
In menopause transition, women spend more time in what menstrual phase - Correct
Answer ✔✔ - Luteal
What is the HPO axis theory of menopause transition - Correct Answer ✔✔ - HPO
access becomes less sensitive to estrogen.
Even with good follicle, growth and estradiol, LH surges fail, leading to cycle irregularity.
In the first year after the FMP, there is no production of what hormone - Correct Answer
✔✔ - Progesterone
What 3 products does the adrenal cortex produce - Correct Answer ✔✔ -
Glucocorticoids
Mineralocorticoids
Sex steroids
What does the adrenal medulla produce - Correct Answer ✔✔ - Catecholamines
(epinephrine, norepinephrine, and dopamine)
Glucocorticoids are produced in which layer of the adrenal gland - Correct Answer ✔✔
- Zona fasciculata of adrenal cortex
What are the glucocorticoids - Correct Answer ✔✔ - Cortisol
Cortiosterone
What is the minealrocorticoid - Correct Answer ✔✔ - Aldosterone
What hypothalamic and pituitary hormones control the secretion of glucocorticoids -
Correct Answer ✔✔ - CRH from the hypothalamus
ACTH from the anterior pituitary
Which layer of the adrenal gland produces mineralocorticoids - Correct Answer ✔✔ -
Zona glomerulosa in adrenal cortex
Which layer of the adrenal gland produces sex steroids/androgens - Correct Answer
✔✔ - Zona reticularis of adrenal cortex
Which sex steroids/androgens are produced from the adrenal gland - Correct Answer
✔✔ - DHEA
DHEAS
Androstenedione
What 3 products regulate the secretion of mineralocorticoids (aldosterone) from the
adrenal gland - Correct Answer ✔✔ - Angiotensin II
Potassium concentration
ACTH from the pituitary
What are the only 2 products that the posterior pituitary secretes - Correct Answer ✔✔
- Vasopressin
By 2020, number of women over 50 - Correct Answer ✔✔ - 64 million
By 2060, number of women over 50 - Correct Answer ✔✔ - 90 million
What is the US female life expectancy - Correct Answer ✔✔ - 81.2 years
How many oocytes in the ovary at 20 weeks pregnancy - Correct Answer ✔✔ - 6-7
Million
How many oocytes left at birth - Correct Answer ✔✔ - 1-2 million
How many oocytes left at puberty - Correct Answer ✔✔ - 300,000-500,000
What is the period of change at menopause - Correct Answer ✔✔ - Climacteric or
perimenopause
What is the term for menopause that occurs before age 45 - Correct Answer ✔✔ -
Early menopause
What is the term for menopause that occurs after age 54 - Correct Answer ✔✔ - Late
menopause
What is the timeframe within the first 8 years after FMP (and what numerical SWAN
stages correspond?) - Correct Answer ✔✔ - Early post menopause (+1a, +1b, +1c)
What is the timeframe called after 8 years from FMP (and what numerical SWAN stage
corresponds?) - Correct Answer ✔✔ - Late post menopause (+2)
What is the time before FMP with cycle variability (and what numerical SWAN stages
correspond?) - Correct Answer ✔✔ - Menopause transition (-2, -1)
What is the time of 7 or more days persistent difference in cycle length (and what
numerical SWAN stage corresponds?) - Correct Answer ✔✔ - Early menopause
transition (-2)
What is the time with 60 or more days of amenorrhea at least once (and what numerical
SWAN stage corresponds?) - Correct Answer ✔✔ - Late menopause transition (-1)
What is a retrospective determination of 12 months of amenorrhea - Correct Answer
✔✔ - Natural menopause
What is the timeframe from onset of menstrual cycle irregularity to 1 year after final
menopause transition - Correct Answer ✔✔ - Perimenopause
What is any time frame after FMP - Correct Answer ✔✔ - Post menopause
What is the preferred term for menopause before age 40 - Correct Answer ✔✔ -
Primary ovarian insufficiency (POI)
Preferred since this may not be a permanent state
What term for menopause before age 40 should no longer be used - Correct Answer
✔✔ - Premature ovarian failure
,What percentage of US women experience POI - Correct Answer ✔✔ - 1%
How many total stages in STRAW - Correct Answer ✔✔ - 10 total
Reproductive has 4 (-5 to -3a)
Menopause Transition has 2 (-2 to -1)
Post Menopause has 4 (+1a to +2)
How many reproductive stages in STRAW - Correct Answer ✔✔ - 4 (-5 early
reproductive, -4 Peak reproductive, -3b and -3b late reproductive)
How many stages in menopause transition in STRAW - Correct Answer ✔✔ - 2 (-2
early transition, -1 late transition)
How many stages in postmenopause in STRAW - Correct Answer ✔✔ - 4 (+1a, +1b
and +1c early PM, +2 late PM)
Which STRAW stage is menarche in - Correct Answer ✔✔ - -5 early reproductive
In which STRAW stage are cycles every 21 to 35 days - Correct Answer ✔✔ - -4 Peak
reproductive
What differentiates STRAW stage -3b from -3a - Correct Answer ✔✔ - -3b cycles
normal, FSH wnl, AMH, AFC, inhibit B low
-3a shorter cycles, variable FSH
What effect do inhibin B and AMH have on follicles - Correct Answer ✔✔ - They
prevent too many follicles from growing at once, so the follicle pool is not depleted too
quickly
What happens to inhibin b and AMH levels during menopause transition - Correct
Answer ✔✔ - Decreased number of follicles leads to decreased levels of both of these
products.
This means more follicular atresia
What is a LOOP event - Correct Answer ✔✔ - Luteal Out of Phase event
Explains why some perimenopausal women have elevated estrogen levels sometimes.
In early menopause, transition, elevated FSH is adequate to recruit a second follicle.
This results in a follicular phase-like rise in estradiol during the luteal phase
Compared to normal weight women, how do the pre-menopause and post menopause
estradiol levels of obese women compare - Correct Answer ✔✔ - Lower pre-
menopause estradiol
Higher post menopause estradiol
Which ethnic groups have lower estradiol levels, compared to white/black/Hispanic
women - Correct Answer ✔✔ - Chinese and Japanese women
Where is AMH produced - Correct Answer ✔✔ - Granulosa cells of antral and preantral
follicles
When does AMH peak - Correct Answer ✔✔ - Around 25 yo
(so before age 25, test is not helpful)
How does birth control affect AMH - Correct Answer ✔✔ - Lowers it
What is AFC - Correct Answer ✔✔ - Antral follicle count
Number of follicles 2-10 mm detected with ultrasound
Do African-American women have higher or lower FSH levels - Correct Answer ✔✔ -
Higher
Do Chinese and Japanese women have higher or lower estradiol levels compared to
white women - Correct Answer ✔✔ - Lower
What happens to SHBG at menopause - Correct Answer ✔✔ - Decreases
, (T:SHBG ratio increases by 80%)
What is the Free Androgen Index - Correct Answer ✔✔ - T:SHBG ratio
What hormone is generally higher in obese women and why - Correct Answer ✔✔ -
Estrone
Due to aromatization of estradiol to estrone by excess adipose tissue
What 2 hormones does the postmenopausal ovary continue to produce - Correct
Answer ✔✔ - Testosterone
Androstenedione
Surgical menopause reduces what hormone as compared to natural menopause -
Correct Answer ✔✔ - Testosterone
(40 to 50% lower)
In menopause transition, women spend more time in what menstrual phase - Correct
Answer ✔✔ - Luteal
What is the HPO axis theory of menopause transition - Correct Answer ✔✔ - HPO
access becomes less sensitive to estrogen.
Even with good follicle, growth and estradiol, LH surges fail, leading to cycle irregularity.
In the first year after the FMP, there is no production of what hormone - Correct Answer
✔✔ - Progesterone
What 3 products does the adrenal cortex produce - Correct Answer ✔✔ -
Glucocorticoids
Mineralocorticoids
Sex steroids
What does the adrenal medulla produce - Correct Answer ✔✔ - Catecholamines
(epinephrine, norepinephrine, and dopamine)
Glucocorticoids are produced in which layer of the adrenal gland - Correct Answer ✔✔
- Zona fasciculata of adrenal cortex
What are the glucocorticoids - Correct Answer ✔✔ - Cortisol
Cortiosterone
What is the minealrocorticoid - Correct Answer ✔✔ - Aldosterone
What hypothalamic and pituitary hormones control the secretion of glucocorticoids -
Correct Answer ✔✔ - CRH from the hypothalamus
ACTH from the anterior pituitary
Which layer of the adrenal gland produces mineralocorticoids - Correct Answer ✔✔ -
Zona glomerulosa in adrenal cortex
Which layer of the adrenal gland produces sex steroids/androgens - Correct Answer
✔✔ - Zona reticularis of adrenal cortex
Which sex steroids/androgens are produced from the adrenal gland - Correct Answer
✔✔ - DHEA
DHEAS
Androstenedione
What 3 products regulate the secretion of mineralocorticoids (aldosterone) from the
adrenal gland - Correct Answer ✔✔ - Angiotensin II
Potassium concentration
ACTH from the pituitary
What are the only 2 products that the posterior pituitary secretes - Correct Answer ✔✔
- Vasopressin
