NAMS Menopause Certification Exam Study Guide | NCMP Exam
Prep 2024–2025 NCMP Certification Exam – NAMS Menopause
Study Guide & Practice Questions
What's Included:
✅ Clinical review of menopause, perimenopause, and aging-related care
✅ Hormone Therapy (HRT): risks, benefits, indications, contraindications
✅ Non-hormonal therapy and lifestyle interventions
✅ Case-based practice questions and clinical scenarios
✅ Covers sexual health, osteoporosis, cardiovascular health, and more
✅ Aligned with NAMS 2024–2025 exam blueprint
✅ Created by clinicians for NPs, PAs, MDs, and RNs
Surgical menopause causes women to have lower levels of what hormone?
testosterone. 40-50% lower than in women w/ intact ovaries.
Driving piece of menopause is ovarian follicles depleting. What does this do to the inhibin B and
AMH?
inhibin and AMH decrease
therefore, follicle growth is not restrained, this allows for the growth of the remaining, diminished
follicle pool.
In the menopause transition, women spend more time in what phase?
Luteal-more PMS symptoms, more frequent menstrual periods.
HPO axis theory and the menopause transition
It is felt that the HPO axis may become less sensitive to estrogen, so even with good follicle growth and
estradiol secretion, LH surges can fail which can lead to more cycle irregularity.
In the first year after the FMP, there is no production of what hormone?
progesterone
What region of the adrenal gland secretes the androgens?
, zona reticularis
what are considered the 'adrenal androgens'?
DHEA, DHEAS, Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal gland is regulated by 3 main factors.
Angiotensin II, potassium concentration, adrenocorticotropic hormone secreted by the anterior
pituitary.
What part of the pituitary gland secretes adrenocorticotropic hormone?
Anterior pituitary. The posterior only secretes vasopressin and oxytosin.
Cortisol and HRT
Most serum cortisol circulates bound to cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which increases total cortisol concentration.
Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on serum cortisol concentration.
Do cortisol levels associate with VMS severity?
No, cortisol levels have NOT been associated with more severe VMS.
Local DHEA has been proven to help with what?
vaginal pain and dyspareunia
How to DX POI?
Menstrual disturbance-oligomenorrhea or amenorrhea for at least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart.
Anyone <40years old who misses 3+ consecutive cycles gets these labs
prolactin
FSH
estradiol
TSH
pregnancy test
treatment of POI
Prep 2024–2025 NCMP Certification Exam – NAMS Menopause
Study Guide & Practice Questions
What's Included:
✅ Clinical review of menopause, perimenopause, and aging-related care
✅ Hormone Therapy (HRT): risks, benefits, indications, contraindications
✅ Non-hormonal therapy and lifestyle interventions
✅ Case-based practice questions and clinical scenarios
✅ Covers sexual health, osteoporosis, cardiovascular health, and more
✅ Aligned with NAMS 2024–2025 exam blueprint
✅ Created by clinicians for NPs, PAs, MDs, and RNs
Surgical menopause causes women to have lower levels of what hormone?
testosterone. 40-50% lower than in women w/ intact ovaries.
Driving piece of menopause is ovarian follicles depleting. What does this do to the inhibin B and
AMH?
inhibin and AMH decrease
therefore, follicle growth is not restrained, this allows for the growth of the remaining, diminished
follicle pool.
In the menopause transition, women spend more time in what phase?
Luteal-more PMS symptoms, more frequent menstrual periods.
HPO axis theory and the menopause transition
It is felt that the HPO axis may become less sensitive to estrogen, so even with good follicle growth and
estradiol secretion, LH surges can fail which can lead to more cycle irregularity.
In the first year after the FMP, there is no production of what hormone?
progesterone
What region of the adrenal gland secretes the androgens?
, zona reticularis
what are considered the 'adrenal androgens'?
DHEA, DHEAS, Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal gland is regulated by 3 main factors.
Angiotensin II, potassium concentration, adrenocorticotropic hormone secreted by the anterior
pituitary.
What part of the pituitary gland secretes adrenocorticotropic hormone?
Anterior pituitary. The posterior only secretes vasopressin and oxytosin.
Cortisol and HRT
Most serum cortisol circulates bound to cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which increases total cortisol concentration.
Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on serum cortisol concentration.
Do cortisol levels associate with VMS severity?
No, cortisol levels have NOT been associated with more severe VMS.
Local DHEA has been proven to help with what?
vaginal pain and dyspareunia
How to DX POI?
Menstrual disturbance-oligomenorrhea or amenorrhea for at least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart.
Anyone <40years old who misses 3+ consecutive cycles gets these labs
prolactin
FSH
estradiol
TSH
pregnancy test
treatment of POI
