NAMS Menopause Certification Exam 2025–2027 – Guaranteed
Pass | NCMP Study Guide & Verified Q&A NCMP Certification
Prep (2025–2027) – NAMS Menopause Exam Guide with Verified
Answers
Included in This Package:
✅ Verified, exam-style practice questions
✅ Detailed explanations and correct answers
✅ Complete clinical content review: menopause, perimenopause, HRT, and beyond
✅ Covers NAMS 2025–2027 exam outline
✅ HRT case studies, symptom management, non-hormonal therapies, bone & heart
health
✅ Proven methods used by top-scoring NCMP candidates
🎯 Why Choose This Guide?
All content is aligned with NAMS certification standards
Written by certified women’s health experts
Describe the phases during the early menopause transition and what happens with PMS symptoms
Menstrual cycle shortens. Due to unrestrained FSH, follicular phase compresses. More premenstrual
symptoms due to the longer luteal phase. Cycle irregularity and skipped cycles because of ovulatory
failure and increased atresia.
How to respond if a patient requests FSH lab?
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is not
helpful.
What lab is potentially the superior marker of time to menopause?
AMH
DHEA (dehydroepiandrosterone)
Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
,Location of GU estrogen receptors (4)
Vagina, vulva, urethra, trigone of the bladder
List the effects of estrogen on tissue (4+2)
1 ) maintains blood flow to tissue, maintains the collagen within the epithelium, and maintains the
hyaluronic acid and mucopolysaccharides within the moistened epithelial surface, maintains pH (4.5) 2)
supports microbiome and protects tissue from pathogens
List the vaginal changes with menopause you might note on clinical/microscopic exam.
Thinning of the epithelial layer, loss of elasticity with narrowing of the canal and poor distention, noted
on pelvic exam with loss or absence or rugae. Due to the decrease in glycogen content, the lactobacilli
are decreased resulting in higher pH.
List the vulvar and urethral changes in menopause.
Thinning of the epithelial layers and vagina narrowing leads the urethra to move closer to the introitus.
Stress urinary incontinence
Vaginal estrogen and urinary incontinence: what type does it help with?
Treatment for FPHL
Minoxidil, spironolactone, finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin?
-3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? and why?
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.
AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a low ovarian reserve.
not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
, It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases after
d/cing.
What does AFC stand for? What is considered a normal value?
Antral Follicle Count
> 12 follicles detectable with ultrasound is considered normal
What is the significance of antral follicle count?
The ability of the ovaries to respond. It can represent the number of follicles detectable with ultrasound.
It is sensitive to FSH, and represents the available pool of follicles.
What is the FSH level on a random draw in Late menopause transition (STRAW Stage: -1)?
25 IU/L or higher
Black women have higher or lower FSH levels?
Higher
Chinese and Japanese women have higher or lower estradiol levels compared to white, black and
hispanic women?
Lower
What happens to SHBG during menopause? How does that effect the free androgen index?
SHBG decreases.
Testosterone/SHBG ratio increases by 80%.
Testosterone:SHGB ratio is called what?
The free androgen index
What stage are VMS more likely?
+1b (generally last 2 years)
What hormone is generally higher in obese women?
Estrone-via aromatization.
The postmenopausal ovary continues to produce what two hormones?
testosterone and androstenedione
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? What does that do to FSH?
Pass | NCMP Study Guide & Verified Q&A NCMP Certification
Prep (2025–2027) – NAMS Menopause Exam Guide with Verified
Answers
Included in This Package:
✅ Verified, exam-style practice questions
✅ Detailed explanations and correct answers
✅ Complete clinical content review: menopause, perimenopause, HRT, and beyond
✅ Covers NAMS 2025–2027 exam outline
✅ HRT case studies, symptom management, non-hormonal therapies, bone & heart
health
✅ Proven methods used by top-scoring NCMP candidates
🎯 Why Choose This Guide?
All content is aligned with NAMS certification standards
Written by certified women’s health experts
Describe the phases during the early menopause transition and what happens with PMS symptoms
Menstrual cycle shortens. Due to unrestrained FSH, follicular phase compresses. More premenstrual
symptoms due to the longer luteal phase. Cycle irregularity and skipped cycles because of ovulatory
failure and increased atresia.
How to respond if a patient requests FSH lab?
many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH is not
helpful.
What lab is potentially the superior marker of time to menopause?
AMH
DHEA (dehydroepiandrosterone)
Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues.
,Location of GU estrogen receptors (4)
Vagina, vulva, urethra, trigone of the bladder
List the effects of estrogen on tissue (4+2)
1 ) maintains blood flow to tissue, maintains the collagen within the epithelium, and maintains the
hyaluronic acid and mucopolysaccharides within the moistened epithelial surface, maintains pH (4.5) 2)
supports microbiome and protects tissue from pathogens
List the vaginal changes with menopause you might note on clinical/microscopic exam.
Thinning of the epithelial layer, loss of elasticity with narrowing of the canal and poor distention, noted
on pelvic exam with loss or absence or rugae. Due to the decrease in glycogen content, the lactobacilli
are decreased resulting in higher pH.
List the vulvar and urethral changes in menopause.
Thinning of the epithelial layers and vagina narrowing leads the urethra to move closer to the introitus.
Stress urinary incontinence
Vaginal estrogen and urinary incontinence: what type does it help with?
Treatment for FPHL
Minoxidil, spironolactone, finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin?
-3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? and why?
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.
AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a low ovarian reserve.
not recommended as a screening tool to predict fertility.
Peaks at around 25 years old. So before age 25, this test is not helpful.
, It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases after
d/cing.
What does AFC stand for? What is considered a normal value?
Antral Follicle Count
> 12 follicles detectable with ultrasound is considered normal
What is the significance of antral follicle count?
The ability of the ovaries to respond. It can represent the number of follicles detectable with ultrasound.
It is sensitive to FSH, and represents the available pool of follicles.
What is the FSH level on a random draw in Late menopause transition (STRAW Stage: -1)?
25 IU/L or higher
Black women have higher or lower FSH levels?
Higher
Chinese and Japanese women have higher or lower estradiol levels compared to white, black and
hispanic women?
Lower
What happens to SHBG during menopause? How does that effect the free androgen index?
SHBG decreases.
Testosterone/SHBG ratio increases by 80%.
Testosterone:SHGB ratio is called what?
The free androgen index
What stage are VMS more likely?
+1b (generally last 2 years)
What hormone is generally higher in obese women?
Estrone-via aromatization.
The postmenopausal ovary continues to produce what two hormones?
testosterone and androstenedione
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? What does that do to FSH?
