1|Page
2025/2026BANK NAMS MENOPAUSE
CERTIFICATION EXAM CURRENTLY
TESTING WITH REVISED
QUESTIONS AND ANSWERS GRADED
A+ UPDATE
Climacteric phase –
.............ANSWER...............The period of endocrinology, somatic, and transitory psychologic
changes that occur around the time of menopause.
Early menopause
- .............ANSWER...............LMP before age 45
Late menopause
- .............ANSWER...............LMP after age 54
Primary ovarian insufficiency
- .............ANSWER...............Menopause that occurs before age 40
Early menopause transition (stage -2)
- .............ANSWER...............Persistent difference of 7 days or more in the length of
consecutive cycles.
Late menopause transition (stage -1)
- .............ANSWER...............60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP)
- .............ANSWER...............Explains why some premenopausal 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.
,2|Page
Obese women and estradiol levels during menopause
- .............ANSWER...............Obese women are more likely to have an ovulatory cycles with
high estradiol levels. They are also more likely to have lower premenopausal yet higher post
menopause estradiol levels compared with women of normal weight. (why they are at higher
risk of endometrial cancer)
Chinese and Japanese women
- .............ANSWER...............These ethnic groups have lower estradiol levels then white, black
and his panic women.
stage +2
- .............ANSWER...............late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c
- .............ANSWER...............early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.
Elevated FSH, LH
- .............ANSWER...............Endocrine labs after menopause
AMH, inhibin B
- .............ANSWER...............These hormones work during reproductive years to not deplete
follicle pool too quickly.
Phases during menopause transition and PMS symptoms
- .............ANSWER...............Menstrual cycle variable, persistent >7 day difference between
difference in length of consecutive cycles.
How to respond if a patient requests FSH lab?
- .............ANSWER...............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
, 3|Page
. - .............ANSWER...............AMH
DHEA (dehydroepiandrosterone)
- .............ANSWER...............Adrenal androgens: precursor hormones produced by the
adrenal gland that are enzymatically converted to active androgens or estrogens in peripheral
tissues.
Location of estrogen receptors
- .............ANSWER...............Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue
- .............ANSWER...............maintain blood flow, the collagen, and HA within the epithelial
surfaces. Supports microbiome which supports acidity of vagina and protects tissue from
pathogens.
Vaginal changes with menopause
- .............ANSWER...............Thinning, loss of elasticity, loss or absence or rugae.
Vagina and urethra in menopause
- .............ANSWER...............vagina narrows, urethra moves closer to the introitus.
Stress urinary incontinence
- .............ANSWER...............Vaginal estrogen and urinary incontinence: what type does it
help with?
Treatment for FPHL
- .............ANSWER...............Monoxide, spironolactone, finasteride, estrogen therapy
Late reproductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC,
inhibin?
- .............ANSWER...............-3b: menstrual cycles normal, FSH normal, AMH low, AFC low,
inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
2025/2026BANK NAMS MENOPAUSE
CERTIFICATION EXAM CURRENTLY
TESTING WITH REVISED
QUESTIONS AND ANSWERS GRADED
A+ UPDATE
Climacteric phase –
.............ANSWER...............The period of endocrinology, somatic, and transitory psychologic
changes that occur around the time of menopause.
Early menopause
- .............ANSWER...............LMP before age 45
Late menopause
- .............ANSWER...............LMP after age 54
Primary ovarian insufficiency
- .............ANSWER...............Menopause that occurs before age 40
Early menopause transition (stage -2)
- .............ANSWER...............Persistent difference of 7 days or more in the length of
consecutive cycles.
Late menopause transition (stage -1)
- .............ANSWER...............60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP)
- .............ANSWER...............Explains why some premenopausal 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.
,2|Page
Obese women and estradiol levels during menopause
- .............ANSWER...............Obese women are more likely to have an ovulatory cycles with
high estradiol levels. They are also more likely to have lower premenopausal yet higher post
menopause estradiol levels compared with women of normal weight. (why they are at higher
risk of endometrial cancer)
Chinese and Japanese women
- .............ANSWER...............These ethnic groups have lower estradiol levels then white, black
and his panic women.
stage +2
- .............ANSWER...............late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c
- .............ANSWER...............early post menopause: 2 years after FMP. FSH rises, estradiol
decreases. VMS predominate.
Elevated FSH, LH
- .............ANSWER...............Endocrine labs after menopause
AMH, inhibin B
- .............ANSWER...............These hormones work during reproductive years to not deplete
follicle pool too quickly.
Phases during menopause transition and PMS symptoms
- .............ANSWER...............Menstrual cycle variable, persistent >7 day difference between
difference in length of consecutive cycles.
How to respond if a patient requests FSH lab?
- .............ANSWER...............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
, 3|Page
. - .............ANSWER...............AMH
DHEA (dehydroepiandrosterone)
- .............ANSWER...............Adrenal androgens: precursor hormones produced by the
adrenal gland that are enzymatically converted to active androgens or estrogens in peripheral
tissues.
Location of estrogen receptors
- .............ANSWER...............Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue
- .............ANSWER...............maintain blood flow, the collagen, and HA within the epithelial
surfaces. Supports microbiome which supports acidity of vagina and protects tissue from
pathogens.
Vaginal changes with menopause
- .............ANSWER...............Thinning, loss of elasticity, loss or absence or rugae.
Vagina and urethra in menopause
- .............ANSWER...............vagina narrows, urethra moves closer to the introitus.
Stress urinary incontinence
- .............ANSWER...............Vaginal estrogen and urinary incontinence: what type does it
help with?
Treatment for FPHL
- .............ANSWER...............Monoxide, spironolactone, finasteride, estrogen therapy
Late reproductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC,
inhibin?
- .............ANSWER...............-3b: menstrual cycles normal, FSH normal, AMH low, AFC low,
inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
