NAMS Menopause Certification Exam – Questions and
Answers Study Guide (Graded A+) | 2025/2026
This study guide provides 70 practice questions and answers for the NAMS Menopause
Certification Exam, covering menopause stages, hormonal changes, diagnostics,
symptoms, and treatments. Each question includes a concise answer and rationale to
reinforce understanding. This is not the official exam but a synthesized resource for
preparation.
Section 1: Menopause Definitions and Stages
1. What is the climacteric phase?
Answer: The period of endocrinologic, somatic, and transitory psychologic changes around
menopause.
Rationale: Encompasses the transition from reproductive to non-reproductive years with
hormonal fluctuations and symptoms.
2. What defines early menopause?
Answer: Last menstrual period (LMP) before age 45.
Rationale: Increases risks for cardiovascular disease (CVD) and osteoporosis due to prolonged
estrogen deficiency.
3. What defines late menopause?
Answer: LMP after age 54.
Rationale: Higher lifetime estrogen exposure may increase risks for estrogen-sensitive cancers.
4. What is primary ovarian insufficiency (POI)?
Answer: Menopause before age 40.
, Rationale: Diagnosed with oligomenorrhea/amenorrhea ≥4 months and FSH >25 IU/L twice, 4
weeks apart; requires prompt hormone therapy.
5. What characterizes the early menopause transition (stage -2)?
Answer: Persistent difference of ≥7 days in consecutive cycle lengths.
Rationale: Results from follicular aging and depletion, leading to variable FSH levels.
6. What characterizes the late menopause transition (stage -1)?
Answer: ≥60 consecutive days of amenorrhea.
Rationale: Involves interval amenorrhea, with emerging genitourinary syndrome of
menopause (GSM), bone loss, and CVD risks.
7. What is a luteal out of phase event (LOOP)?
Answer: Elevated FSH recruits a second follicle, causing a follicular phase-like estradiol rise in
the luteal phase.
Rationale: Explains elevated estrogen and symptoms like heavy bleeding or PMS exacerbation
in perimenopause.
8. How do estradiol levels differ in obese women during menopause?
Answer: Anovulatory cycles with high estradiol; lower premenopause but higher
postmenopause estradiol than normal-weight women.
Rationale: Adiposity increases peripheral estrogen conversion, raising endometrial cancer risk.
9. Which ethnic groups have lower estradiol levels compared to white, black, and Hispanic
women?
Answer: Chinese and Japanese women.
Rationale: Ethnic variations influence symptom severity and disease risks.
Answers Study Guide (Graded A+) | 2025/2026
This study guide provides 70 practice questions and answers for the NAMS Menopause
Certification Exam, covering menopause stages, hormonal changes, diagnostics,
symptoms, and treatments. Each question includes a concise answer and rationale to
reinforce understanding. This is not the official exam but a synthesized resource for
preparation.
Section 1: Menopause Definitions and Stages
1. What is the climacteric phase?
Answer: The period of endocrinologic, somatic, and transitory psychologic changes around
menopause.
Rationale: Encompasses the transition from reproductive to non-reproductive years with
hormonal fluctuations and symptoms.
2. What defines early menopause?
Answer: Last menstrual period (LMP) before age 45.
Rationale: Increases risks for cardiovascular disease (CVD) and osteoporosis due to prolonged
estrogen deficiency.
3. What defines late menopause?
Answer: LMP after age 54.
Rationale: Higher lifetime estrogen exposure may increase risks for estrogen-sensitive cancers.
4. What is primary ovarian insufficiency (POI)?
Answer: Menopause before age 40.
, Rationale: Diagnosed with oligomenorrhea/amenorrhea ≥4 months and FSH >25 IU/L twice, 4
weeks apart; requires prompt hormone therapy.
5. What characterizes the early menopause transition (stage -2)?
Answer: Persistent difference of ≥7 days in consecutive cycle lengths.
Rationale: Results from follicular aging and depletion, leading to variable FSH levels.
6. What characterizes the late menopause transition (stage -1)?
Answer: ≥60 consecutive days of amenorrhea.
Rationale: Involves interval amenorrhea, with emerging genitourinary syndrome of
menopause (GSM), bone loss, and CVD risks.
7. What is a luteal out of phase event (LOOP)?
Answer: Elevated FSH recruits a second follicle, causing a follicular phase-like estradiol rise in
the luteal phase.
Rationale: Explains elevated estrogen and symptoms like heavy bleeding or PMS exacerbation
in perimenopause.
8. How do estradiol levels differ in obese women during menopause?
Answer: Anovulatory cycles with high estradiol; lower premenopause but higher
postmenopause estradiol than normal-weight women.
Rationale: Adiposity increases peripheral estrogen conversion, raising endometrial cancer risk.
9. Which ethnic groups have lower estradiol levels compared to white, black, and Hispanic
women?
Answer: Chinese and Japanese women.
Rationale: Ethnic variations influence symptom severity and disease risks.
