NAMs Menopause Certification Exam 2024-
2025 Guide
1. Climacteric The period of endocrinologic, somatic, and transitory psychologic changes that
phase occur around the time of menopause.
2. Early menopause LMP before age 45.
3. Late menopause LMP after age 54.
4. Primary ovarian Menopause that occurs before age 40.
insufficiency
5. Early menopause Persistent ditterence of 7 days or more in the length of consecutive cycles.
transition (stage
-2)
6. Late menopause 60 or more consecutive days of amenorrhea.
transition (stage
-1)
7. Luteal out of Explains why some perimenopausal women have elevated estrogen levels some-
phase event times.
(LOOP)
8. Obese women Obese women are more likely to have anovulatory cycles with high estradiol levels.
and estradiol
levels during
menopause
9. Chinese and These ethnic groups have lower estradiol levels than white, black, and Hispanic
Japanese women women.
10. Stage +2 Late menopause stage: 5-8 years after FMP. Somatic aging predominates.
11. Stages +1a, +1b, Early post menopause: 2 years after FMP. FSH rises, estradiol decreases.
+1c
, NAMs Menopause Certification Exam 2024-
2025 Guide
12. Elevated FSH, LH Endocrine labs after menopause.
13. AMH, inhibin B These hormones work during reproductive years to not deplete follicle pool too
quickly.
14. Phases during Menstrual cycle variable, persistent >7 day ditterence between ditterence in
menopause tran- length of consecutive cycles.
sition and PMS
symptoms
15. How to respond Many pitfalls, variable depending on the day of the cycle you draw the lab.
if a patient re-
quests FSH lab?
16. The potentially AMH.
superior marker
of menopause, a
lab.
17. DHEA Adrenal androgens: precursor hormones produced by the adrenal gland that are
(dehy- enzymatically converted to active androgens or estrogens in peripheral tissues.
droepiandros-
terone)
18. Location of estro- Vagina, vulva, urethra, trigone of the bladder.
gen receptors
19. Effects of estro- Maintain blood flow, the collagen, and HA within the epithelial surfaces.
gen on tissue
20. Vaginal changes Thinning, loss of elasticity, loss or absence of rugae.
with menopause
,21. Vagina and Vagina narrows, urethra moves closer to the introitus.
urethra in
menopause
22. Stress urinary in- Vaginal estrogen and urinary incontinence: what type does it help with?
continence
23. Treatment for Minoxidil, spironolactone, finasteride, estrogen therapy.
FPHL
24. Late reproduc- -3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low. -3a:
tive years -3b and subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
-3a
25. When it is appro- Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH
priate to check level.
an FSH during
the cycle if you
check it?
26. AFC Antral follicle count. Number of follicles that are detectable with ultrasound.
27. Late menopause 25 or higher.
transition (-1)
FSH level on ran-
dom draw
28. Black women Higher.
have higher or
lower FSH levels?
29. Chinese and Lower.
Japanese women
have higher or
, lower estradi-
ol levels com-
pared to white,
black and His-
panic women?
30. Menopause tran- SHBG decreases. Testosterone/SHBG ratio increases by 80%.
sition-changes in
SHBG and testos-
terone?
31. Testos- The free androgen index.
terone/SHBG
ratio is called
what?
32. What stage are +1b (generally last 2 years).
VMS more likely?
33. What hormone is Estrone-via aromatization.
generally higher
in obese women?
34. The Testosterone and androstenedione.
postmenopausal
ovary continues
to produce what
two hormones?
35. Surgical Testosterone. 40-50% lower than in women w/ intact ovaries.
menopause
causes women
to have lower
2025 Guide
1. Climacteric The period of endocrinologic, somatic, and transitory psychologic changes that
phase occur around the time of menopause.
2. Early menopause LMP before age 45.
3. Late menopause LMP after age 54.
4. Primary ovarian Menopause that occurs before age 40.
insufficiency
5. Early menopause Persistent ditterence of 7 days or more in the length of consecutive cycles.
transition (stage
-2)
6. Late menopause 60 or more consecutive days of amenorrhea.
transition (stage
-1)
7. Luteal out of Explains why some perimenopausal women have elevated estrogen levels some-
phase event times.
(LOOP)
8. Obese women Obese women are more likely to have anovulatory cycles with high estradiol levels.
and estradiol
levels during
menopause
9. Chinese and These ethnic groups have lower estradiol levels than white, black, and Hispanic
Japanese women women.
10. Stage +2 Late menopause stage: 5-8 years after FMP. Somatic aging predominates.
11. Stages +1a, +1b, Early post menopause: 2 years after FMP. FSH rises, estradiol decreases.
+1c
, NAMs Menopause Certification Exam 2024-
2025 Guide
12. Elevated FSH, LH Endocrine labs after menopause.
13. AMH, inhibin B These hormones work during reproductive years to not deplete follicle pool too
quickly.
14. Phases during Menstrual cycle variable, persistent >7 day ditterence between ditterence in
menopause tran- length of consecutive cycles.
sition and PMS
symptoms
15. How to respond Many pitfalls, variable depending on the day of the cycle you draw the lab.
if a patient re-
quests FSH lab?
16. The potentially AMH.
superior marker
of menopause, a
lab.
17. DHEA Adrenal androgens: precursor hormones produced by the adrenal gland that are
(dehy- enzymatically converted to active androgens or estrogens in peripheral tissues.
droepiandros-
terone)
18. Location of estro- Vagina, vulva, urethra, trigone of the bladder.
gen receptors
19. Effects of estro- Maintain blood flow, the collagen, and HA within the epithelial surfaces.
gen on tissue
20. Vaginal changes Thinning, loss of elasticity, loss or absence of rugae.
with menopause
,21. Vagina and Vagina narrows, urethra moves closer to the introitus.
urethra in
menopause
22. Stress urinary in- Vaginal estrogen and urinary incontinence: what type does it help with?
continence
23. Treatment for Minoxidil, spironolactone, finasteride, estrogen therapy.
FPHL
24. Late reproduc- -3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low. -3a:
tive years -3b and subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
-3a
25. When it is appro- Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH
priate to check level.
an FSH during
the cycle if you
check it?
26. AFC Antral follicle count. Number of follicles that are detectable with ultrasound.
27. Late menopause 25 or higher.
transition (-1)
FSH level on ran-
dom draw
28. Black women Higher.
have higher or
lower FSH levels?
29. Chinese and Lower.
Japanese women
have higher or
, lower estradi-
ol levels com-
pared to white,
black and His-
panic women?
30. Menopause tran- SHBG decreases. Testosterone/SHBG ratio increases by 80%.
sition-changes in
SHBG and testos-
terone?
31. Testos- The free androgen index.
terone/SHBG
ratio is called
what?
32. What stage are +1b (generally last 2 years).
VMS more likely?
33. What hormone is Estrone-via aromatization.
generally higher
in obese women?
34. The Testosterone and androstenedione.
postmenopausal
ovary continues
to produce what
two hormones?
35. Surgical Testosterone. 40-50% lower than in women w/ intact ovaries.
menopause
causes women
to have lower
