NAMS MENOPAUSE CERTIFICATION
EVALUATION EXAMS SOLVED QUESTIONS
STUDY GUIDE GUARANTEED TO PASS
◉ 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
perimenopausal 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.
,◉ Obese women and estradiol levels during menopause. Answer:
Obese women are more likely to have anovulatory cycles with high
estradiol levels. They are also more likely to have lower
premenopause yet higher postmenopause 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 hispanic 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 shortenes, follicular phase compresses, women spend
more time in luteal phase.. meaning more premenstrual symptoms and
more frequent menstrual periods.
, ◉ 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.. Answer:
AMH
◉ DHEA (dehydroepiandrosterone). Answer: Adrenal androgens:
precursor hromones 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
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?
EVALUATION EXAMS SOLVED QUESTIONS
STUDY GUIDE GUARANTEED TO PASS
◉ 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
perimenopausal 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.
,◉ Obese women and estradiol levels during menopause. Answer:
Obese women are more likely to have anovulatory cycles with high
estradiol levels. They are also more likely to have lower
premenopause yet higher postmenopause 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 hispanic 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 shortenes, follicular phase compresses, women spend
more time in luteal phase.. meaning more premenstrual symptoms and
more frequent menstrual periods.
, ◉ 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.. Answer:
AMH
◉ DHEA (dehydroepiandrosterone). Answer: Adrenal androgens:
precursor hromones 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
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?
