NAMs Menopause Certification
Exam 2026 Expert Verified | Ace
the Test
The period of endrocrinologic, somatic, and transitory psychologic changes
that occur around the time of menopause. - 🧠ANSWER ✔✔Climacteric
phase
LMP before age 45 - 🧠ANSWER ✔✔Early menopause
LMP after age 54 - 🧠ANSWER ✔✔Late menopause
,Menopause that occurs before age 40 - 🧠ANSWER ✔✔Primary ovarian
insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles.
- 🧠ANSWER ✔✔Early menopause transition (stage -2)
60 or more consecutive days of amenorrhea - 🧠ANSWER ✔✔Late
menopause transition (stage -1)
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. - 🧠ANSWER ✔✔Luteal out of phase event
(LOOP)
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) - 🧠ANSWER
✔✔Obese women and estradiol levels during menopause
,These ethnic groups have lower estradiol levels then white, black and
hispanic women. - 🧠ANSWER ✔✔Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms. - 🧠ANSWER ✔✔stage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases.
VMS predominate. - 🧠ANSWER ✔✔Stages +1a, +1b, +1c
Endocrine labs after menopause - 🧠ANSWER ✔✔Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool
too quickly. - 🧠ANSWER ✔✔AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in
length of consecutive cycles. - 🧠ANSWER ✔✔Phases during menopause
transition and PMS symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful. - 🧠ANSWER ✔✔How to respond if a
patient requests FSH lab?
AMH - 🧠ANSWER ✔✔The potentially superior marker of menopause, a lab.
3
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
, Adrenal androgens: precursor hromones produced by the adrenal gland
that are enzymatically converted to active androgens or estrogens in
peripheral tissues. - 🧠ANSWER ✔✔DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - 🧠ANSWER ✔✔Location of
estrogen receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces.
Supports microbiome which supports acidity of vagina and protects tissue
from pathogens. - 🧠ANSWER ✔✔Effects of estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - 🧠ANSWER
✔✔Vaginal changes with menopause
vagina narrows, urethra moves closer to the introitus. - 🧠ANSWER
✔✔Vagina and urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it help with? -
🧠ANSWER ✔✔Stress urinary incontinence
Minoxidil, spironolactone, finasteride, estrogen therapy - 🧠ANSWER
✔✔Treatment for FPHL
-3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
Exam 2026 Expert Verified | Ace
the Test
The period of endrocrinologic, somatic, and transitory psychologic changes
that occur around the time of menopause. - 🧠ANSWER ✔✔Climacteric
phase
LMP before age 45 - 🧠ANSWER ✔✔Early menopause
LMP after age 54 - 🧠ANSWER ✔✔Late menopause
,Menopause that occurs before age 40 - 🧠ANSWER ✔✔Primary ovarian
insufficiency
Persistent difference of 7 days or more in the length of consecutive cycles.
- 🧠ANSWER ✔✔Early menopause transition (stage -2)
60 or more consecutive days of amenorrhea - 🧠ANSWER ✔✔Late
menopause transition (stage -1)
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. - 🧠ANSWER ✔✔Luteal out of phase event
(LOOP)
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) - 🧠ANSWER
✔✔Obese women and estradiol levels during menopause
,These ethnic groups have lower estradiol levels then white, black and
hispanic women. - 🧠ANSWER ✔✔Chinese and Japanese women
late menopause stage: 5-8 years after FMP. Somatic aging predominates.
Increased genitourinary symptoms. - 🧠ANSWER ✔✔stage +2
early post menopause: 2 years after FMP. FSH rises, estradiol decreases.
VMS predominate. - 🧠ANSWER ✔✔Stages +1a, +1b, +1c
Endocrine labs after menopause - 🧠ANSWER ✔✔Elevated FSH, LH
These hormones work during reproductive years to not deplete follicle pool
too quickly. - 🧠ANSWER ✔✔AMH, inhibin B
Menstrual cycle variable, persistent >7 day difference between difference in
length of consecutive cycles. - 🧠ANSWER ✔✔Phases during menopause
transition and PMS symptoms
many pitfalls, variable depending on the day of the cycle you draw the lab,
normal or low FSH is not helpful. - 🧠ANSWER ✔✔How to respond if a
patient requests FSH lab?
AMH - 🧠ANSWER ✔✔The potentially superior marker of menopause, a lab.
3
COPYRIGHT©JOSHCLAY 2025/2026. YEAR PUBLISHED 2026. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE. PRIVACY
STATEMENT. ALL RIGHTS RESERVED
, Adrenal androgens: precursor hromones produced by the adrenal gland
that are enzymatically converted to active androgens or estrogens in
peripheral tissues. - 🧠ANSWER ✔✔DHEA (dehydroepiandrosterone)
Vagina, vulva, urethra, trigone of the bladder - 🧠ANSWER ✔✔Location of
estrogen receptors
maintain blood flow, the collagen, and HA within the epithelial surfaces.
Supports microbiome which supports acidity of vagina and protects tissue
from pathogens. - 🧠ANSWER ✔✔Effects of estrogen on tissue
Thinning, loss of elasticity, loss or absence or rugae. - 🧠ANSWER
✔✔Vaginal changes with menopause
vagina narrows, urethra moves closer to the introitus. - 🧠ANSWER
✔✔Vagina and urethra in menopause
Vaginal estrogen and urinary incontinence: what type does it help with? -
🧠ANSWER ✔✔Stress urinary incontinence
Minoxidil, spironolactone, finasteride, estrogen therapy - 🧠ANSWER
✔✔Treatment for FPHL
-3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
