MENOPAUSE SOCIETY EXAM
2026 ACTUAL STUDY
QUESTIONS 100% CORRECT
ANSWERS
What is the primary effect of menopause on bone health? - answer- Estrogen deficiency
after menopause accelerates bone resorption, leading to rapid bone loss.
List three major risk factors for low bone mass and fracture in postmenopausal women. -
answer- Advanced age, prior fragility fracture, and glucocorticoid use are major risk
factors.
Which tool is commonly used to estimate 10-year fracture risk in clinical practice? - answer-
FRAX (Fracture Risk Assessment Tool) is commonly used to estimate 10-year fracture risk.
What is the World Health Organization (WHO) definition of osteoporosis based on bone mineral
density (BMD) T-score? - answer- A T-score ≤ -2.5 at the lumbar spine, femoral neck, or
total hip defines osteoporosis per WHO criteria.
At what age does the North American Menopause Society recommend routine DXA screening
for osteoporosis in postmenopausal women? - answer- Age 65 years or older is the
,threshold for routine DXA screening in postmenopausal women, or younger if risk factors are
present.
How is osteopenia defined by T-score on DXA? - answer- A T-score between -1.0 and -2.5
defines osteopenia.
What is the threshold 10-year risk of hip fracture or major osteoporotic fracture that indicates
pharmacologic therapy according to FRAX? - answer- A 10-year hip fracture risk ≥3% or
major osteoporotic fracture risk ≥20% indicates pharmacologic therapy per FRAX.
Name two first-line pharmacologic therapies for osteoporosis in postmenopausal women. -
answer- Bisphosphonates (e.g., alendronate, risedronate, zoledronic acid) and
denosumab are first-line therapies.
What is the role of hormone therapy in the prevention of postmenopausal osteoporosis? -
answer- Hormone therapy is effective for prevention of bone loss in early
postmenopausal women at risk, but not first-line for osteoporosis treatment.
Which pharmacologic agent is preferred for women at very high risk of fracture? - answer-
Anabolic agents (e.g., teriparatide, abaloparatide, romosozumab) are preferred for
women at very high fracture risk.
List two common side effects of systemic hormone therapy. - answer- Breast tenderness
and vaginal bleeding are common side effects of systemic hormone therapy.
Name two types of selective estrogen receptor modulators (SERMs) used in menopause
management. - answer- Raloxifene and bazedoxifene are SERMs used in menopause
management.
, What are the risks associated with compounded or non-approved hormone therapy
preparations? - answer- Compounded or non-approved hormone therapies carry risks of
inconsistent dosing, lack of efficacy, and increased adverse effects.
Which local therapy is recommended for genitourinary syndrome of menopause? - answer-
Vaginal estrogen is recommended for genitourinary syndrome of menopause (GSM).
Name two nonhormonal prescription options for vasomotor symptom management. - answer-
SSRIs (e.g., paroxetine) and SNRIs (e.g., venlafaxine) are nonhormonal prescription
options for vasomotor symptoms.
What is the evidence for the efficacy of over-the-counter herbal supplements in menopause
symptom relief? - answer- There is insufficient evidence for efficacy of most herbal
supplements (e.g., black cohosh, soy) in menopause symptom relief.
What is the role of vaginal moisturizers and lubricants in managing genitourinary syndrome of
menopause? - answer- Vaginal moisturizers and lubricants are first-line for mild GSM
symptoms and safe for long-term use.
What are the main contraindications to menopausal hormone therapy? - answer- Active
or recent breast cancer, unexplained vaginal bleeding, active thromboembolic disease, and liver
dysfunction are main contraindications to hormone therapy.
Why is progestogen added to estrogen therapy in women with an intact uterus? - answer-
Progestogen is needed with estrogen therapy in women with a uterus to prevent
endometrial hyperplasia/cancer.
Compare the risks of oral versus transdermal estrogen therapy. - answer- Transdermal
estrogen has a lower risk of venous thromboembolism and stroke compared to oral estrogen.
2026 ACTUAL STUDY
QUESTIONS 100% CORRECT
ANSWERS
What is the primary effect of menopause on bone health? - answer- Estrogen deficiency
after menopause accelerates bone resorption, leading to rapid bone loss.
List three major risk factors for low bone mass and fracture in postmenopausal women. -
answer- Advanced age, prior fragility fracture, and glucocorticoid use are major risk
factors.
Which tool is commonly used to estimate 10-year fracture risk in clinical practice? - answer-
FRAX (Fracture Risk Assessment Tool) is commonly used to estimate 10-year fracture risk.
What is the World Health Organization (WHO) definition of osteoporosis based on bone mineral
density (BMD) T-score? - answer- A T-score ≤ -2.5 at the lumbar spine, femoral neck, or
total hip defines osteoporosis per WHO criteria.
At what age does the North American Menopause Society recommend routine DXA screening
for osteoporosis in postmenopausal women? - answer- Age 65 years or older is the
,threshold for routine DXA screening in postmenopausal women, or younger if risk factors are
present.
How is osteopenia defined by T-score on DXA? - answer- A T-score between -1.0 and -2.5
defines osteopenia.
What is the threshold 10-year risk of hip fracture or major osteoporotic fracture that indicates
pharmacologic therapy according to FRAX? - answer- A 10-year hip fracture risk ≥3% or
major osteoporotic fracture risk ≥20% indicates pharmacologic therapy per FRAX.
Name two first-line pharmacologic therapies for osteoporosis in postmenopausal women. -
answer- Bisphosphonates (e.g., alendronate, risedronate, zoledronic acid) and
denosumab are first-line therapies.
What is the role of hormone therapy in the prevention of postmenopausal osteoporosis? -
answer- Hormone therapy is effective for prevention of bone loss in early
postmenopausal women at risk, but not first-line for osteoporosis treatment.
Which pharmacologic agent is preferred for women at very high risk of fracture? - answer-
Anabolic agents (e.g., teriparatide, abaloparatide, romosozumab) are preferred for
women at very high fracture risk.
List two common side effects of systemic hormone therapy. - answer- Breast tenderness
and vaginal bleeding are common side effects of systemic hormone therapy.
Name two types of selective estrogen receptor modulators (SERMs) used in menopause
management. - answer- Raloxifene and bazedoxifene are SERMs used in menopause
management.
, What are the risks associated with compounded or non-approved hormone therapy
preparations? - answer- Compounded or non-approved hormone therapies carry risks of
inconsistent dosing, lack of efficacy, and increased adverse effects.
Which local therapy is recommended for genitourinary syndrome of menopause? - answer-
Vaginal estrogen is recommended for genitourinary syndrome of menopause (GSM).
Name two nonhormonal prescription options for vasomotor symptom management. - answer-
SSRIs (e.g., paroxetine) and SNRIs (e.g., venlafaxine) are nonhormonal prescription
options for vasomotor symptoms.
What is the evidence for the efficacy of over-the-counter herbal supplements in menopause
symptom relief? - answer- There is insufficient evidence for efficacy of most herbal
supplements (e.g., black cohosh, soy) in menopause symptom relief.
What is the role of vaginal moisturizers and lubricants in managing genitourinary syndrome of
menopause? - answer- Vaginal moisturizers and lubricants are first-line for mild GSM
symptoms and safe for long-term use.
What are the main contraindications to menopausal hormone therapy? - answer- Active
or recent breast cancer, unexplained vaginal bleeding, active thromboembolic disease, and liver
dysfunction are main contraindications to hormone therapy.
Why is progestogen added to estrogen therapy in women with an intact uterus? - answer-
Progestogen is needed with estrogen therapy in women with a uterus to prevent
endometrial hyperplasia/cancer.
Compare the risks of oral versus transdermal estrogen therapy. - answer- Transdermal
estrogen has a lower risk of venous thromboembolism and stroke compared to oral estrogen.
