NAMs Menopause Certification
Exam Study Guide – Practice
Questions with Verified
Answers. GRADED A+. Latest
2026/2027 Update
Climacteric phase - Answer✔✔-The period of endocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
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 levels sometimes.
Obese women and estradiol levels during menopause - Answer✔✔-Obese
women are more likely to have anovulatory cycles with high estradiol levels.
Chinese and Japanese women - Answer✔✔-These ethnic groups have lower
estradiol levels than white, black, and Hispanic women.
Stage +2 - Answer✔✔-Late menopause stage: 5-8 years after FMP. Somatic
aging predominates.
Stages +1a, +1b, +1c - Answer✔✔-Early post menopause: 2 years after FMP.
FSH rises, estradiol decreases.
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 variable, persistent >7 day difference between difference in
length of consecutive cycles.
,How to respond if a patient requests FSH lab? - Answer✔✔-Many pitfalls,
variable depending on the day of the cycle you draw the lab.
The potentially superior marker of menopause, a lab. - Answer✔✔-AMH.
DHEA (dehydroepiandrosterone) - Answer✔✔-Adrenal androgens: precursor
hormones 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.
Vaginal changes with menopause - Answer✔✔-Thinning, loss of elasticity, loss
or absence of 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?
Treatment for FPHL - Answer✔✔-Minoxidil, spironolactone, finasteride,
estrogen therapy.
, Late reproductive years -3b and -3a - Answer✔✔--3b: menstrual cycles normal,
FSH normal, AMH low, AFC low, inhibin low. -3a: subtle menstrual changes,
variable FSH, AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? -
Answer✔✔-Cycle day #3. Elevated estradiol can suppress FSH giving a falsely
normal FSH level.
AFC - Answer✔✔-Antral follicle count. Number of follicles that are detectable
with ultrasound.
Late menopause transition (-1) FSH level on random draw - Answer✔✔-25 or
higher.
Black women have higher or lower FSH levels? - Answer✔✔-Higher.
Chinese and Japanese women have higher or lower estradiol levels compared
to white, black and Hispanic women? - Answer✔✔-Lower.
Menopause transition-changes in SHBG and testosterone? - Answer✔✔-SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
Testosterone/SHBG ratio is called what? - Answer✔✔-The free androgen index.
What stage are VMS more likely? - Answer✔✔-+1b (generally last 2 years).
Exam Study Guide – Practice
Questions with Verified
Answers. GRADED A+. Latest
2026/2027 Update
Climacteric phase - Answer✔✔-The period of endocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
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 levels sometimes.
Obese women and estradiol levels during menopause - Answer✔✔-Obese
women are more likely to have anovulatory cycles with high estradiol levels.
Chinese and Japanese women - Answer✔✔-These ethnic groups have lower
estradiol levels than white, black, and Hispanic women.
Stage +2 - Answer✔✔-Late menopause stage: 5-8 years after FMP. Somatic
aging predominates.
Stages +1a, +1b, +1c - Answer✔✔-Early post menopause: 2 years after FMP.
FSH rises, estradiol decreases.
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 variable, persistent >7 day difference between difference in
length of consecutive cycles.
,How to respond if a patient requests FSH lab? - Answer✔✔-Many pitfalls,
variable depending on the day of the cycle you draw the lab.
The potentially superior marker of menopause, a lab. - Answer✔✔-AMH.
DHEA (dehydroepiandrosterone) - Answer✔✔-Adrenal androgens: precursor
hormones 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.
Vaginal changes with menopause - Answer✔✔-Thinning, loss of elasticity, loss
or absence of 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?
Treatment for FPHL - Answer✔✔-Minoxidil, spironolactone, finasteride,
estrogen therapy.
, Late reproductive years -3b and -3a - Answer✔✔--3b: menstrual cycles normal,
FSH normal, AMH low, AFC low, inhibin low. -3a: subtle menstrual changes,
variable FSH, AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? -
Answer✔✔-Cycle day #3. Elevated estradiol can suppress FSH giving a falsely
normal FSH level.
AFC - Answer✔✔-Antral follicle count. Number of follicles that are detectable
with ultrasound.
Late menopause transition (-1) FSH level on random draw - Answer✔✔-25 or
higher.
Black women have higher or lower FSH levels? - Answer✔✔-Higher.
Chinese and Japanese women have higher or lower estradiol levels compared
to white, black and Hispanic women? - Answer✔✔-Lower.
Menopause transition-changes in SHBG and testosterone? - Answer✔✔-SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
Testosterone/SHBG ratio is called what? - Answer✔✔-The free androgen index.
What stage are VMS more likely? - Answer✔✔-+1b (generally last 2 years).
