NAMS MENOPAUSE CERTIFICATION
EXAM QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS 100%
CORRECT RATED A+ NEWLY UPDATED
2026/2027
What is the climacteric phase?
✔✔ Answer: The transition period surrounding menopause during which a person
experiences temporary physical, psychological, and hormonal changes.
At what age is menopause classified as "early"?
✔✔ Answer: Menopause is considered early if a person's final menstrual period
happens before they reach age 45.
At what age is menopause classified as "late"?
✔✔ Answer: Menopause is designated as late if the final menstrual cycle occurs
after a person reaches age 54.
What defines primary ovarian insufficiency?
✔✔ Answer: The loss of standard ovarian function that leads to menopause taking
place before a person turns 40.
What characterizes stage -2 of the early menopause transition?
✔✔ Answer: A phase marked by an ongoing irregularity where consecutive
menstrual cycles vary in length by a week or more.
What characterizes stage -1 of the late menopause transition?
✔✔ Answer: A phase defined by experiencing a consecutive stretch of at least 60
days without a menstrual period.
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?
Treatment for FPHL -ANSWER ✔✔Minoxidil, spironolactone, finasteride,
estrogen therapy
EXAM QUESTIONS AND ANSWERS
WITH COMPLETE SOLUTIONS 100%
CORRECT RATED A+ NEWLY UPDATED
2026/2027
What is the climacteric phase?
✔✔ Answer: The transition period surrounding menopause during which a person
experiences temporary physical, psychological, and hormonal changes.
At what age is menopause classified as "early"?
✔✔ Answer: Menopause is considered early if a person's final menstrual period
happens before they reach age 45.
At what age is menopause classified as "late"?
✔✔ Answer: Menopause is designated as late if the final menstrual cycle occurs
after a person reaches age 54.
What defines primary ovarian insufficiency?
✔✔ Answer: The loss of standard ovarian function that leads to menopause taking
place before a person turns 40.
What characterizes stage -2 of the early menopause transition?
✔✔ Answer: A phase marked by an ongoing irregularity where consecutive
menstrual cycles vary in length by a week or more.
What characterizes stage -1 of the late menopause transition?
✔✔ Answer: A phase defined by experiencing a consecutive stretch of at least 60
days without a menstrual period.
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?
Treatment for FPHL -ANSWER ✔✔Minoxidil, spironolactone, finasteride,
estrogen therapy
