NAMs Menopause Certification
Exam Study Guide – Practice
Questions with Verified
Answers. GRADED A+. Latest
2026/2027 Update
Climacteric phase - Answer✔✔-The period of endrocrinologic, 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 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 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, 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 which supports
acidity of vagina 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
Late reporoductive years -3b and -3a. What happens with menstrual cycles,
FSH, AMH, AFC, inhibin? - 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? and
why? - Answer✔✔-Cycle day #3. Elevated estradiol can suppress FSH giving a
falsely normal FSH level.
AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak? - Answer✔✔-produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a
low ovarian reserve.
not recommended as a screening tool to predict fertility.
Exam Study Guide – Practice
Questions with Verified
Answers. GRADED A+. Latest
2026/2027 Update
Climacteric phase - Answer✔✔-The period of endrocrinologic, 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 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 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, 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 which supports
acidity of vagina 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
Late reporoductive years -3b and -3a. What happens with menstrual cycles,
FSH, AMH, AFC, inhibin? - 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? and
why? - Answer✔✔-Cycle day #3. Elevated estradiol can suppress FSH giving a
falsely normal FSH level.
AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak? - Answer✔✔-produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the woman has a
low ovarian reserve.
not recommended as a screening tool to predict fertility.
