NAMS Menopause Certification Study Guide
2025\2026 Exam Questions With Correct A+
Answers
Physiology of VMS
- accurate answers-thermoregulatory center altered by increase in KNDy
neurons; activation of NK3R causes hot flashes; blockade of NK3R
reduces/eliminates hot flashes; may also be affected by: serotonin,
epinephrine, and norepinephrine; parasympathetic nerve activity.
Off label rx for VMS
- accurate answers-SSRIs, SNRIs, Gabapentinoids, Clonidine, Oxybutynin.
Studies on Fractional Co2 Laser for GSM
- accurate answers-not FDA approved; vaginal symptoms and sexual function
scores increased significantly at 3 months; noted continued improvement at 1
year.
Ospemifene (Osphena) indications and MOA
- accurate answers-for treatment of dyspareunia; decreases vaginal pH;
improves vaginal dryness; shifts vaginal maturational index to superficial
cells; estrogen agonist/antagonist.
Ospemifene (Osphena) adverse effects
- accurate answers-increase in uterine polyps; proliferative endometrium;
slight increased risk of hemorrhagic stroke and VTE; can increase VMS.
treatment of urge incontinence
- accurate answers-behavioral modifications; overactivity of the detrusor
muscle; antimuscarinics: oxybutynin; nerve stimulation; botox.
pelvic floor muscles - superficial
- accurate answers-transverse perineal, bulbospongiosus, ischiocavernosus.
pelvic floor muscles - deep
- accurate answers-pubococcygeus, iliococcygeus, obturator internus,
coccygeus.
,What is low-tone pelvic floor dysfunction?
- accurate answers-weak, underactive and hypotonic muscles that cannot
maintain adequate contraction.
What is high-tone Pelvic Floor Dysfunction?
- accurate answers-weak pelvic floor muscles cannot attain or maintain
adequate relaxation; muscles are overactive, hypertonic, spastic, shortened.
What are the symptoms of low-tone PFD?
- accurate answers-heaviness, pressure, pelvic organ prolapse, incontinence,
altered sexual sensation.
What are the symptoms of high-tone PFD?
- accurate answers-urinary retention, frequency, urgency, dysuria, fecal
retention/constipation, penetrative dyspareunia and/or vaginismus.
Vaginal dilators for PFD
- accurate answers-Choose size that does not cause pain; Show how to insert
with a mirror; Apply lubricant to dilator, insert dilator as far as is comfortable,
leave dilator in place for 5-10 min 1-2 times daily; Use each for 4 weeks before
progressing to a size similar to partner size.
HRT and cognition - natural menopause
- accurate answers-In RCT, HRT has little or no overall effect on short or long-
term cognition.
HRT and cognition - surgical menopause
- accurate answers-HRT may be beneficial in improving verbal memory in the
short term.
In the SWANN survey, which groups of women were most likely to experience
sleep disturbance?
- accurate answers-late perimenopause (45%), surgical menopause (47%).
non-menopausal causes of chronic myalgia
- accurate answers-fibromyalgia, arthritis, statins, biphosphonates.
, 3 simple questions to dx arthritis
- accurate answers-1
SWANN survey sleep disturbance
- accurate answers-Late perimenopause (45%); surgical menopause (47%).
Most common sites of osteoarthritis
- accurate answers-Knee, hip, hand.
Onset of rheumatoid arthritis
- accurate answers-Peak age of onset: women age 35-55.
Most common cause of hypothyroidism
- accurate answers-Hashimoto's thyroiditis.
Gallbladder disease and HT
- accurate answers-Prescribe HT with caution in women with gallstones or
h/o gallbladder disease; suggested that oral estrogen has a greater risk of
gallbladder disease vs transdermal; CHCs and HT increase risk of
cholelithiasis, cholecystitis, and cholecystectomy.
Who to screen for hepatitis C
- accurate answers-All patients born between 1945 and 1965.
Primary syphilis symptoms
- accurate answers-Single, painless chancre for 3-6 weeks.
Secondary syphilis symptoms
- accurate answers-Rash on palms/soles; Mucous membrane lesions;
Lymphadenopathy; Malaise; Fever.
Latent (tertiary) syphilis symptoms
- accurate answers-Brain damage, dementia and mental health problems;
Heart disease; Movement disorders and muscle problems; Nerve damage;
Seizures; Tumors, usually on the bones and skin; Vision problems.
Prevalence of osteoporosis
- accurate answers-Of 10 million adults with osteoporosis, 8 million are
women.
2025\2026 Exam Questions With Correct A+
Answers
Physiology of VMS
- accurate answers-thermoregulatory center altered by increase in KNDy
neurons; activation of NK3R causes hot flashes; blockade of NK3R
reduces/eliminates hot flashes; may also be affected by: serotonin,
epinephrine, and norepinephrine; parasympathetic nerve activity.
Off label rx for VMS
- accurate answers-SSRIs, SNRIs, Gabapentinoids, Clonidine, Oxybutynin.
Studies on Fractional Co2 Laser for GSM
- accurate answers-not FDA approved; vaginal symptoms and sexual function
scores increased significantly at 3 months; noted continued improvement at 1
year.
Ospemifene (Osphena) indications and MOA
- accurate answers-for treatment of dyspareunia; decreases vaginal pH;
improves vaginal dryness; shifts vaginal maturational index to superficial
cells; estrogen agonist/antagonist.
Ospemifene (Osphena) adverse effects
- accurate answers-increase in uterine polyps; proliferative endometrium;
slight increased risk of hemorrhagic stroke and VTE; can increase VMS.
treatment of urge incontinence
- accurate answers-behavioral modifications; overactivity of the detrusor
muscle; antimuscarinics: oxybutynin; nerve stimulation; botox.
pelvic floor muscles - superficial
- accurate answers-transverse perineal, bulbospongiosus, ischiocavernosus.
pelvic floor muscles - deep
- accurate answers-pubococcygeus, iliococcygeus, obturator internus,
coccygeus.
,What is low-tone pelvic floor dysfunction?
- accurate answers-weak, underactive and hypotonic muscles that cannot
maintain adequate contraction.
What is high-tone Pelvic Floor Dysfunction?
- accurate answers-weak pelvic floor muscles cannot attain or maintain
adequate relaxation; muscles are overactive, hypertonic, spastic, shortened.
What are the symptoms of low-tone PFD?
- accurate answers-heaviness, pressure, pelvic organ prolapse, incontinence,
altered sexual sensation.
What are the symptoms of high-tone PFD?
- accurate answers-urinary retention, frequency, urgency, dysuria, fecal
retention/constipation, penetrative dyspareunia and/or vaginismus.
Vaginal dilators for PFD
- accurate answers-Choose size that does not cause pain; Show how to insert
with a mirror; Apply lubricant to dilator, insert dilator as far as is comfortable,
leave dilator in place for 5-10 min 1-2 times daily; Use each for 4 weeks before
progressing to a size similar to partner size.
HRT and cognition - natural menopause
- accurate answers-In RCT, HRT has little or no overall effect on short or long-
term cognition.
HRT and cognition - surgical menopause
- accurate answers-HRT may be beneficial in improving verbal memory in the
short term.
In the SWANN survey, which groups of women were most likely to experience
sleep disturbance?
- accurate answers-late perimenopause (45%), surgical menopause (47%).
non-menopausal causes of chronic myalgia
- accurate answers-fibromyalgia, arthritis, statins, biphosphonates.
, 3 simple questions to dx arthritis
- accurate answers-1
SWANN survey sleep disturbance
- accurate answers-Late perimenopause (45%); surgical menopause (47%).
Most common sites of osteoarthritis
- accurate answers-Knee, hip, hand.
Onset of rheumatoid arthritis
- accurate answers-Peak age of onset: women age 35-55.
Most common cause of hypothyroidism
- accurate answers-Hashimoto's thyroiditis.
Gallbladder disease and HT
- accurate answers-Prescribe HT with caution in women with gallstones or
h/o gallbladder disease; suggested that oral estrogen has a greater risk of
gallbladder disease vs transdermal; CHCs and HT increase risk of
cholelithiasis, cholecystitis, and cholecystectomy.
Who to screen for hepatitis C
- accurate answers-All patients born between 1945 and 1965.
Primary syphilis symptoms
- accurate answers-Single, painless chancre for 3-6 weeks.
Secondary syphilis symptoms
- accurate answers-Rash on palms/soles; Mucous membrane lesions;
Lymphadenopathy; Malaise; Fever.
Latent (tertiary) syphilis symptoms
- accurate answers-Brain damage, dementia and mental health problems;
Heart disease; Movement disorders and muscle problems; Nerve damage;
Seizures; Tumors, usually on the bones and skin; Vision problems.
Prevalence of osteoporosis
- accurate answers-Of 10 million adults with osteoporosis, 8 million are
women.
