1|Page
NAMS MENOPAUSE CERTIFICATION
EXAM |ACTUAL QUESTIONS AND
ANSWERS 2026
What hormone is generally higher in obese women? - correct-answer - Estrone-
via aromatization.
The postmenopausal ovary continues to produce what two hormones? - correct-
answer - testosterone and androstenedione
Surgical menopause causes women to have lower levels of what hormone? -
correct-answer - testosterone. 40-50% lower than in women w/ intact ovaries.
,2|Page
Driving piece of menopause is ovarian follicles depleting. What does this do to the
inhibin B and AMH? - correct-answer - inhibin and AMH decrease
therefore, follicle growth is not restrained, this allows for the growth of the
remaining, diminished follicle pool.
In the menopause transition, women spend more time in what phase? - correct-
answer - Luteal-more PMS symptoms, more frequent menstrual periods.
HPO axis theory and the menopause transition - correct-answer - It is felt that the
HPO axis may become less sensitive to estrogen, so even with good follicle growth
and estradiol secretion, LH surges can fail which can lead to more cycle
irregularity.
In the first year after the FMP, there is no production of what hormone? - correct-
answer - progesterone
,3|Page
What region of the adrenal gland secretes the androgens? - correct-answer - zona
reticularis
what are considered the 'adrenal androgens'? - correct-answer - DHEA, DHEAS,
Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal gland is regulated
by 3 main factors. - correct-answer - Angiotensin II, potassium concentration,
adrenocorticotropic hormone secreted by the anterior pituitary.
What part of the pituitary gland secretes adrenocorticotropic hormone? - correct-
answer - Anterior pituitary. The posterior only secretes vasopressin and oxytosin.
, 4|Page
Cortisol and HRT - correct-answer - Most serum cortisol circulates bound to
cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which increases total cortisol
concentration.
Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on serum cortisol
concentration.
Do cortisol levels associate with VMS severity? - correct-answer - No, cortisol
levels have NOT been associated with more severe VMS.
Local DHEA has been proven to help with what? - correct-answer - vaginal pain
and dyspareunia
NAMS MENOPAUSE CERTIFICATION
EXAM |ACTUAL QUESTIONS AND
ANSWERS 2026
What hormone is generally higher in obese women? - correct-answer - Estrone-
via aromatization.
The postmenopausal ovary continues to produce what two hormones? - correct-
answer - testosterone and androstenedione
Surgical menopause causes women to have lower levels of what hormone? -
correct-answer - testosterone. 40-50% lower than in women w/ intact ovaries.
,2|Page
Driving piece of menopause is ovarian follicles depleting. What does this do to the
inhibin B and AMH? - correct-answer - inhibin and AMH decrease
therefore, follicle growth is not restrained, this allows for the growth of the
remaining, diminished follicle pool.
In the menopause transition, women spend more time in what phase? - correct-
answer - Luteal-more PMS symptoms, more frequent menstrual periods.
HPO axis theory and the menopause transition - correct-answer - It is felt that the
HPO axis may become less sensitive to estrogen, so even with good follicle growth
and estradiol secretion, LH surges can fail which can lead to more cycle
irregularity.
In the first year after the FMP, there is no production of what hormone? - correct-
answer - progesterone
,3|Page
What region of the adrenal gland secretes the androgens? - correct-answer - zona
reticularis
what are considered the 'adrenal androgens'? - correct-answer - DHEA, DHEAS,
Androstenedione.
Aldosterone secretion from the zona reticularis in the adrenal gland is regulated
by 3 main factors. - correct-answer - Angiotensin II, potassium concentration,
adrenocorticotropic hormone secreted by the anterior pituitary.
What part of the pituitary gland secretes adrenocorticotropic hormone? - correct-
answer - Anterior pituitary. The posterior only secretes vasopressin and oxytosin.
, 4|Page
Cortisol and HRT - correct-answer - Most serum cortisol circulates bound to
cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which increases total cortisol
concentration.
Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on serum cortisol
concentration.
Do cortisol levels associate with VMS severity? - correct-answer - No, cortisol
levels have NOT been associated with more severe VMS.
Local DHEA has been proven to help with what? - correct-answer - vaginal pain
and dyspareunia
