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NAMS Menopause Exam Q-Bank | Practice
Questions & Answers | Study Guide | Latest
Update
EXAM COVERAGE SUMMARY
This 250-question Q-Bank covers the complete NAMS menopause medicine
curriculum including:
Menopause Staging & Transition — STRAW+10 criteria, early/late transition,
FMP definitions, POI diagnosis, surgical menopause, ethnic variations
Hormonal Physiology — HPO axis, FSH/LH patterns, AMH, inhibin B, AFC, LOOP
events, adrenal androgens, SHBG, free androgen index
Vasomotor Symptoms — Etiology theories, duration, ethnic differences, non-
hormonal and hormonal management
Genitourinary Syndrome — Vaginal atrophy, estrogen receptors, VIN, Paget's
disease, vulvar cancer, urinary incontinence
Osteoporosis — T/Z-score interpretation, fracture risk, bisphosphonates,
raloxifene, teriparatide, denosumab, atypical fractures
Hormone Therapy — Indications, risks/benefits, WHI/WHIMS studies, routes,
dementia risk, gallbladder disease, breast cancer considerations
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Medical Comorbidities — Thyroid disorders, migraines, hepatitis C screening,
HPV, cardiovascular risk
Special Populations — POI, breast cancer survivors, endometriosis, fibroids,
ethnic differences, obesity
NAMS Menopause Exam Q-Bank
Question 1
A 52-year-old woman presents with complaints of hot flashes occurring 8-10 times daily. She is 3 years
past her final menstrual period. Her BMI is 31 kg/m². Which hormonal finding is most likely elevated in
this patient compared to a normal-weight woman at the same menopausal stage?
A. Estradiol
B. Progesterone
C. Estrone
D. Testosterone
Correct Answer: C
RATIONALE: Obese women have higher estrone levels due to peripheral aromatization of androgens in
adipose tissue. This explains their increased risk of endometrial cancer and why they often have higher
postmenopausal estradiol levels compared to normal-weight women.
Question 2
A 48-year-old woman reports irregular menstrual cycles with persistent differences of 8 days in cycle
length over the past 6 months. She has no other symptoms. According to the STRAW+10 staging system,
which stage best describes her current menopausal transition?
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A. Stage -1
B. Stage -2
C. Stage -3a
D. Stage +1a
Correct Answer: B
RATIONALE: Early menopause transition (stage -2) is defined by a persistent difference of 7 days or more
in the length of consecutive cycles. This represents the onset of menstrual irregularity in the menopausal
transition.
Question 3
A 41-year-old woman has missed 4 consecutive menstrual periods. Laboratory testing reveals FSH of 32
mIU/mL on two occasions 5 weeks apart. What is the most appropriate diagnosis?
A. Premature ovarian failure
B. Primary ovarian insufficiency
C. Early menopause
D. Late menopause transition
Correct Answer: B
RATIONALE: Primary ovarian insufficiency is diagnosed in women under age 40 with menstrual
disturbance (oligomenorrhea or amenorrhea for at least 4 months) AND elevated FSH over 25 mIU/mL on
two occasions at least 4 weeks apart.
Question 4
A 55-year-old woman with a history of hypertension is considering hormone therapy for bothersome
vasomotor symptoms. She is 6 years postmenopausal. Which stage of menopause best describes her
current status?
A. Stage +1a
B. Stage +1b
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C. Stage +1c
D. Stage +2
Correct Answer: D
RATIONALE: Stage +2 represents late menopause, occurring 5-8 years after the final menstrual period.
During this stage, somatic aging predominates and genitourinary symptoms become more prominent.
Question 5
A 53-year-old woman reports severe hot flashes that are affecting her quality of life. She is 1 year past
her final menstrual period. Laboratory evaluation reveals elevated FSH and LH levels. Which statement
best explains the etiology of her hot flashes?
A. Elevated estrogen levels widen the thermoregulatory zone
B. Lower ovarian estradiol narrows the thermoregulatory zone
C. Increased progesterone causes hypothalamic dysfunction
D. Elevated LH directly triggers vasomotor instability
Correct Answer: B
RATIONALE: Hot flashes are thought to result from a narrowed thermoregulatory zone caused by lower
ovarian estradiol levels. Additional theories involve neurokinins regulating GnRH secretion, serotonin,
cortisol/HPI axis dysregulation, and endothelial dysfunction.
Question 6
A 58-year-old woman presents with vulvar itching and burning that has not improved with topical steroid
treatment. On examination, there is an erythematous, well-demarcated lesion on the labia majora. What
is the most likely diagnosis?
A. Lichen sclerosus
B. Vulvar Paget's disease
C. Squamous cell carcinoma
D. Contact dermatitis
NAMS Menopause Exam Q-Bank | Practice
Questions & Answers | Study Guide | Latest
Update
EXAM COVERAGE SUMMARY
This 250-question Q-Bank covers the complete NAMS menopause medicine
curriculum including:
Menopause Staging & Transition — STRAW+10 criteria, early/late transition,
FMP definitions, POI diagnosis, surgical menopause, ethnic variations
Hormonal Physiology — HPO axis, FSH/LH patterns, AMH, inhibin B, AFC, LOOP
events, adrenal androgens, SHBG, free androgen index
Vasomotor Symptoms — Etiology theories, duration, ethnic differences, non-
hormonal and hormonal management
Genitourinary Syndrome — Vaginal atrophy, estrogen receptors, VIN, Paget's
disease, vulvar cancer, urinary incontinence
Osteoporosis — T/Z-score interpretation, fracture risk, bisphosphonates,
raloxifene, teriparatide, denosumab, atypical fractures
Hormone Therapy — Indications, risks/benefits, WHI/WHIMS studies, routes,
dementia risk, gallbladder disease, breast cancer considerations
,2|Page
Medical Comorbidities — Thyroid disorders, migraines, hepatitis C screening,
HPV, cardiovascular risk
Special Populations — POI, breast cancer survivors, endometriosis, fibroids,
ethnic differences, obesity
NAMS Menopause Exam Q-Bank
Question 1
A 52-year-old woman presents with complaints of hot flashes occurring 8-10 times daily. She is 3 years
past her final menstrual period. Her BMI is 31 kg/m². Which hormonal finding is most likely elevated in
this patient compared to a normal-weight woman at the same menopausal stage?
A. Estradiol
B. Progesterone
C. Estrone
D. Testosterone
Correct Answer: C
RATIONALE: Obese women have higher estrone levels due to peripheral aromatization of androgens in
adipose tissue. This explains their increased risk of endometrial cancer and why they often have higher
postmenopausal estradiol levels compared to normal-weight women.
Question 2
A 48-year-old woman reports irregular menstrual cycles with persistent differences of 8 days in cycle
length over the past 6 months. She has no other symptoms. According to the STRAW+10 staging system,
which stage best describes her current menopausal transition?
,3|Page
A. Stage -1
B. Stage -2
C. Stage -3a
D. Stage +1a
Correct Answer: B
RATIONALE: Early menopause transition (stage -2) is defined by a persistent difference of 7 days or more
in the length of consecutive cycles. This represents the onset of menstrual irregularity in the menopausal
transition.
Question 3
A 41-year-old woman has missed 4 consecutive menstrual periods. Laboratory testing reveals FSH of 32
mIU/mL on two occasions 5 weeks apart. What is the most appropriate diagnosis?
A. Premature ovarian failure
B. Primary ovarian insufficiency
C. Early menopause
D. Late menopause transition
Correct Answer: B
RATIONALE: Primary ovarian insufficiency is diagnosed in women under age 40 with menstrual
disturbance (oligomenorrhea or amenorrhea for at least 4 months) AND elevated FSH over 25 mIU/mL on
two occasions at least 4 weeks apart.
Question 4
A 55-year-old woman with a history of hypertension is considering hormone therapy for bothersome
vasomotor symptoms. She is 6 years postmenopausal. Which stage of menopause best describes her
current status?
A. Stage +1a
B. Stage +1b
, 4|Page
C. Stage +1c
D. Stage +2
Correct Answer: D
RATIONALE: Stage +2 represents late menopause, occurring 5-8 years after the final menstrual period.
During this stage, somatic aging predominates and genitourinary symptoms become more prominent.
Question 5
A 53-year-old woman reports severe hot flashes that are affecting her quality of life. She is 1 year past
her final menstrual period. Laboratory evaluation reveals elevated FSH and LH levels. Which statement
best explains the etiology of her hot flashes?
A. Elevated estrogen levels widen the thermoregulatory zone
B. Lower ovarian estradiol narrows the thermoregulatory zone
C. Increased progesterone causes hypothalamic dysfunction
D. Elevated LH directly triggers vasomotor instability
Correct Answer: B
RATIONALE: Hot flashes are thought to result from a narrowed thermoregulatory zone caused by lower
ovarian estradiol levels. Additional theories involve neurokinins regulating GnRH secretion, serotonin,
cortisol/HPI axis dysregulation, and endothelial dysfunction.
Question 6
A 58-year-old woman presents with vulvar itching and burning that has not improved with topical steroid
treatment. On examination, there is an erythematous, well-demarcated lesion on the labia majora. What
is the most likely diagnosis?
A. Lichen sclerosus
B. Vulvar Paget's disease
C. Squamous cell carcinoma
D. Contact dermatitis
