NAMS MENOPAUSE CERTIFICATION
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. According to the 2022 NAMS Position Statement, what is the primary indication for
systemic hormone therapy (HT)?
A. Prevention of cardiovascular disease
B. Prevention of type 2 diabetes
C. Treatment of cognitive decline
D. Treatment of vasomotor symptoms (VMS)
Answer: D
Conceptual Explanation: The primary indication for systemic HT is the treatment of
bothersome vasomotor symptoms (VMS), which remain the most common symptom of the
menopause transition.
2. Which of the following describes the ‘Window of Opportunity’ hypothesis regarding
hormone therapy and cardiovascular health?
A. HT is most beneficial when started after age 70
,B. Initiating HT under age 60 or within 10 years of menopause onset reduces CVD risk
C. HT has no effect on cardiovascular risk regardless of age
D. HT should only be used for women with pre-existing heart disease
Answer: B
Conceptual Explanation: The timing hypothesis suggests that initiating HT in women
younger than 60 or within 10 years of menopause onset is associated with a reduction in
coronary heart disease and all-cause mortality.
3. What is the standard diagnostic criteria for menopause in a woman with an intact uterus?
A. Six months of amenorrhea with an FSH > 20 IU/L
B. One year of irregular cycles and high LH levels
C. Twelve consecutive months of amenorrhea without other causes
D. A single elevated FSH level above 40 IU/L
Answer: C
Conceptual Explanation: Menopause is a clinical diagnosis defined by 12 consecutive
months of amenorrhea in a woman with an intact uterus, resulting from the loss of ovarian
follicular activity.
4. In the Women’s Health Initiative (WHI) trial, what was the primary difference in breast
cancer risk between the E+P and E-only groups?
A. Both groups showed a significant increase in breast cancer risk
, B. There was no difference in risk between the two groups
C. E+P therapy decreased breast cancer risk
D. E-only therapy showed a decreased risk of breast cancer compared to placebo
Answer: D
Conceptual Explanation: In the WHI long-term follow-up, estrogen-only therapy (CEE)
was associated with a statistically significant lower risk of breast cancer, whereas estrogen
plus progestogen (CEE+MPA) was associated with an increased risk.
5. Which non-hormonal medication is the first NK3 receptor antagonist FDA-approved for the
treatment of moderate-to-severe VMS?
A. Fezolinetant
B. Venlafaxine
C. Paroxetine 7.5mg
D. Gabapentin
Answer: A
Conceptual Explanation: Fezolinetant is a neurokinin 3 (NK3) receptor antagonist
specifically approved for treating vasomotor symptoms by targeting the KNDy neurons in
the hypothalamus.
PRACTICE EXAM QUESTIONS AND
ANSWERS
1. According to the 2022 NAMS Position Statement, what is the primary indication for
systemic hormone therapy (HT)?
A. Prevention of cardiovascular disease
B. Prevention of type 2 diabetes
C. Treatment of cognitive decline
D. Treatment of vasomotor symptoms (VMS)
Answer: D
Conceptual Explanation: The primary indication for systemic HT is the treatment of
bothersome vasomotor symptoms (VMS), which remain the most common symptom of the
menopause transition.
2. Which of the following describes the ‘Window of Opportunity’ hypothesis regarding
hormone therapy and cardiovascular health?
A. HT is most beneficial when started after age 70
,B. Initiating HT under age 60 or within 10 years of menopause onset reduces CVD risk
C. HT has no effect on cardiovascular risk regardless of age
D. HT should only be used for women with pre-existing heart disease
Answer: B
Conceptual Explanation: The timing hypothesis suggests that initiating HT in women
younger than 60 or within 10 years of menopause onset is associated with a reduction in
coronary heart disease and all-cause mortality.
3. What is the standard diagnostic criteria for menopause in a woman with an intact uterus?
A. Six months of amenorrhea with an FSH > 20 IU/L
B. One year of irregular cycles and high LH levels
C. Twelve consecutive months of amenorrhea without other causes
D. A single elevated FSH level above 40 IU/L
Answer: C
Conceptual Explanation: Menopause is a clinical diagnosis defined by 12 consecutive
months of amenorrhea in a woman with an intact uterus, resulting from the loss of ovarian
follicular activity.
4. In the Women’s Health Initiative (WHI) trial, what was the primary difference in breast
cancer risk between the E+P and E-only groups?
A. Both groups showed a significant increase in breast cancer risk
, B. There was no difference in risk between the two groups
C. E+P therapy decreased breast cancer risk
D. E-only therapy showed a decreased risk of breast cancer compared to placebo
Answer: D
Conceptual Explanation: In the WHI long-term follow-up, estrogen-only therapy (CEE)
was associated with a statistically significant lower risk of breast cancer, whereas estrogen
plus progestogen (CEE+MPA) was associated with an increased risk.
5. Which non-hormonal medication is the first NK3 receptor antagonist FDA-approved for the
treatment of moderate-to-severe VMS?
A. Fezolinetant
B. Venlafaxine
C. Paroxetine 7.5mg
D. Gabapentin
Answer: A
Conceptual Explanation: Fezolinetant is a neurokinin 3 (NK3) receptor antagonist
specifically approved for treating vasomotor symptoms by targeting the KNDy neurons in
the hypothalamus.
