NAMS MENOPAUSE CERTIFICATION
FINAL EXAM PREP 2026/2027
QUESTIONS AND ANSWERS
1. According to the STRAW + 10 staging system, what is the principal marker for the transition
from the late menopausal transition (Stage -1) to the early postmenopause (Stage +1a)?
A. A rise in FSH levels above 100 IU/L
B. The occurrence of the final menstrual period (FMP)
C. Amenorrhea for at least 12 consecutive months
D. The detection of low AMH levels below 0.1 ng/mL
Answer: B
Conceptual Explanation: The transition from Stage -1 (late transition) to Stage +1a (early
postmenopause) is defined by the Final Menstrual Period (FMP), which is recognized
retrospectively after 12 months of amenorrhea.
2. Which of the following defines Primary Ovarian Insufficiency (POI)?
A. Amenorrhea for 3 months with FSH > 25 IU/L in women under 45
,B. Oligomenorrhea or amenorrhea for 4 months, FSH > 40 IU/L (twice, 4 weeks apart)
before age 40
C. Elevated LH/FSH ratio and polycystic ovaries on ultrasound before age 40
D. Absence of menstruation for 12 months with low estradiol in women under 30
Answer: B
Conceptual Explanation: POI is diagnosed by the loss of ovarian activity before age 40,
characterized by amenorrhea for at least 4 months and FSH levels in the menopausal range
(typically >40 IU/L) on two occasions at least 4 weeks apart.
3. Which non-hormonal medication is the first neurokinin 3 (NK3) receptor antagonist FDA-
approved for the treatment of moderate-to-severe vasomotor symptoms?
A. Fezolinetant
B. Gabapentin
C. Paroxetine mesylate
D. Venlafaxine
Answer: A
Conceptual Explanation: Fezolinetant (Veozah) is the first NK3 receptor antagonist
approved to treat VMS by blocking the NKB binding on the KNDy neurons in the
hypothalamus.
, 4. In the Women’s Health Initiative (WHI), the conjugated equine estrogen (CEE) plus
medroxyprogesterone acetate (MPA) arm was stopped early due to an increased risk of:
A. Endometrial cancer
B. Colorectal cancer
C. Invasive breast cancer
D. Hip fractures
Answer: C
Conceptual Explanation: The CEE+MPA arm of the WHI was halted in 2002 because the
health risks, specifically the increased risk of invasive breast cancer and cardiovascular
events, outweighed the benefits.
5. A 55-year-old woman with an intact uterus presents with severe hot flashes. Which of the
following is an absolute contraindication for systemic Hormone Therapy (HT)?
A. Controlled hypertension
B. History of deep vein thrombosis (DVT) or pulmonary embolism
C. Type 2 Diabetes mellitus
D. Family history of breast cancer
Answer: B
FINAL EXAM PREP 2026/2027
QUESTIONS AND ANSWERS
1. According to the STRAW + 10 staging system, what is the principal marker for the transition
from the late menopausal transition (Stage -1) to the early postmenopause (Stage +1a)?
A. A rise in FSH levels above 100 IU/L
B. The occurrence of the final menstrual period (FMP)
C. Amenorrhea for at least 12 consecutive months
D. The detection of low AMH levels below 0.1 ng/mL
Answer: B
Conceptual Explanation: The transition from Stage -1 (late transition) to Stage +1a (early
postmenopause) is defined by the Final Menstrual Period (FMP), which is recognized
retrospectively after 12 months of amenorrhea.
2. Which of the following defines Primary Ovarian Insufficiency (POI)?
A. Amenorrhea for 3 months with FSH > 25 IU/L in women under 45
,B. Oligomenorrhea or amenorrhea for 4 months, FSH > 40 IU/L (twice, 4 weeks apart)
before age 40
C. Elevated LH/FSH ratio and polycystic ovaries on ultrasound before age 40
D. Absence of menstruation for 12 months with low estradiol in women under 30
Answer: B
Conceptual Explanation: POI is diagnosed by the loss of ovarian activity before age 40,
characterized by amenorrhea for at least 4 months and FSH levels in the menopausal range
(typically >40 IU/L) on two occasions at least 4 weeks apart.
3. Which non-hormonal medication is the first neurokinin 3 (NK3) receptor antagonist FDA-
approved for the treatment of moderate-to-severe vasomotor symptoms?
A. Fezolinetant
B. Gabapentin
C. Paroxetine mesylate
D. Venlafaxine
Answer: A
Conceptual Explanation: Fezolinetant (Veozah) is the first NK3 receptor antagonist
approved to treat VMS by blocking the NKB binding on the KNDy neurons in the
hypothalamus.
, 4. In the Women’s Health Initiative (WHI), the conjugated equine estrogen (CEE) plus
medroxyprogesterone acetate (MPA) arm was stopped early due to an increased risk of:
A. Endometrial cancer
B. Colorectal cancer
C. Invasive breast cancer
D. Hip fractures
Answer: C
Conceptual Explanation: The CEE+MPA arm of the WHI was halted in 2002 because the
health risks, specifically the increased risk of invasive breast cancer and cardiovascular
events, outweighed the benefits.
5. A 55-year-old woman with an intact uterus presents with severe hot flashes. Which of the
following is an absolute contraindication for systemic Hormone Therapy (HT)?
A. Controlled hypertension
B. History of deep vein thrombosis (DVT) or pulmonary embolism
C. Type 2 Diabetes mellitus
D. Family history of breast cancer
Answer: B
