NAMS MENOPAUSE CERTIFICATION
EXAM REVIEW 2026/2027 QUESTIONS
AND ANSWERS
1. According to the STRAW+10 staging system, which stage is characterized by increased
variability in cycle length (>7 days difference between consecutive cycles)?
A. Stage +1a (Early Postmenopause)
B. Stage -1 (Late Menopausal Transition)
C. Stage -2 (Early Menopausal Transition)
D. Stage -3 (Late Reproductive)
Answer: C
Conceptual Explanation: Stage -2 is the Early Menopausal Transition, defined by
persistent changes in cycle length of 7 days or more. Stage -1 is the Late Menopausal
Transition, marked by intervals of amenorrhea of 60 days or more.
,2. Which of the following is the most accurate description of the ‘Window of Opportunity’ for
initiating Hormone Therapy (HT)?
A. HT is most beneficial and has fewer risks when started within 10 years of menopause or
before age 60.
B. HT should only be used in women under age 50.
C. HT must be discontinued exactly 5 years after initiation regardless of symptoms.
D. HT is only safe for women who have had a surgical menopause.
Answer: A
Conceptual Explanation: The Window of Opportunity hypothesis suggests that the
benefit-risk ratio for HT is most favorable when started in women under age 60 or within
10 years of menopause onset, particularly regarding cardiovascular protection.
3. A 52-year-old woman with an intact uterus presents with severe vasomotor symptoms.
Which of the following is the standard of care to prevent endometrial hyperplasia?
A. Estrogen-only therapy at the lowest possible dose
B. Using vaginal estrogen cream daily
C. Adding a progestogen for at least 12-14 days per month
D. Annual endometrial biopsies while on estrogen therapy
Answer: C
, Conceptual Explanation: Women with an intact uterus who use systemic estrogen
therapy must also take a progestogen to protect the endometrium from hyperplasia and
cancer. 12-14 days of progestogen is required in a sequential regimen.
4. Which neurokinin B antagonist was recently FDA-approved for the treatment of moderate-
to-severe vasomotor symptoms?
A. Paroxetine salt
B. Fezolinetant
C. Venlafaxine
D. Gabapentin
Answer: B
Conceptual Explanation: Fezolinetant (Veozah) is a neurokinin 3 (NK3) receptor
antagonist that acts on the KNDy neurons in the hypothalamus to regulate body
temperature without using hormones.
5. According to NAMS guidelines, what is the primary indication for Hormone Therapy?
A. Primary prevention of coronary heart disease
B. Long-term treatment of clinical depression
C. Prevention of Alzheimer’s disease
D. Treatment of moderate-to-severe vasomotor symptoms
Answer: D
EXAM REVIEW 2026/2027 QUESTIONS
AND ANSWERS
1. According to the STRAW+10 staging system, which stage is characterized by increased
variability in cycle length (>7 days difference between consecutive cycles)?
A. Stage +1a (Early Postmenopause)
B. Stage -1 (Late Menopausal Transition)
C. Stage -2 (Early Menopausal Transition)
D. Stage -3 (Late Reproductive)
Answer: C
Conceptual Explanation: Stage -2 is the Early Menopausal Transition, defined by
persistent changes in cycle length of 7 days or more. Stage -1 is the Late Menopausal
Transition, marked by intervals of amenorrhea of 60 days or more.
,2. Which of the following is the most accurate description of the ‘Window of Opportunity’ for
initiating Hormone Therapy (HT)?
A. HT is most beneficial and has fewer risks when started within 10 years of menopause or
before age 60.
B. HT should only be used in women under age 50.
C. HT must be discontinued exactly 5 years after initiation regardless of symptoms.
D. HT is only safe for women who have had a surgical menopause.
Answer: A
Conceptual Explanation: The Window of Opportunity hypothesis suggests that the
benefit-risk ratio for HT is most favorable when started in women under age 60 or within
10 years of menopause onset, particularly regarding cardiovascular protection.
3. A 52-year-old woman with an intact uterus presents with severe vasomotor symptoms.
Which of the following is the standard of care to prevent endometrial hyperplasia?
A. Estrogen-only therapy at the lowest possible dose
B. Using vaginal estrogen cream daily
C. Adding a progestogen for at least 12-14 days per month
D. Annual endometrial biopsies while on estrogen therapy
Answer: C
, Conceptual Explanation: Women with an intact uterus who use systemic estrogen
therapy must also take a progestogen to protect the endometrium from hyperplasia and
cancer. 12-14 days of progestogen is required in a sequential regimen.
4. Which neurokinin B antagonist was recently FDA-approved for the treatment of moderate-
to-severe vasomotor symptoms?
A. Paroxetine salt
B. Fezolinetant
C. Venlafaxine
D. Gabapentin
Answer: B
Conceptual Explanation: Fezolinetant (Veozah) is a neurokinin 3 (NK3) receptor
antagonist that acts on the KNDy neurons in the hypothalamus to regulate body
temperature without using hormones.
5. According to NAMS guidelines, what is the primary indication for Hormone Therapy?
A. Primary prevention of coronary heart disease
B. Long-term treatment of clinical depression
C. Prevention of Alzheimer’s disease
D. Treatment of moderate-to-severe vasomotor symptoms
Answer: D
