NAMS MENOPAUSE EXAM PREP: 200 QUESTIONS,
ANSWERS & RATIONALES FOR CERTIFICATION SUCCESS
1. According to the STRAW+10 staging system, which stage is defined
by the onset of persistent menstrual cycle variability of ≥7 days in
consecutive cycles?
A. Stage -3 (Late Reproductive)
B. Stage -2 (Early Menopausal Transition)
C. Stage -1 (Late Menopausal Transition)
D. Stage +1a (Early Postmenopause)
Correct Answer: B
Rationale: STRAW+10 Stage -2 (Early Menopausal Transition) is defined
by persistent variability in menstrual cycle length of ≥7 days in
consecutive cycles. Stage -1 is characterized by intervals of amenorrhea
≥60 days.
2. A 52-year-old woman presents with 14 months of amenorrhea.
According to STRAW+10, which stage is she in?
A. Stage +1a
B. Stage -1
C. Stage +1b
D. Stage +2
Correct Answer: A
Rationale: The first 12 months following the final menstrual period
correspond to Stage +1a.
,3. Which of the following best defines the climacteric phase?
A. The 12 months following the final menstrual period
B. The period of endocrinologic, somatic, and psychologic changes
around menopause
C. The first 5 years after menopause
D. The period of regular cycling before any changes
Correct Answer: B
Rationale: The climacteric phase is a broader term encompassing the
transition from reproductive to non-reproductive years, including
hormonal fluctuations and associated symptoms.
4. In the STRAW+10 system, what is the hallmark of Stage -1 (Late
Menopausal Transition)?
A. A persistent difference of ≥7 days in cycle length
B. An interval of amenorrhea of ≥60 days
C. The final menstrual period
D. Regular cycles with elevated FSH
Correct Answer: B
Rationale: The late menopausal transition (Stage -1) is characterized by
intervals of amenorrhea of ≥60 days.
5. Which of the following is a key limitation of the STRAW+10 staging
system?
A. It is based on data exclusively from Caucasian women
B. It has limited applicability for women with irregular cycles due to
PCOS or hysterectomy
C. It requires daily hormone monitoring
D. It cannot be used to stage women over age 55
,Correct Answer: B
Rationale: The STRAW+10 system has limited applicability for women
with irregular menstrual cycles, such as those with PCOS or a history of
hysterectomy.
6. What is the mean age of natural menopause in the United States?
A. 48 years
B. 51 years
C. 54 years
D. 45 years
Correct Answer: B
Rationale: The mean age of natural menopause in US women is
approximately 51 years.
7. A 48-year-old woman reports her cycles have become irregular,
varying between 25 and 40 days. She has occasional hot flashes.
According to STRAW+10, she is in:
A. Stage -1
B. Stage -2
C. Stage +1a
D. Stage -3
Correct Answer: B
Rationale: The persistent difference of >7 days in cycle length places
her in Stage -2 (Early Menopausal Transition).
8. The final menstrual period is designated as which STRAW+10 stage?
A. Stage 0
B. Stage +1a
C. Stage -1
D. Stage +1b
, Correct Answer: A
Rationale: The final menstrual period is the single point designated as
Stage 0 in the STRAW+10 system.
9. Which stage of STRAW+10 covers the period from 1 to 2 years after
the final menstrual period?
A. Stage +1a
B. Stage +1b
C. Stage +1c
D. Stage +2
Correct Answer: B
Rationale: Stage +1b corresponds to the second 12 months following
the final menstrual period.
10. A 45-year-old woman has a history of regular cycles but notes a
subtle change in cycle length. According to STRAW+10, she is most
likely in:
A. Stage -3a
B. Stage -3b
C. Stage -2
D. Stage -1
Correct Answer: B
Rationale: Stage -3b (Late Reproductive) is characterized by regular
cycles with subtle hormonal changes and variable cycle length.
11. What is the primary hormone that increases in response to
declining ovarian function during the menopausal transition?
A. Estradiol
B. Progesterone
ANSWERS & RATIONALES FOR CERTIFICATION SUCCESS
1. According to the STRAW+10 staging system, which stage is defined
by the onset of persistent menstrual cycle variability of ≥7 days in
consecutive cycles?
A. Stage -3 (Late Reproductive)
B. Stage -2 (Early Menopausal Transition)
C. Stage -1 (Late Menopausal Transition)
D. Stage +1a (Early Postmenopause)
Correct Answer: B
Rationale: STRAW+10 Stage -2 (Early Menopausal Transition) is defined
by persistent variability in menstrual cycle length of ≥7 days in
consecutive cycles. Stage -1 is characterized by intervals of amenorrhea
≥60 days.
2. A 52-year-old woman presents with 14 months of amenorrhea.
According to STRAW+10, which stage is she in?
A. Stage +1a
B. Stage -1
C. Stage +1b
D. Stage +2
Correct Answer: A
Rationale: The first 12 months following the final menstrual period
correspond to Stage +1a.
,3. Which of the following best defines the climacteric phase?
A. The 12 months following the final menstrual period
B. The period of endocrinologic, somatic, and psychologic changes
around menopause
C. The first 5 years after menopause
D. The period of regular cycling before any changes
Correct Answer: B
Rationale: The climacteric phase is a broader term encompassing the
transition from reproductive to non-reproductive years, including
hormonal fluctuations and associated symptoms.
4. In the STRAW+10 system, what is the hallmark of Stage -1 (Late
Menopausal Transition)?
A. A persistent difference of ≥7 days in cycle length
B. An interval of amenorrhea of ≥60 days
C. The final menstrual period
D. Regular cycles with elevated FSH
Correct Answer: B
Rationale: The late menopausal transition (Stage -1) is characterized by
intervals of amenorrhea of ≥60 days.
5. Which of the following is a key limitation of the STRAW+10 staging
system?
A. It is based on data exclusively from Caucasian women
B. It has limited applicability for women with irregular cycles due to
PCOS or hysterectomy
C. It requires daily hormone monitoring
D. It cannot be used to stage women over age 55
,Correct Answer: B
Rationale: The STRAW+10 system has limited applicability for women
with irregular menstrual cycles, such as those with PCOS or a history of
hysterectomy.
6. What is the mean age of natural menopause in the United States?
A. 48 years
B. 51 years
C. 54 years
D. 45 years
Correct Answer: B
Rationale: The mean age of natural menopause in US women is
approximately 51 years.
7. A 48-year-old woman reports her cycles have become irregular,
varying between 25 and 40 days. She has occasional hot flashes.
According to STRAW+10, she is in:
A. Stage -1
B. Stage -2
C. Stage +1a
D. Stage -3
Correct Answer: B
Rationale: The persistent difference of >7 days in cycle length places
her in Stage -2 (Early Menopausal Transition).
8. The final menstrual period is designated as which STRAW+10 stage?
A. Stage 0
B. Stage +1a
C. Stage -1
D. Stage +1b
, Correct Answer: A
Rationale: The final menstrual period is the single point designated as
Stage 0 in the STRAW+10 system.
9. Which stage of STRAW+10 covers the period from 1 to 2 years after
the final menstrual period?
A. Stage +1a
B. Stage +1b
C. Stage +1c
D. Stage +2
Correct Answer: B
Rationale: Stage +1b corresponds to the second 12 months following
the final menstrual period.
10. A 45-year-old woman has a history of regular cycles but notes a
subtle change in cycle length. According to STRAW+10, she is most
likely in:
A. Stage -3a
B. Stage -3b
C. Stage -2
D. Stage -1
Correct Answer: B
Rationale: Stage -3b (Late Reproductive) is characterized by regular
cycles with subtle hormonal changes and variable cycle length.
11. What is the primary hormone that increases in response to
declining ovarian function during the menopausal transition?
A. Estradiol
B. Progesterone
