,NAMS MENOPAUSE CERTIFICATION
EXAM QUESTIONS AND ANSWERS 100%
CORRECT!
Climacteric phase - ANSWER The period of endocrinology, somatic, and transitory
psychological changes that occur around the time of menopause.
Early menopause - ANSWER LMP before age 45
Late menopause - ANSWER LMP after age 54
Primary ovarian insufficiency - ANSWER Menopause that occurs before age 40
Early menopause transition (stage -2) - ANSWER Persistent difference of 7 days or
more in the length of consecutive cycles.
Late menopause transition (stage -1) - ANSWER 60 or more consecutive days of
amenorrhea
Luteal out of phase event (LOOP) - ANSWER Explains why some perimenopausal
women have elevated estrogen level sometimes...In the early menopause transition,
elevated FSH levels are adequate to recruit a second follicle which results in a follicular
phase-like rise in estradiol secretion superimposed on the mid-to-late luteal phase of the
ongoing ovulatory cycle.
Obese women and estradiol levels during menopause - ANSWER Obese women are
more likely to have anovulatory cycles with high estradiol levels. They are also more
likely to have lower perimenopause yet higher postmenopausal estradiol levels
compared with women of normal weight. (why they are at higher risk of endometrial
cancer)
Chinese and Japanese women - ANSWER These ethnic groups have lower estradiol
levels then white, black and hispanic women.
stage +2 - ANSWER late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
, Phases during menopause transition and PMS symptoms - ANSWER Menstrual cycle
variable, persistent >7 day difference between difference in length of consecutive
cycles.
How to respond if a patient requests FSH lab? - ANSWER many pitfalls, variable
depending on the day of the cycle you draw the lab, normal or low FSH is not helpful.
The potentially superior marker of menopause, a lab. - ANSWER AMH
DHEA (dehydroepiandrosterone) - ANSWER Adrenal androgens: precursor hromones
produced by the adrenal gland that are enzymatically converted to active androgens or
estrogens in peripheral tissues.
Location of estrogen receptors - ANSWER Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue - ANSWER maintain blood flow, the collagen, and HA
within the epithelial surfaces. Supports microbiome which supports acidity of vagina and
protects tissue from pathogens.
Vaginal changes with menopause - ANSWER Thinning, loss of elasticity, loss or
absence or rugae.
Vagina and urethra in menopause - ANSWER vagina narrows, urethra moves closer to
the introitus.
Stress urinary incontinence - ANSWER Vaginal estrogen and urinary incontinence: what
type does it help with?
Treatment for FPHL - ANSWER Minoxidil, spironolactone, finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH,
AFC, inhibin? - ANSWER -3b: menstrual cycles normal, FSH normal, AMH low, AFC
low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? and why? -
ANSWER Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal
FSH level.
AMH
EXAM QUESTIONS AND ANSWERS 100%
CORRECT!
Climacteric phase - ANSWER The period of endocrinology, somatic, and transitory
psychological changes that occur around the time of menopause.
Early menopause - ANSWER LMP before age 45
Late menopause - ANSWER LMP after age 54
Primary ovarian insufficiency - ANSWER Menopause that occurs before age 40
Early menopause transition (stage -2) - ANSWER Persistent difference of 7 days or
more in the length of consecutive cycles.
Late menopause transition (stage -1) - ANSWER 60 or more consecutive days of
amenorrhea
Luteal out of phase event (LOOP) - ANSWER Explains why some perimenopausal
women have elevated estrogen level sometimes...In the early menopause transition,
elevated FSH levels are adequate to recruit a second follicle which results in a follicular
phase-like rise in estradiol secretion superimposed on the mid-to-late luteal phase of the
ongoing ovulatory cycle.
Obese women and estradiol levels during menopause - ANSWER Obese women are
more likely to have anovulatory cycles with high estradiol levels. They are also more
likely to have lower perimenopause yet higher postmenopausal estradiol levels
compared with women of normal weight. (why they are at higher risk of endometrial
cancer)
Chinese and Japanese women - ANSWER These ethnic groups have lower estradiol
levels then white, black and hispanic women.
stage +2 - ANSWER late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
, Phases during menopause transition and PMS symptoms - ANSWER Menstrual cycle
variable, persistent >7 day difference between difference in length of consecutive
cycles.
How to respond if a patient requests FSH lab? - ANSWER many pitfalls, variable
depending on the day of the cycle you draw the lab, normal or low FSH is not helpful.
The potentially superior marker of menopause, a lab. - ANSWER AMH
DHEA (dehydroepiandrosterone) - ANSWER Adrenal androgens: precursor hromones
produced by the adrenal gland that are enzymatically converted to active androgens or
estrogens in peripheral tissues.
Location of estrogen receptors - ANSWER Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue - ANSWER maintain blood flow, the collagen, and HA
within the epithelial surfaces. Supports microbiome which supports acidity of vagina and
protects tissue from pathogens.
Vaginal changes with menopause - ANSWER Thinning, loss of elasticity, loss or
absence or rugae.
Vagina and urethra in menopause - ANSWER vagina narrows, urethra moves closer to
the introitus.
Stress urinary incontinence - ANSWER Vaginal estrogen and urinary incontinence: what
type does it help with?
Treatment for FPHL - ANSWER Minoxidil, spironolactone, finasteride, estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH,
AFC, inhibin? - ANSWER -3b: menstrual cycles normal, FSH normal, AMH low, AFC
low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low.
When it is appropriate to check an FSH during the cycle if you check it? and why? -
ANSWER Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal
FSH level.
AMH
