NAMS EXAM QUESTIONS AND ANSWERS
By 2020, number of women over 50 - Answers-64 million
By 2060, number of women over 50 - Answers-90 million
What is the US female life expectancy - Answers-81.2 years
How many oocytes in the ovary at 20 weeks pregnancy - Answers-6-7 Million
How many oocytes left at birth - Answers-1-2 million
What is the time before FMP with cycle variability (and what numerical SWAN stages
correspond?) - Answers-Menopause transition (-2, -1)
What is the time of 7 or more days persistent difference in cycle length (and what
numerical SWAN stage corresponds?) - Answers-Early menopause transition (-2)
What is the time with 60 or more days of amenorrhea at least once (and what numerical
SWAN stage corresponds?) - Answers-Late menopause transition (-1)
What is a retrospective determination of 12 months of amenorrhea - Answers-Natural
menopause
What is the timeframe from onset of menstrual cycle irregularity to 1 year after final
menopause transition - Answers-Perimenopause
What is any time frame after FMP - Answers-Post menopause
What is the preferred term for menopause before age 40 - Answers-Primary ovarian
insufficiency (POI)
Preferred since this may not be a permanent state
What term for menopause before age 40 should no longer be used - Answers-
Premature ovarian failure
What percentage of US women experience POI - Answers-1%
How many oocytes left at puberty - Answers-300,000-500,000
What is the period of change at menopause - Answers-Climacteric or perimenopause
What is the term for menopause that occurs before age 45 - Answers-Early menopause
What is the term for menopause that occurs after age 54 - Answers-Late menopause
,What is the timeframe within the first 8 years after FMP (and what numerical SWAN
stages correspond?) - Answers-Early post menopause (+1a, +1b, +1c)
What is the timeframe called after 8 years from FMP (and what numerical SWAN stage
corresponds?) - Answers-Late post menopause (+2)
How many total stages in STRAW - Answers-10 total
Reproductive has 4 (-5 to -3a)
Menopause Transition has 2 (-2 to -1)
Post Menopause has 4 (+1a to +2)
How many reproductive stages in STRAW - Answers-4 (-5 early reproductive, -4 Peak
reproductive, -3b and -3b late reproductive)
How many stages in menopause transition in STRAW - Answers-2 (-2 early transition, -
1 late transition)
How many stages in postmenopause in STRAW - Answers-4 (+1a, +1b and +1c early
PM, +2 late PM)
Which STRAW stage is menarche in - Answers--5 early reproductive
In which STRAW stage are cycles every 21 to 35 days - Answers--4 Peak reproductive
What differentiates STRAW stage -3b from -3a - Answers--3b cycles normal, FSH wnl,
AMH, AFC, inhibit B low
-3a shorter cycles, variable FSH
What effect do inhibin B and AMH have on follicles - Answers-They prevent too many
follicles from growing at once, so the follicle pool is not depleted too quickly
What happens to inhibin b and AMH levels during menopause transition - Answers-
Decreased number of follicles leads to decreased levels of both of these products.
This means more follicular atresia
What is a LOOP event - Answers-Luteal Out of Phase event
Explains why some perimenopausal women have elevated estrogen levels sometimes.
In early menopause, transition, elevated FSH is adequate to recruit a second follicle.
This results in a follicular phase-like rise in estradiol during the luteal phase
Compared to normal weight women, how do the pre-menopause and post menopause
estradiol levels of obese women compare - Answers-Lower pre-menopause estradiol
Higher post menopause estradiol
, Which ethnic groups have lower estradiol levels, compared to white/black/Hispanic
women - Answers-Chinese and Japanese women
Where is AMH produced - Answers-Granulosa cells of antral and preantral follicles
When does AMH peak - Answers-Around 25 yo
(so before age 25, test is not helpful)
How does birth control affect AMH - Answers-Lowers it
What is AFC - Answers-Antral follicle count
Number of follicles 2-10 mm detected with ultrasound
Do African-American women have higher or lower FSH levels - Answers-Higher
Do Chinese and Japanese women have higher or lower estradiol levels compared to
white women - Answers-Lower
What happens to SHBG at menopause - Answers-Decreases
(T:SHBG ratio increases by 80%)
What is the Free Androgen Index - Answers-T:SHBG ratio
What hormone is generally higher in obese women and why - Answers-Estrone
Due to aromatization of estradiol to estrone by excess adipose tissue
What 2 hormones does the postmenopausal ovary continue to produce - Answers-
Testosterone
Androstenedione
Surgical menopause reduces what hormone as compared to natural menopause -
Answers-Testosterone
(40 to 50% lower)
In menopause transition, women spend more time in what menstrual phase - Answers-
Luteal
What is the HPO axis theory of menopause transition - Answers-HPO access becomes
less sensitive to estrogen.
Even with good follicle, growth and estradiol, LH surges fail, leading to cycle irregularity.
In the first year after the FMP, there is no production of what hormone - Answers-
Progesterone
What 3 products does the adrenal cortex produce - Answers-Glucocorticoids
Mineralocorticoids
By 2020, number of women over 50 - Answers-64 million
By 2060, number of women over 50 - Answers-90 million
What is the US female life expectancy - Answers-81.2 years
How many oocytes in the ovary at 20 weeks pregnancy - Answers-6-7 Million
How many oocytes left at birth - Answers-1-2 million
What is the time before FMP with cycle variability (and what numerical SWAN stages
correspond?) - Answers-Menopause transition (-2, -1)
What is the time of 7 or more days persistent difference in cycle length (and what
numerical SWAN stage corresponds?) - Answers-Early menopause transition (-2)
What is the time with 60 or more days of amenorrhea at least once (and what numerical
SWAN stage corresponds?) - Answers-Late menopause transition (-1)
What is a retrospective determination of 12 months of amenorrhea - Answers-Natural
menopause
What is the timeframe from onset of menstrual cycle irregularity to 1 year after final
menopause transition - Answers-Perimenopause
What is any time frame after FMP - Answers-Post menopause
What is the preferred term for menopause before age 40 - Answers-Primary ovarian
insufficiency (POI)
Preferred since this may not be a permanent state
What term for menopause before age 40 should no longer be used - Answers-
Premature ovarian failure
What percentage of US women experience POI - Answers-1%
How many oocytes left at puberty - Answers-300,000-500,000
What is the period of change at menopause - Answers-Climacteric or perimenopause
What is the term for menopause that occurs before age 45 - Answers-Early menopause
What is the term for menopause that occurs after age 54 - Answers-Late menopause
,What is the timeframe within the first 8 years after FMP (and what numerical SWAN
stages correspond?) - Answers-Early post menopause (+1a, +1b, +1c)
What is the timeframe called after 8 years from FMP (and what numerical SWAN stage
corresponds?) - Answers-Late post menopause (+2)
How many total stages in STRAW - Answers-10 total
Reproductive has 4 (-5 to -3a)
Menopause Transition has 2 (-2 to -1)
Post Menopause has 4 (+1a to +2)
How many reproductive stages in STRAW - Answers-4 (-5 early reproductive, -4 Peak
reproductive, -3b and -3b late reproductive)
How many stages in menopause transition in STRAW - Answers-2 (-2 early transition, -
1 late transition)
How many stages in postmenopause in STRAW - Answers-4 (+1a, +1b and +1c early
PM, +2 late PM)
Which STRAW stage is menarche in - Answers--5 early reproductive
In which STRAW stage are cycles every 21 to 35 days - Answers--4 Peak reproductive
What differentiates STRAW stage -3b from -3a - Answers--3b cycles normal, FSH wnl,
AMH, AFC, inhibit B low
-3a shorter cycles, variable FSH
What effect do inhibin B and AMH have on follicles - Answers-They prevent too many
follicles from growing at once, so the follicle pool is not depleted too quickly
What happens to inhibin b and AMH levels during menopause transition - Answers-
Decreased number of follicles leads to decreased levels of both of these products.
This means more follicular atresia
What is a LOOP event - Answers-Luteal Out of Phase event
Explains why some perimenopausal women have elevated estrogen levels sometimes.
In early menopause, transition, elevated FSH is adequate to recruit a second follicle.
This results in a follicular phase-like rise in estradiol during the luteal phase
Compared to normal weight women, how do the pre-menopause and post menopause
estradiol levels of obese women compare - Answers-Lower pre-menopause estradiol
Higher post menopause estradiol
, Which ethnic groups have lower estradiol levels, compared to white/black/Hispanic
women - Answers-Chinese and Japanese women
Where is AMH produced - Answers-Granulosa cells of antral and preantral follicles
When does AMH peak - Answers-Around 25 yo
(so before age 25, test is not helpful)
How does birth control affect AMH - Answers-Lowers it
What is AFC - Answers-Antral follicle count
Number of follicles 2-10 mm detected with ultrasound
Do African-American women have higher or lower FSH levels - Answers-Higher
Do Chinese and Japanese women have higher or lower estradiol levels compared to
white women - Answers-Lower
What happens to SHBG at menopause - Answers-Decreases
(T:SHBG ratio increases by 80%)
What is the Free Androgen Index - Answers-T:SHBG ratio
What hormone is generally higher in obese women and why - Answers-Estrone
Due to aromatization of estradiol to estrone by excess adipose tissue
What 2 hormones does the postmenopausal ovary continue to produce - Answers-
Testosterone
Androstenedione
Surgical menopause reduces what hormone as compared to natural menopause -
Answers-Testosterone
(40 to 50% lower)
In menopause transition, women spend more time in what menstrual phase - Answers-
Luteal
What is the HPO axis theory of menopause transition - Answers-HPO access becomes
less sensitive to estrogen.
Even with good follicle, growth and estradiol, LH surges fail, leading to cycle irregularity.
In the first year after the FMP, there is no production of what hormone - Answers-
Progesterone
What 3 products does the adrenal cortex produce - Answers-Glucocorticoids
Mineralocorticoids
