NAMS MENOPAUSE CERTIFICATION EXAM 2025| ACTUAL
EXAM QUESTIONS WITH IN-DEPTH ANSWERS|LATEST
VERSION|EXPERT VERIFIED FOR GUARANTEED PASS
1. Which statement best defines the term “climacteric phase” in a woman’s life?
A. The phase during which bone density increases due to high estrogen levels
B. A period marked by very steady hormone levels before menopause
C. The period of endocrinologic, somatic, and transitory psychologic changes around
menopause
D. The immediate 2 years following the final menstrual period (FMP)
Correct Answer: C. The period of endocrinologic, somatic, and transitory psychologic changes
around menopause
Rationale: The climacteric phase encompasses the entire transition leading up to and
immediately after menopause when multiple systemic changes occur.
2. Early menopause is defined as a woman’s final menstrual period (FMP) occurring:
A. After age 50 but before 52
B. Before age 45
C. After age 54
D. Exactly at age 40
Correct Answer: B. Before age 45
Rationale: “Early menopause” is when menses cease before 45 years old. This differs from
primary ovarian insufficiency (before 40) and late menopause (after 54).
3. Late menopause is best described as the last menstrual period occurring:
A. Exactly on a woman’s 60th birthday
B. After age 54
C. Between ages 45 and 50
D. When menopausal symptoms are mild
Correct Answer: B. After age 54
Rationale: Late menopause refers to menopause that occurs at 55 years or older (often
operationally described as after 54).
4. Primary ovarian insufficiency (POI) refers to menopause that occurs:
A. Before age 40
B. Between ages 40 and 45
,C. Exactly at age 52
D. After a bilateral oophorectomy only
Correct Answer: A. Before age 40
Rationale: POI is characterized by ovarian failure leading to menopause-like changes prior to
age 40.
5. In the early menopause transition (Stage –2), the key cycle marker is:
A. 60 or more consecutive days of amenorrhea
B. Persistent difference of 7 days or more in the length of consecutive cycles
C. No changes in menstrual regularity
D. FSH always above 25 IU/L
Correct Answer: B. Persistent difference of ≥7 days in consecutive cycle lengths
Rationale: The early transition is often signaled by more variable cycle lengths (≥7-day
fluctuation).
6. In the late menopause transition (Stage –1), the hallmark menstrual change is:
A. Persistent hot flashes with regular periods
B. Cycle shortening to 21 days or less
C. 60 or more consecutive days of amenorrhea
D. Ovulation occurring twice per cycle
Correct Answer: C. 60 or more consecutive days of amenorrhea
Rationale: In the late menopause transition, women can have longer gaps between cycles (≥60
days with no menses).
7. The concept of a “luteal out-of-phase event” (LOOP) best explains which phenomenon in
perimenopausal women?
A. Persistent low estrogen levels
B. Elevated estrogen levels in the mid-to-late luteal phase
C. Complete ovarian suppression of estradiol
D. Consistently low FSH throughout the cycle
Correct Answer: B. Elevated estrogen levels in the mid-to-late luteal phase
Rationale: A LOOP event refers to a second follicular recruitment causing an uncharacteristic
estradiol surge superimposed on the luteal phase.
, 8. Among obese perimenopausal women, how do estradiol levels generally compare to those
in normal-weight women?
A. Always lower in all reproductive stages
B. Higher in the perimenopausal phase due to more anovulatory cycles
C. Exactly the same, with no weight-based difference
D. Lower postmenopausal estradiol levels compared to normal-weight women
Correct Answer: B. Higher in the perimenopausal phase
Rationale: Obese women tend to have more anovulatory cycles and higher peripheral
conversion of androgens to estrogens, leading to higher estradiol levels, especially
premenopausally.
9. Chinese and Japanese women generally have which pattern of estradiol levels compared
to White, Black, or Hispanic women?
A. Significantly higher after menopause
B. The same levels across all stages
C. Lower estradiol levels
D. Fluctuating but generally 2–3 times higher
Correct Answer: C. Lower estradiol levels
Rationale: Studies indicate Chinese and Japanese women have comparatively lower mean
estradiol levels.
10. Stage +2 (late postmenopause, about 5–8 years after FMP) is often characterized by:
A. FSH returning to premenopausal levels
B. Stabilization of genitourinary symptoms
C. Increased genitourinary symptoms (GSM) and somatic aging
D. Decrease in bone turnover and no further menopausal symptoms
Correct Answer: C. Increased genitourinary symptoms
Rationale: Stage +2 generally sees ongoing changes such as GSM and somatic (aging-related)
symptoms.
11. Elevated FSH and LH levels in lab testing are characteristic of:
A. Late follicular phase in normal cycles
B. Endocrine profile after menopause
C. Early pregnancy
D. Polycystic ovary syndrome
EXAM QUESTIONS WITH IN-DEPTH ANSWERS|LATEST
VERSION|EXPERT VERIFIED FOR GUARANTEED PASS
1. Which statement best defines the term “climacteric phase” in a woman’s life?
A. The phase during which bone density increases due to high estrogen levels
B. A period marked by very steady hormone levels before menopause
C. The period of endocrinologic, somatic, and transitory psychologic changes around
menopause
D. The immediate 2 years following the final menstrual period (FMP)
Correct Answer: C. The period of endocrinologic, somatic, and transitory psychologic changes
around menopause
Rationale: The climacteric phase encompasses the entire transition leading up to and
immediately after menopause when multiple systemic changes occur.
2. Early menopause is defined as a woman’s final menstrual period (FMP) occurring:
A. After age 50 but before 52
B. Before age 45
C. After age 54
D. Exactly at age 40
Correct Answer: B. Before age 45
Rationale: “Early menopause” is when menses cease before 45 years old. This differs from
primary ovarian insufficiency (before 40) and late menopause (after 54).
3. Late menopause is best described as the last menstrual period occurring:
A. Exactly on a woman’s 60th birthday
B. After age 54
C. Between ages 45 and 50
D. When menopausal symptoms are mild
Correct Answer: B. After age 54
Rationale: Late menopause refers to menopause that occurs at 55 years or older (often
operationally described as after 54).
4. Primary ovarian insufficiency (POI) refers to menopause that occurs:
A. Before age 40
B. Between ages 40 and 45
,C. Exactly at age 52
D. After a bilateral oophorectomy only
Correct Answer: A. Before age 40
Rationale: POI is characterized by ovarian failure leading to menopause-like changes prior to
age 40.
5. In the early menopause transition (Stage –2), the key cycle marker is:
A. 60 or more consecutive days of amenorrhea
B. Persistent difference of 7 days or more in the length of consecutive cycles
C. No changes in menstrual regularity
D. FSH always above 25 IU/L
Correct Answer: B. Persistent difference of ≥7 days in consecutive cycle lengths
Rationale: The early transition is often signaled by more variable cycle lengths (≥7-day
fluctuation).
6. In the late menopause transition (Stage –1), the hallmark menstrual change is:
A. Persistent hot flashes with regular periods
B. Cycle shortening to 21 days or less
C. 60 or more consecutive days of amenorrhea
D. Ovulation occurring twice per cycle
Correct Answer: C. 60 or more consecutive days of amenorrhea
Rationale: In the late menopause transition, women can have longer gaps between cycles (≥60
days with no menses).
7. The concept of a “luteal out-of-phase event” (LOOP) best explains which phenomenon in
perimenopausal women?
A. Persistent low estrogen levels
B. Elevated estrogen levels in the mid-to-late luteal phase
C. Complete ovarian suppression of estradiol
D. Consistently low FSH throughout the cycle
Correct Answer: B. Elevated estrogen levels in the mid-to-late luteal phase
Rationale: A LOOP event refers to a second follicular recruitment causing an uncharacteristic
estradiol surge superimposed on the luteal phase.
, 8. Among obese perimenopausal women, how do estradiol levels generally compare to those
in normal-weight women?
A. Always lower in all reproductive stages
B. Higher in the perimenopausal phase due to more anovulatory cycles
C. Exactly the same, with no weight-based difference
D. Lower postmenopausal estradiol levels compared to normal-weight women
Correct Answer: B. Higher in the perimenopausal phase
Rationale: Obese women tend to have more anovulatory cycles and higher peripheral
conversion of androgens to estrogens, leading to higher estradiol levels, especially
premenopausally.
9. Chinese and Japanese women generally have which pattern of estradiol levels compared
to White, Black, or Hispanic women?
A. Significantly higher after menopause
B. The same levels across all stages
C. Lower estradiol levels
D. Fluctuating but generally 2–3 times higher
Correct Answer: C. Lower estradiol levels
Rationale: Studies indicate Chinese and Japanese women have comparatively lower mean
estradiol levels.
10. Stage +2 (late postmenopause, about 5–8 years after FMP) is often characterized by:
A. FSH returning to premenopausal levels
B. Stabilization of genitourinary symptoms
C. Increased genitourinary symptoms (GSM) and somatic aging
D. Decrease in bone turnover and no further menopausal symptoms
Correct Answer: C. Increased genitourinary symptoms
Rationale: Stage +2 generally sees ongoing changes such as GSM and somatic (aging-related)
symptoms.
11. Elevated FSH and LH levels in lab testing are characteristic of:
A. Late follicular phase in normal cycles
B. Endocrine profile after menopause
C. Early pregnancy
D. Polycystic ovary syndrome
