NAMs Menopause Certification
NAMs Menopause Certification Exam
with Complete Solutions UPDATED 2025
Climacteric phase -Correct Answer ✔The period of endocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause -Correct Answer ✔LMP before age 45
Late menopause -Correct Answer ✔LMP after age 54
Primary ovarian insufficiency -Correct Answer ✔Menopause that occurs before age 40
Early menopause transition (stage -2) -Correct Answer ✔Persistent difference of 7 days
or more in the length of consecutive cycles.
Late menopause transition (stage -1) -Correct Answer ✔60 or more consecutive days of
amenorrhea
Luteal out of phase event (LOOP) -Correct 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 -Correct Answer ✔Obese women
are more likely to have anovulatory cycles with high estradiol levels. They are also more
likely to have lower premenopause yet higher postmenopause estradiol levels
compared with women of normal weight. (why they are at higher risk of endometrial
cancer)
Chinese and Japanese women -Correct Answer ✔These ethnic groups have lower
estradiol levels then white, black and hispanic women.
stage +2 -Correct Answer ✔late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c -Correct Answer ✔early post menopause: 2 years after FMP.
FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH -Correct Answer ✔Endocrine labs after menopause
NAMs Menopause Certification
, NAMs Menopause Certification
AMH, inhibin B -Correct Answer ✔These hormones work during reproductive years to
not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms -Correct Answer ✔Menstrual
cycle shortenes, follicular phase compresses, women spend more time in luteal phase..
meaning more premenstrual symptoms and more frequent menstrual periods.
How to respond if a patient requests FSH lab? -Correct 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. -Correct Answer ✔AMH
DHEA (dehydroepiandrosterone) -Correct 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 -Correct Answer ✔Vagina, vulva, urethra, trigone of the
bladder
Effects of estrogen on tissue -Correct Answer ✔maintain blood flow, the collagen, and
HA within the epithelial surfaces. Supports microbiome and protects tissue from
pathogens.
Vaginal changes with menopause -Correct Answer ✔Thinning, loss of elasticity, loss or
absence or rugae.
Vagina and urethra in menopause -Correct Answer ✔vagina narrows, urethra moves
closer to the introitus.
Stress urinary incontinence -Correct Answer ✔Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL -Correct Answer ✔Minoxidil, spironolactone, finasteride, estrogen
therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH,
AFC, inhibin? -Correct 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? -
Correct Answer ✔Cycle day #3. Elevated estradiol can suppress FSH giving a falsely
normal FSH level.
NAMs Menopause Certification
NAMs Menopause Certification Exam
with Complete Solutions UPDATED 2025
Climacteric phase -Correct Answer ✔The period of endocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause -Correct Answer ✔LMP before age 45
Late menopause -Correct Answer ✔LMP after age 54
Primary ovarian insufficiency -Correct Answer ✔Menopause that occurs before age 40
Early menopause transition (stage -2) -Correct Answer ✔Persistent difference of 7 days
or more in the length of consecutive cycles.
Late menopause transition (stage -1) -Correct Answer ✔60 or more consecutive days of
amenorrhea
Luteal out of phase event (LOOP) -Correct 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 -Correct Answer ✔Obese women
are more likely to have anovulatory cycles with high estradiol levels. They are also more
likely to have lower premenopause yet higher postmenopause estradiol levels
compared with women of normal weight. (why they are at higher risk of endometrial
cancer)
Chinese and Japanese women -Correct Answer ✔These ethnic groups have lower
estradiol levels then white, black and hispanic women.
stage +2 -Correct Answer ✔late menopause stage: 5-8 years after FMP. Somatic aging
predominates. Increased genitourinary symptoms.
Stages +1a, +1b, +1c -Correct Answer ✔early post menopause: 2 years after FMP.
FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH -Correct Answer ✔Endocrine labs after menopause
NAMs Menopause Certification
, NAMs Menopause Certification
AMH, inhibin B -Correct Answer ✔These hormones work during reproductive years to
not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms -Correct Answer ✔Menstrual
cycle shortenes, follicular phase compresses, women spend more time in luteal phase..
meaning more premenstrual symptoms and more frequent menstrual periods.
How to respond if a patient requests FSH lab? -Correct 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. -Correct Answer ✔AMH
DHEA (dehydroepiandrosterone) -Correct 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 -Correct Answer ✔Vagina, vulva, urethra, trigone of the
bladder
Effects of estrogen on tissue -Correct Answer ✔maintain blood flow, the collagen, and
HA within the epithelial surfaces. Supports microbiome and protects tissue from
pathogens.
Vaginal changes with menopause -Correct Answer ✔Thinning, loss of elasticity, loss or
absence or rugae.
Vagina and urethra in menopause -Correct Answer ✔vagina narrows, urethra moves
closer to the introitus.
Stress urinary incontinence -Correct Answer ✔Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL -Correct Answer ✔Minoxidil, spironolactone, finasteride, estrogen
therapy
Late reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH,
AFC, inhibin? -Correct 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? -
Correct Answer ✔Cycle day #3. Elevated estradiol can suppress FSH giving a falsely
normal FSH level.
NAMs Menopause Certification
