NAMS MENOPAUSE CERTIFICATION EXAM
WITH COMPLETE SOLUTIONS LATEST
UPDATES
Climacteric vphase v- vAnswer vThe vperiod vof vendrocrinologic, vsomatic, vand vtransitory
vpsychologic vchanges vthat voccur varound vthe vtime vof vmenopause.
Early vmenopause v- vAnswer vLMP vbefore vage v45
Late vmenopause v- vAnswer vLMP vafter vage v54
Primary vovarian vinsufficiency v- vAnswer vMenopause vthat voccurs vbefore vage v40
Early vmenopause vtransition v(stage v-2) v- vAnswer vPersistent vdifference vof v7 vdays vor
vmore vin vthe vlength vof vconsecutive vcycles.
Late vmenopause vtransition v(stage v-1) v- vAnswer v60 vor vmore vconsecutive vdays vof
vamenorrhea
Luteal vout vof vphase vevent v(LOOP) v- vAnswer vExplains vwhy vsome vperimenopausal
vwomen vhave velevated vestrogen vlevel vsometimes...In vthe vearly vmenopause
vtransition, velevated vFSH vlevels vare vadequate vto vrecruit va vsecond vfollicle vwhich
vresults vin va vfollicular vphase-like vrise vin vestradiol vsecretion vsuperimposed von vthe
vmid-to-late vluteal vphase vof vthe vongoing vovulatory vcycle.
Obese vwomen vand vestradiol vlevels vduring vmenopause v- vAnswer vObese vwomen
vare vmore vlikely vto vhave vanovulatory vcycles vwith vhigh vestradiol vlevels. vThey vare
valso vmore vlikely vto vhave vlower vpremenopause vyet vhigher vpostmenopause vestradiol
vlevels vcompared vwith vwomen vof vnormal vweight. v(why vthey vare vat vhigher vrisk vof
vendometrial vcancer)
Chinese vand vJapanese vwomen v- vAnswer vThese vethnic vgroups vhave vlower
vestradiol vlevels vthen vwhite, vblack vand vhispanic vwomen.
stage v+2 v- vAnswer vlate vmenopause vstage: v5-8 vyears vafter vFMP. vSomatic vaging
vpredominates. vIncreased vgenitourinary vsymptoms.
Stages v+1a, v+1b, v+1c v- vAnswer vearly vpost vmenopause: v2 vyears vafter vFMP. vFSH
vrises, vestradiol vdecreases. vVMS vpredominate.
Elevated vFSH, vLH v- vAnswer vEndocrine vlabs vafter vmenopause
AMH, vinhibin vB v- vAnswer vThese vhormones vwork vduring vreproductive vyears vto vnot
vdeplete vfollicle vpool vtoo vquickly.
, Phases vduring vmenopause vtransition vand vPMS vsymptoms v- vAnswer vMenstrual
vcycle vshortenes, vfollicular vphase vcompresses, vwomen vspend vmore vtime vin vluteal
vphase.. vmeaning vmore vpremenstrual vsymptoms vand vmore vfrequent vmenstrual
vperiods.
How vto vrespond vif va vpatient vrequests vFSH vlab? v- vAnswer vmany vpitfalls, vvariable
vdepending von vthe vday vof vthe vcycle vyou vdraw vthe vlab, vnormal vor vlow vFSH vis vnot
vhelpful.
The vpotentially vsuperior vmarker vof vmenopause, va vlab. v- vAnswer vAMH
DHEA v(dehydroepiandrosterone) v- vAnswer vAdrenal vandrogens: vprecursor vhromones
vproduced vby vthe vadrenal vgland vthat vare venzymatically vconverted vto vactive
vandrogens vor vestrogens vin vperipheral vtissues.
Location vof vestrogen vreceptors v- vAnswer vVagina, vvulva, vurethra, vtrigone vof vthe
vbladder
Effects vof vestrogen von vtissue v- vAnswer vmaintain vblood vflow, vthe vcollagen, vand vHA
vwithin vthe vepithelial vsurfaces. vSupports vmicrobiome vand vprotects vtissue vfrom
vpathogens.
Vaginal vchanges vwith vmenopause v- vAnswer vThinning, vloss vof velasticity, vloss vor
vabsence vor vrugae.
Vagina vand vurethra vin vmenopause v- vAnswer vvagina vnarrows, vurethra vmoves vcloser
vto vthe vintroitus.
Stress vurinary vincontinence v- vAnswer vVaginal vestrogen vand vurinary vincontinence:
vwhat vtype vdoes vit vhelp vwith?
Treatment vfor vFPHL v- vAnswer vMinoxidil, vspironolactone, vfinasteride, vestrogen
vtherapy
Late vreporoductive vyears v-3b vand v-3a. vWhat vhappens vwith vmenstrual vcycles, vFSH,
vAMH, vAFC, vinhibin? v- vAnswer v-3b: vmenstrual vcycles vnormal, vFSH vnormal, vAMH
vlow, vAFC vlow, vinhibin vlow. v
-3a: vsubtle vmenstrual vchanges, vvariable vFSH, vAMH vlow, vAFC vlow, vinhibin vlow.
When vit vis vappropriate vto vcheck van vFSH vduring vthe vcycle vif vyou vcheck vit? vand
vwhy? v- vAnswer vCycle vday v#3. vElevated vestradiol vcan vsuppress vFSH vgiving va
vfalsely vnormal vFSH vlevel.
AMH
WITH COMPLETE SOLUTIONS LATEST
UPDATES
Climacteric vphase v- vAnswer vThe vperiod vof vendrocrinologic, vsomatic, vand vtransitory
vpsychologic vchanges vthat voccur varound vthe vtime vof vmenopause.
Early vmenopause v- vAnswer vLMP vbefore vage v45
Late vmenopause v- vAnswer vLMP vafter vage v54
Primary vovarian vinsufficiency v- vAnswer vMenopause vthat voccurs vbefore vage v40
Early vmenopause vtransition v(stage v-2) v- vAnswer vPersistent vdifference vof v7 vdays vor
vmore vin vthe vlength vof vconsecutive vcycles.
Late vmenopause vtransition v(stage v-1) v- vAnswer v60 vor vmore vconsecutive vdays vof
vamenorrhea
Luteal vout vof vphase vevent v(LOOP) v- vAnswer vExplains vwhy vsome vperimenopausal
vwomen vhave velevated vestrogen vlevel vsometimes...In vthe vearly vmenopause
vtransition, velevated vFSH vlevels vare vadequate vto vrecruit va vsecond vfollicle vwhich
vresults vin va vfollicular vphase-like vrise vin vestradiol vsecretion vsuperimposed von vthe
vmid-to-late vluteal vphase vof vthe vongoing vovulatory vcycle.
Obese vwomen vand vestradiol vlevels vduring vmenopause v- vAnswer vObese vwomen
vare vmore vlikely vto vhave vanovulatory vcycles vwith vhigh vestradiol vlevels. vThey vare
valso vmore vlikely vto vhave vlower vpremenopause vyet vhigher vpostmenopause vestradiol
vlevels vcompared vwith vwomen vof vnormal vweight. v(why vthey vare vat vhigher vrisk vof
vendometrial vcancer)
Chinese vand vJapanese vwomen v- vAnswer vThese vethnic vgroups vhave vlower
vestradiol vlevels vthen vwhite, vblack vand vhispanic vwomen.
stage v+2 v- vAnswer vlate vmenopause vstage: v5-8 vyears vafter vFMP. vSomatic vaging
vpredominates. vIncreased vgenitourinary vsymptoms.
Stages v+1a, v+1b, v+1c v- vAnswer vearly vpost vmenopause: v2 vyears vafter vFMP. vFSH
vrises, vestradiol vdecreases. vVMS vpredominate.
Elevated vFSH, vLH v- vAnswer vEndocrine vlabs vafter vmenopause
AMH, vinhibin vB v- vAnswer vThese vhormones vwork vduring vreproductive vyears vto vnot
vdeplete vfollicle vpool vtoo vquickly.
, Phases vduring vmenopause vtransition vand vPMS vsymptoms v- vAnswer vMenstrual
vcycle vshortenes, vfollicular vphase vcompresses, vwomen vspend vmore vtime vin vluteal
vphase.. vmeaning vmore vpremenstrual vsymptoms vand vmore vfrequent vmenstrual
vperiods.
How vto vrespond vif va vpatient vrequests vFSH vlab? v- vAnswer vmany vpitfalls, vvariable
vdepending von vthe vday vof vthe vcycle vyou vdraw vthe vlab, vnormal vor vlow vFSH vis vnot
vhelpful.
The vpotentially vsuperior vmarker vof vmenopause, va vlab. v- vAnswer vAMH
DHEA v(dehydroepiandrosterone) v- vAnswer vAdrenal vandrogens: vprecursor vhromones
vproduced vby vthe vadrenal vgland vthat vare venzymatically vconverted vto vactive
vandrogens vor vestrogens vin vperipheral vtissues.
Location vof vestrogen vreceptors v- vAnswer vVagina, vvulva, vurethra, vtrigone vof vthe
vbladder
Effects vof vestrogen von vtissue v- vAnswer vmaintain vblood vflow, vthe vcollagen, vand vHA
vwithin vthe vepithelial vsurfaces. vSupports vmicrobiome vand vprotects vtissue vfrom
vpathogens.
Vaginal vchanges vwith vmenopause v- vAnswer vThinning, vloss vof velasticity, vloss vor
vabsence vor vrugae.
Vagina vand vurethra vin vmenopause v- vAnswer vvagina vnarrows, vurethra vmoves vcloser
vto vthe vintroitus.
Stress vurinary vincontinence v- vAnswer vVaginal vestrogen vand vurinary vincontinence:
vwhat vtype vdoes vit vhelp vwith?
Treatment vfor vFPHL v- vAnswer vMinoxidil, vspironolactone, vfinasteride, vestrogen
vtherapy
Late vreporoductive vyears v-3b vand v-3a. vWhat vhappens vwith vmenstrual vcycles, vFSH,
vAMH, vAFC, vinhibin? v- vAnswer v-3b: vmenstrual vcycles vnormal, vFSH vnormal, vAMH
vlow, vAFC vlow, vinhibin vlow. v
-3a: vsubtle vmenstrual vchanges, vvariable vFSH, vAMH vlow, vAFC vlow, vinhibin vlow.
When vit vis vappropriate vto vcheck van vFSH vduring vthe vcycle vif vyou vcheck vit? vand
vwhy? v- vAnswer vCycle vday v#3. vElevated vestradiol vcan vsuppress vFSH vgiving va
vfalsely vnormal vFSH vlevel.
AMH
