NAMS MENOPAUSE CERTIFICATION ACTUAL TEST PAPER
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔How to DX POI? - ✔✔Menstrual disturbance-oligomenorrhea or amenorrhea for at
least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart.
✔✔Anyone <40years old who misses 3+ consecutive cycles gets these labs -
✔✔prolactin
FSH
estradiol
TSH
pregnancy test
✔✔treatment of POI - ✔✔100 microgram estradiol patch
1.25 mg CEE
2mg oral estradiol
If intact uterus-progesterone for 12 days of the month.
Physiologic is better than continuous hormonal contractption, but if menorrhagia-IUD
plus estrogen patch, or if really not wanting to risk pregnancy, continuous HRT can be
used.
✔✔Hair loss. Difference between FPHL and telogen effluvium? - ✔✔FPHL is gradual,
telogen effluvium is sudden and usually precipitated by a life stressor, chronic illness,
beta blockers or anticoagulants-usually more patchy hair loss.
✔✔FPHL pattern - ✔✔thinning at the crown of the head and widening of the hair part
✔✔Treating FPHL - ✔✔MINOXIDIL
spironolactone
finasteride
✔✔What ethnicity has the least likely chance of having bad hot flashes? - ✔✔Japanese
✔✔What ethnicity is the most likely to have bad hot flashes? - ✔✔black
more frequent, longer duration.
✔✔Median length of hot flashes - ✔✔10 years, early menopause transition women have
them the longest.
, ✔✔Theories about etiology of hot flashes (6) - ✔✔lower ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction.
✔✔VIN
low grade-what to do
high grade-what to do
differentiated VIN-what to do - ✔✔low grade is not precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma.
✔✔most common type of vulvar cancer - ✔✔squamous cell carcinoma
✔✔Vulvar disorder commonly misdiagnosed as eczema or dermatitis? - ✔✔paget's
disease
will not improve on steroids
screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time.
✔✔Normal PVR - ✔✔<100mL
✔✔systemic and vaginal estrogen will not help with this type of urinary incontinence? -
✔✔will NOT help with stress incontinence.
✔✔Which topical vaginal estrogen has the highest dose? - ✔✔the vaginal rings
FEMRING IS THE HIGHEST
✔✔Most common cause of vulvovaginitis? - ✔✔BV
✔✔post menopause burning and diffuse yellow/brown discharge and dyspareunia that
does not respond to local ET? - ✔✔desquamative inflammatory vaginitis. treat different
with clindamycin or hydrocortisone+ET
✔✔What hormones are associated with sexual desire in women? - ✔✔circulating
androgens
✔✔Women who have had a BSO experience an abrupt and persistent decline in what
hormone? - ✔✔circulating androgen levels
2025/2026 QUESTIONS WITH ANSWERS GRADED A+
✔✔How to DX POI? - ✔✔Menstrual disturbance-oligomenorrhea or amenorrhea for at
least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart.
✔✔Anyone <40years old who misses 3+ consecutive cycles gets these labs -
✔✔prolactin
FSH
estradiol
TSH
pregnancy test
✔✔treatment of POI - ✔✔100 microgram estradiol patch
1.25 mg CEE
2mg oral estradiol
If intact uterus-progesterone for 12 days of the month.
Physiologic is better than continuous hormonal contractption, but if menorrhagia-IUD
plus estrogen patch, or if really not wanting to risk pregnancy, continuous HRT can be
used.
✔✔Hair loss. Difference between FPHL and telogen effluvium? - ✔✔FPHL is gradual,
telogen effluvium is sudden and usually precipitated by a life stressor, chronic illness,
beta blockers or anticoagulants-usually more patchy hair loss.
✔✔FPHL pattern - ✔✔thinning at the crown of the head and widening of the hair part
✔✔Treating FPHL - ✔✔MINOXIDIL
spironolactone
finasteride
✔✔What ethnicity has the least likely chance of having bad hot flashes? - ✔✔Japanese
✔✔What ethnicity is the most likely to have bad hot flashes? - ✔✔black
more frequent, longer duration.
✔✔Median length of hot flashes - ✔✔10 years, early menopause transition women have
them the longest.
, ✔✔Theories about etiology of hot flashes (6) - ✔✔lower ovarian estradiol
thermoregulation zone is narrowed
neurokinins-regulate GnRH secretion. KNDy new meds
serotonin
cortisol and HPI axis dysregulation
endothelial dysfunction.
✔✔VIN
low grade-what to do
high grade-what to do
differentiated VIN-what to do - ✔✔low grade is not precancerous
high grade is precancerous-GYN ONC
differentiated-wide local excision-high risk of invasive carcinoma.
✔✔most common type of vulvar cancer - ✔✔squamous cell carcinoma
✔✔Vulvar disorder commonly misdiagnosed as eczema or dermatitis? - ✔✔paget's
disease
will not improve on steroids
screen for co-existing breast, GI or GU cancer. They are present 20-30% of the time.
✔✔Normal PVR - ✔✔<100mL
✔✔systemic and vaginal estrogen will not help with this type of urinary incontinence? -
✔✔will NOT help with stress incontinence.
✔✔Which topical vaginal estrogen has the highest dose? - ✔✔the vaginal rings
FEMRING IS THE HIGHEST
✔✔Most common cause of vulvovaginitis? - ✔✔BV
✔✔post menopause burning and diffuse yellow/brown discharge and dyspareunia that
does not respond to local ET? - ✔✔desquamative inflammatory vaginitis. treat different
with clindamycin or hydrocortisone+ET
✔✔What hormones are associated with sexual desire in women? - ✔✔circulating
androgens
✔✔Women who have had a BSO experience an abrupt and persistent decline in what
hormone? - ✔✔circulating androgen levels
