NAMS MENOPAUSE CERTIFICATION EXAM /
REAL ACTUAL EXAM TEST STUDY GUIDE
QUESTIONS AND ANSWERS LATEST 2025-2026
UPDATE
DHEA (dehydroepiandrosterone) - 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 - Answer-Vagina, vulva, urethra, trigone
of the bladder
Effects of estrogen on tissue - Answer-maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome
and protects tissue from pathogens.
Vaginal changes with menopause - Answer-Thinning, loss of elasticity,
loss or absence or rugae.
Vagina and urethra in menopause - Answer-vagina narrows, urethra
moves closer to the introitus.
Stress urinary incontinence - Answer-Vaginal estrogen and urinary
incontinence: what type does it help with?
, Treatment for FPHL - Answer-Minoxidil, spironolactone, finasteride,
estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual
cycles, FSH, AMH, AFC, inhibin? - 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? - Answer-Cycle day #3. Elevated estradiol can suppress FSH
giving a falsely normal FSH level.
AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak? - Answer-produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the
woman has a low ovarian reserve.
not recommended as a screening tool to predict fertility.
, Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal
contraception users, but increases after d/cing.
Climacteric phase - Answer-The period of endrocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause - Answer-LMP before age 45
Late menopause - Answer-LMP after age 54
Primary ovarian insufficiency - Answer-Menopause that occurs before
age 40
Early menopause transition (stage -2) - Answer-Persistent difference of
7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) - Answer-60 or more consecutive
days of amenorrhea
Luteal out of phase event (LOOP) - Answer-Explains why some
perimenopausal women have elevated estrogen level sometimes...In the
early menopause transition, elevated FSH levels are adequate to recruit a
REAL ACTUAL EXAM TEST STUDY GUIDE
QUESTIONS AND ANSWERS LATEST 2025-2026
UPDATE
DHEA (dehydroepiandrosterone) - 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 - Answer-Vagina, vulva, urethra, trigone
of the bladder
Effects of estrogen on tissue - Answer-maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome
and protects tissue from pathogens.
Vaginal changes with menopause - Answer-Thinning, loss of elasticity,
loss or absence or rugae.
Vagina and urethra in menopause - Answer-vagina narrows, urethra
moves closer to the introitus.
Stress urinary incontinence - Answer-Vaginal estrogen and urinary
incontinence: what type does it help with?
, Treatment for FPHL - Answer-Minoxidil, spironolactone, finasteride,
estrogen therapy
Late reporoductive years -3b and -3a. What happens with menstrual
cycles, FSH, AMH, AFC, inhibin? - 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? - Answer-Cycle day #3. Elevated estradiol can suppress FSH
giving a falsely normal FSH level.
AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak? - Answer-produced by granulosa cells
used to test damage to ovarian follicle reserve. If AMH is low, the
woman has a low ovarian reserve.
not recommended as a screening tool to predict fertility.
, Peaks at around 25 years old. So before age 25, this test is not helpful.
It is influenced by exogenous hormones. Lower in hormonal
contraception users, but increases after d/cing.
Climacteric phase - Answer-The period of endrocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause - Answer-LMP before age 45
Late menopause - Answer-LMP after age 54
Primary ovarian insufficiency - Answer-Menopause that occurs before
age 40
Early menopause transition (stage -2) - Answer-Persistent difference of
7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) - Answer-60 or more consecutive
days of amenorrhea
Luteal out of phase event (LOOP) - Answer-Explains why some
perimenopausal women have elevated estrogen level sometimes...In the
early menopause transition, elevated FSH levels are adequate to recruit a
