Page 1 of 49
NAMS MENOPAUSE CERTIFICATION EXAM STUDY
GUIDE WITH COMPLETE 180 QUESTIONS AND
WELL ELABORATED ANSWERS JUST RELEASED
QUESTION: These ethnic groups have lower estradiol levels then white, black and hispanic
women. - ANSWER✔✔Chinese and Japanese women
QUESTION: late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms. - ANSWER✔✔stage +2
QUESTION: early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate. - ANSWER✔✔Stages +1a, +1b, +1c
QUESTION: Endocrine labs after menopause - ANSWER✔✔Elevated FSH, LH
QUESTION: These hormones work during reproductive years to not deplete follicle pool too
quickly. - ANSWER✔✔AMH, inhibin B
QUESTION: Menstrual cycle variable, persistent >7 day difference between difference in length
of consecutive cycles. - ANSWER✔✔Phases during menopause transition and PMS symptoms
, Page 2 of 49
QUESTION:The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause. - ANSWER✔✔Climacteric phase
QUESTION: LMP before age 45 - ANSWER✔✔Early menopause
QUESTION: LMP after age 54 - ANSWER✔✔Late menopause
QUESTION: Menopause that occurs before age 40 - ANSWER✔✔Primary ovarian insufficiency
QUESTION: Persistent difference of 7 days or more in the length of consecutive cycles. -
ANSWER✔✔Early menopause transition (stage -2)
QUESTION: 60 or more consecutive days of amenorrhea - ANSWER✔✔Late menopause
transition (stage -1)
QUESTION: 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. - ANSWER✔✔Luteal out of phase
event (LOOP)
, Page 3 of 49
QUESTION: 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) - ANSWER✔✔Obese women and estradiol levels during menopause
QUESTION: many pitfalls, variable depending on the day of the cycle you draw the lab, normal
or low FSH is not helpful. - ANSWER✔✔How to respond if a patient requests FSH lab?
QUESTION: AMH - ANSWER✔✔The potentially superior marker of menopause, a lab.
QUESTION: Adrenal androgens: precursor hromones produced by the adrenal gland that are
enzymatically converted to active androgens or estrogens in peripheral tissues. -
ANSWER✔✔DHEA (dehydroepiandrosterone)
QUESTION: Vagina, vulva, urethra, trigone of the bladder - ANSWER✔✔Location of estrogen
receptors
QUESTION: maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports
microbiome which supports acidity of vagina and protects tissue from pathogens. -
ANSWER✔✔Effects of estrogen on tissue
, Page 4 of 49
QUESTION: Thinning, loss of elasticity, loss or absence or rugae. - ANSWER✔✔Vaginal changes
with menopause
QUESTION: vagina narrows, urethra moves closer to the introitus. - ANSWER✔✔Vagina and
urethra in menopause
QUESTION: Vaginal estrogen and urinary incontinence: what type does it help with? -
ANSWER✔✔Stress urinary incontinence
QUESTION: Minoxidil, spironolactone, finasteride, estrogen therapy - ANSWER✔✔Treatment
for FPHL
QUESTION: -3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low. - ANSWER✔✔Late
reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin?
QUESTION: Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level. -
ANSWER✔✔When it is appropriate to check an FSH during the cycle if you check it? and why?
QUESTION: produced by granulosa cells
NAMS MENOPAUSE CERTIFICATION EXAM STUDY
GUIDE WITH COMPLETE 180 QUESTIONS AND
WELL ELABORATED ANSWERS JUST RELEASED
QUESTION: These ethnic groups have lower estradiol levels then white, black and hispanic
women. - ANSWER✔✔Chinese and Japanese women
QUESTION: late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms. - ANSWER✔✔stage +2
QUESTION: early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate. - ANSWER✔✔Stages +1a, +1b, +1c
QUESTION: Endocrine labs after menopause - ANSWER✔✔Elevated FSH, LH
QUESTION: These hormones work during reproductive years to not deplete follicle pool too
quickly. - ANSWER✔✔AMH, inhibin B
QUESTION: Menstrual cycle variable, persistent >7 day difference between difference in length
of consecutive cycles. - ANSWER✔✔Phases during menopause transition and PMS symptoms
, Page 2 of 49
QUESTION:The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause. - ANSWER✔✔Climacteric phase
QUESTION: LMP before age 45 - ANSWER✔✔Early menopause
QUESTION: LMP after age 54 - ANSWER✔✔Late menopause
QUESTION: Menopause that occurs before age 40 - ANSWER✔✔Primary ovarian insufficiency
QUESTION: Persistent difference of 7 days or more in the length of consecutive cycles. -
ANSWER✔✔Early menopause transition (stage -2)
QUESTION: 60 or more consecutive days of amenorrhea - ANSWER✔✔Late menopause
transition (stage -1)
QUESTION: 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. - ANSWER✔✔Luteal out of phase
event (LOOP)
, Page 3 of 49
QUESTION: 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) - ANSWER✔✔Obese women and estradiol levels during menopause
QUESTION: many pitfalls, variable depending on the day of the cycle you draw the lab, normal
or low FSH is not helpful. - ANSWER✔✔How to respond if a patient requests FSH lab?
QUESTION: AMH - ANSWER✔✔The potentially superior marker of menopause, a lab.
QUESTION: Adrenal androgens: precursor hromones produced by the adrenal gland that are
enzymatically converted to active androgens or estrogens in peripheral tissues. -
ANSWER✔✔DHEA (dehydroepiandrosterone)
QUESTION: Vagina, vulva, urethra, trigone of the bladder - ANSWER✔✔Location of estrogen
receptors
QUESTION: maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports
microbiome which supports acidity of vagina and protects tissue from pathogens. -
ANSWER✔✔Effects of estrogen on tissue
, Page 4 of 49
QUESTION: Thinning, loss of elasticity, loss or absence or rugae. - ANSWER✔✔Vaginal changes
with menopause
QUESTION: vagina narrows, urethra moves closer to the introitus. - ANSWER✔✔Vagina and
urethra in menopause
QUESTION: Vaginal estrogen and urinary incontinence: what type does it help with? -
ANSWER✔✔Stress urinary incontinence
QUESTION: Minoxidil, spironolactone, finasteride, estrogen therapy - ANSWER✔✔Treatment
for FPHL
QUESTION: -3b: menstrual cycles normal, FSH normal, AMH low, AFC low, inhibin low.
-3a: subtle menstrual changes, variable FSH, AMH low, AFC low, inhibin low. - ANSWER✔✔Late
reporoductive years -3b and -3a. What happens with menstrual cycles, FSH, AMH, AFC, inhibin?
QUESTION: Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level. -
ANSWER✔✔When it is appropriate to check an FSH during the cycle if you check it? and why?
QUESTION: produced by granulosa cells
