NAMs Menopause Certification Exam
Climacteric phase ANS: The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause.
Early menopause ANS: LMP before age 45
Late menopause ANS: LMP after age 54
Primary ovarian insufficiency ANS: Menopause that occurs before age 40
Early menopause transition (stage -2) ANS: Persistent difference of 7 days or more in the length of
consecutive cycles.
Late menopause transition (stage -1) ANS: 60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) ANS: 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 ANS: 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 ANS: These ethnic groups have lower estradiol levels then white, black
and hispanic women.
, stage +2 ANS: late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
Stages +1a, +1b, +1c ANS: early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate.
Elevated FSH, LH ANS: Endocrine labs after menopause
AMH, inhibin B ANS: These hormones work during reproductive years to not deplete follicle pool too
quickly.
Phases during menopause transition and PMS symptoms ANS: 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? ANS: 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. ANS: AMH
DHEA (dehydroepiandrosterone) ANS: 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 ANS: Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue ANS: maintain blood flow, the collagen, and HA within the epithelial
surfaces. Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause ANS: Thinning, loss of elasticity, loss or absence or rugae.
Climacteric phase ANS: The period of endrocrinologic, somatic, and transitory psychologic changes that
occur around the time of menopause.
Early menopause ANS: LMP before age 45
Late menopause ANS: LMP after age 54
Primary ovarian insufficiency ANS: Menopause that occurs before age 40
Early menopause transition (stage -2) ANS: Persistent difference of 7 days or more in the length of
consecutive cycles.
Late menopause transition (stage -1) ANS: 60 or more consecutive days of amenorrhea
Luteal out of phase event (LOOP) ANS: 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 ANS: 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 ANS: These ethnic groups have lower estradiol levels then white, black
and hispanic women.
, stage +2 ANS: late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased
genitourinary symptoms.
Stages +1a, +1b, +1c ANS: early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS
predominate.
Elevated FSH, LH ANS: Endocrine labs after menopause
AMH, inhibin B ANS: These hormones work during reproductive years to not deplete follicle pool too
quickly.
Phases during menopause transition and PMS symptoms ANS: 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? ANS: 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. ANS: AMH
DHEA (dehydroepiandrosterone) ANS: 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 ANS: Vagina, vulva, urethra, trigone of the bladder
Effects of estrogen on tissue ANS: maintain blood flow, the collagen, and HA within the epithelial
surfaces. Supports microbiome and protects tissue from pathogens.
Vaginal changes with menopause ANS: Thinning, loss of elasticity, loss or absence or rugae.
