NAMS MENOPAUSE CERTIFICATION EXAM |ACTUAL EXAM QUESTIONS WITH
DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS) |UPDATED VERSION
|/ALREADY GRADE A
1.AMH - ANSWER The potentially superior marker of menopause, a lab.
2.Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues. - ANSWER DHEA
(dehydroepiandrosterone)
3.Vagina, vulva, urethra, trigone of the bladder - ANSWER Location of estrogen receptors
4.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
5.Thinning, loss of elasticity, loss or absence or rugae. - ANSWER Vaginal changes with menopause
6.vagina narrows, urethra moves closer to the introitus. - ANSWER Vagina and urethra in menopause
7.Vaginal estrogen and urinary incontinence: what type does it help with? - ANSWER Stress urinary
incontinence
8.Minoxidil, spironolactone, finasteride, estrogen therapy - ANSWER Treatment for FPHL
-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?
9.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?
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.
10.It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases after
d/cing. - ANSWER AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
11.Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability pool of follicles. - ANSWER AFC
12.The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the
time of menopause. - ANSWER Climacteric phase
13.LMP before age 45 - ANSWER Early menopause
14.LMP after age 54 - ANSWER Late menopause
15.Menopause that occurs before age 40 - ANSWER Primary ovarian insufficiency
16.Persistent difference of 7 days or more in the length of consecutive cycles. - ANSWER Early
menopause transition (stage -2)
17.60 or more consecutive days of amenorrhea - ANSWER Late menopause transition (stage -1)
18.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)
19.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
20.These ethnic groups have lower estradiol levels then white, black and hispanic women. - ANSWER
Chinese and Japanese women
21.late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary
symptoms. - ANSWER stage +2
22.early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate. - ANSWER
Stages +1a, +1b, +1c
23.Endocrine labs after menopause - ANSWER Elevated FSH, LH
24.These hormones work during reproductive years to not deplete follicle pool too quickly. - ANSWER
AMH, inhibin B
25.Menstrual cycle variable, persistent >7 day difference between difference in length of consecutive
cycles. - ANSWER Phases during menopause transition and PMS symptoms
26.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?
27.25 or higher - ANSWER Late menopause transition (-1) FSH level on random draw
28.Higher - ANSWER Black women have higher or lower FSH levels?
, 29.lower - ANSWER Chinese and Japanese women have higher or lower estradiol levels compared to
white, black and hispanic women?
SHBG decreases
30.Testosterone/SHBG ratio increases by 80%. - ANSWER Menopause transition-changes in SHBG and
testosterone? ratio?
31.The free androgen index - ANSWER Testosterone/SHGB ratio is called what?
32.+1b (generally last 2 years) - ANSWER What stage are VMS more likely?
33.Estrone-via aromatization. - ANSWER What hormone is generally higher in obese women?
34.testosterone and androstenedione - ANSWER The postmenopausal ovary continues to produce what
two hormones?
35.testosterone. 40-50% lower than in women w/ intact ovaries. - ANSWER Surgical menopause causes
women to have lower levels of what hormone?
36.inhibin and AMH decrease therefore, follicle growth is not restrained, this allows for the growth of
the remaining, diminished follicle pool. - ANSWER Driving piece of menopause is ovarian follicles
depleting. What does this do to the inhibin B and AMH?
Luteal-more PMS symptoms, more frequent menstrual periods. - ANSWER In the menopause transition,
women spend more time in what phase?
It is felt that the HPO axis may become less sensitive to estrogen, so even with good follicle growth and
estradiol secretion, LH surges can fail which can lead to more cycle irregularity. - ANSWER HPO axis
theory and the menopause transition
progesterone - ANSWER In the first year after the FMP, there is no production of what hormone?
DETAILED VERIFIED ANSWERS (100% CORRECT ANSWERS) |UPDATED VERSION
|/ALREADY GRADE A
1.AMH - ANSWER The potentially superior marker of menopause, a lab.
2.Adrenal androgens: precursor hromones produced by the adrenal gland that are enzymatically
converted to active androgens or estrogens in peripheral tissues. - ANSWER DHEA
(dehydroepiandrosterone)
3.Vagina, vulva, urethra, trigone of the bladder - ANSWER Location of estrogen receptors
4.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
5.Thinning, loss of elasticity, loss or absence or rugae. - ANSWER Vaginal changes with menopause
6.vagina narrows, urethra moves closer to the introitus. - ANSWER Vagina and urethra in menopause
7.Vaginal estrogen and urinary incontinence: what type does it help with? - ANSWER Stress urinary
incontinence
8.Minoxidil, spironolactone, finasteride, estrogen therapy - ANSWER Treatment for FPHL
-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?
9.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?
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.
10.It is influenced by exogenous hormones. Lower in hormonal contraception users, but increases after
d/cing. - ANSWER AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak?
11.Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability pool of follicles. - ANSWER AFC
12.The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the
time of menopause. - ANSWER Climacteric phase
13.LMP before age 45 - ANSWER Early menopause
14.LMP after age 54 - ANSWER Late menopause
15.Menopause that occurs before age 40 - ANSWER Primary ovarian insufficiency
16.Persistent difference of 7 days or more in the length of consecutive cycles. - ANSWER Early
menopause transition (stage -2)
17.60 or more consecutive days of amenorrhea - ANSWER Late menopause transition (stage -1)
18.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)
19.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
20.These ethnic groups have lower estradiol levels then white, black and hispanic women. - ANSWER
Chinese and Japanese women
21.late menopause stage: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary
symptoms. - ANSWER stage +2
22.early post menopause: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate. - ANSWER
Stages +1a, +1b, +1c
23.Endocrine labs after menopause - ANSWER Elevated FSH, LH
24.These hormones work during reproductive years to not deplete follicle pool too quickly. - ANSWER
AMH, inhibin B
25.Menstrual cycle variable, persistent >7 day difference between difference in length of consecutive
cycles. - ANSWER Phases during menopause transition and PMS symptoms
26.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?
27.25 or higher - ANSWER Late menopause transition (-1) FSH level on random draw
28.Higher - ANSWER Black women have higher or lower FSH levels?
, 29.lower - ANSWER Chinese and Japanese women have higher or lower estradiol levels compared to
white, black and hispanic women?
SHBG decreases
30.Testosterone/SHBG ratio increases by 80%. - ANSWER Menopause transition-changes in SHBG and
testosterone? ratio?
31.The free androgen index - ANSWER Testosterone/SHGB ratio is called what?
32.+1b (generally last 2 years) - ANSWER What stage are VMS more likely?
33.Estrone-via aromatization. - ANSWER What hormone is generally higher in obese women?
34.testosterone and androstenedione - ANSWER The postmenopausal ovary continues to produce what
two hormones?
35.testosterone. 40-50% lower than in women w/ intact ovaries. - ANSWER Surgical menopause causes
women to have lower levels of what hormone?
36.inhibin and AMH decrease therefore, follicle growth is not restrained, this allows for the growth of
the remaining, diminished follicle pool. - ANSWER Driving piece of menopause is ovarian follicles
depleting. What does this do to the inhibin B and AMH?
Luteal-more PMS symptoms, more frequent menstrual periods. - ANSWER In the menopause transition,
women spend more time in what phase?
It is felt that the HPO axis may become less sensitive to estrogen, so even with good follicle growth and
estradiol secretion, LH surges can fail which can lead to more cycle irregularity. - ANSWER HPO axis
theory and the menopause transition
progesterone - ANSWER In the first year after the FMP, there is no production of what hormone?
