Menopause Society Exam 2025

Menopause Society Exam 2025 What is the World Health Organization (WHO) definition of osteoporosis based on bone mineral density (BMD) T-score? - Correct Ans-A T-score ≤ -2.5 at the lumbar spine, femoral neck, or total hip defines osteoporosis per WHO criteria. At what age does the North American Menopause Society recommend routine DXA screening for osteoporosis in postmenopausal women? - Correct Ans-Age 65 years or older is the threshold for routine DXA screening in postmenopausal women, or younger if risk factors are present. How is osteopenia defined by T-score on DXA? - Correct Ans-A T-score between -1.0 and -2.5 defines osteopenia. What is the primary effect of menopause on bone health? - Correct Ans-Estrogen deficiency after menopause accelerates bone resorption, leading to rapid bone loss. List three major risk factors for low bone mass and fracture in postmenopausal women. - Correct Ans-Advanced age, prior fragility fracture, and glucocorticoid use are major risk factors. Which tool is commonly used to estimate 10-year fracture risk in clinical practice? - Correct Ans-FRAX (Fracture Risk Assessment Tool) is commonly used to estimate 10 year fracture risk. What is the threshold 10-year risk of hip fracture or major osteoporotic fracture that indicates pharmacologic therapy according to FRAX? - Correct Ans-A 10-year hip fracture risk ≥3% or major osteoporotic fracture risk ≥20% indicates pharmacologic therapy per FRAX. Name two first-line pharmacologic therapies for osteoporosis in postmenopausal women. - Correct Ans-Bisphosphonates (e.g., alendronate, risedronate, zoledronic acid) and denosumab are first-line therapies. What is the role of hormone therapy in the prevention of postmenopausal osteoporosis? - Correct Ans-Hormone therapy is effective for prevention of bone loss in early postmenopausal women at risk, but not first-line for osteoporosis treatment. Which pharmacologic agent is preferred for women at very high risk of fracture? - Correct Ans-Anabolic agents (e.g., teriparatide, abaloparatide, romosozumab) are preferred for women at very high fracture risk. Menopause Menopause What are the main contraindications to menopausal hormone therapy? - Correct Ans Active or recent breast cancer, unexplained vaginal bleeding, active thromboembolic disease, and liver dysfunction are main contraindications to hormone therapy. Why is progestogen added to estrogen therapy in women with an intact uterus? - Correct Ans-Progestogen is needed with estrogen therapy in women with a uterus to prevent endometrial hyperplasia/cancer. Compare the risks of oral versus transdermal estrogen therapy. - Correct Ans Transdermal estrogen has a lower risk of venous thromboembolism and stroke compared to oral estrogen. What is the recommended duration of systemic hormone therapy for vasomotor symptoms? - Correct Ans-The shortest duration necessary to control symptoms, typically reassessed annually; often 3-5 years for systemic therapy. Describe the difference between continuous and sequential hormone therapy regimens. - Correct Ans-Continuous regimens provide daily estrogen and progestogen; sequential regimens provide estrogen daily and progestogen for 10-14 days/month. List two common side effects of systemic hormone therapy. - Correct Ans-Breast tenderness and vaginal bleeding are common side effects of systemic hormone therapy. Name two types of selective estrogen receptor modulators (SERMs) used in menopause management. - Correct Ans-Raloxifene and bazedoxifene are SERMs used in menopause management. What are the risks associated with compounded or non-approved hormone therapy preparations? - Correct Ans-Compounded or non-approved hormone therapies carry risks of inconsistent dosing, lack of efficacy, and increased adverse effects. Which local therapy is recommended for genitourinary syndrome of menopause? - Correct Ans-Vaginal estrogen is recommended for genitourinary syndrome of menopause (GSM). Name two nonhormonal prescription options for vasomotor symptom management. - Correct Ans-SSRIs (e.g., paroxetine) and SNRIs (e.g., venlafaxine) are nonhormonal prescription options for vasomotor symptoms. What is the evidence for the efficacy of over-the-counter herbal supplements in menopause symptom relief? - Correct Ans-There is insufficient evidence for efficacy of most herbal supplements (e.g., black cohosh, soy) in menopause symptom relief. What is the role of vaginal moisturizers and lubricants in managing genitourinary syndrome of menopause? - Correct Ans-Vaginal moisturizers and lubricants are first line for mild GSM symptoms and safe for long-term use. Menopause Menopause List two non-pharmacological interventions for vasomotor symptoms. - Correct Ans Cognitive behavioral therapy (CBT) and structured exercise are non-pharmacological interventions for vasomotor symptoms. What is the role of pelvic floor physical therapy in genitourinary syndrome of menopause? - Correct Ans-Pelvic floor physical therapy improves GSM symptoms and sexual function. Which immunizations are recommended for midlife women to reduce morbidity? - Correct Ans-Shingles (zoster), influenza, pneumococcal, and HPV vaccines are recommended for midlife women. Name three common sexually transmitted infections relevant to midlife women. - Correct Ans-Chlamydia, gonorrhea, and human papillomavirus (HPV) are common STIs in midlife women. What screening tools are recommended for intimate partner violence in midlife women? - Correct Ans-HITS and WAST are validated screening tools for intimate partner violence. What dietary recommendations support bone health in postmenopausal women? - Correct Ans-A diet rich in calcium, vitamin D, protein, fruits, and vegetables supports bone health. What is the recommended daily intake of calcium and vitamin D for postmenopausal women? - Correct Ans-1,200 mg calcium and 800-1,000 IU vitamin D daily are recommended for postmenopausal women. How does regular weight-bearing exercise contribute to the prevention of osteoporosis? - Correct Ans-Regular weight-bearing and resistance exercise increases or maintains bone density and reduces fracture risk. Here is your content converted into a single-line Quizlet format: - Correct Ans- **word 1 [tab] definition 1** (each Q&A on one line, tab-separated): - Correct Ans- ``` - Correct Ans- What is the clinical definition of menopause? - Correct Ans-Menopause is defined as the permanent cessation of menstruation for 12 consecutive months due to loss of ovarian follicular activity. How does the menopause transition differ from postmenopause in terms of hormonal changes? - Correct Ans-The menopause transition (perimenopause) is the interval of Menopause Menopause hormonal fluctuation and menstrual irregularity before menopause, while postmenopause refers to the time after the final menstrual period. What is the mean age of natural menopause in the United States? - Correct Ans-The mean age of natural menopause in the United States is 51 years. What is the estimated prevalence of menopause among women aged 45-55 years? - Correct Ans-The prevalence of menopause among women aged 45-55 is high, as most women experience menopause between these ages. List the three main phases defined by the STRAW+10 staging system. - Correct Ans The three main phases in the STRAW+10 staging system are reproductive, menopausal transition, and postmenopause. Which STRAW stage is characterized by variable cycle length and increased FSH? - Correct Ans-The late menopausal transition (STRAW -1) is characterized by variable cycle length and increased FSH. What are the dominant symptoms during the late menopausal transition? - Correct Ans Vasomotor symptoms (hot flashes, night sweats) are dominant during the late menopausal transition. What is the expected duration of the early menopausal transition according to STRAW? - Correct Ans-The expected duration of the early menopausal transition is about 2-5 years, but varies. Define a luteal out-of-phase (LOOP) event and its clinical significance. - Correct Ans-A luteal out-of-phase (LOOP) event is an abnormal luteal phase with altered hormone secretion, often causing irregular bleeding. What symptoms are commonly associated with LOOP events during perimenopause? - Correct Ans-LOOP events commonly cause irregular bleeding and vasomotor symptoms. How does a decline in estrogen affect bone health during menopause? - Correct Ans Estrogen decline leads to bone loss and increased fracture risk. What is the impact of androgen decline on sexual function in menopausal women? - Correct Ans-Androgen decline can contribute to reduced libido and sexual dysfunction. Name two measures of ovarian reserve used in the menopause transition. - Correct Ans-Anti-Müllerian hormone (AMH) and antral follicle count are measures of ovarian reserve. List three causes of secondary amenorrhea in women under 40. - Correct Ans-Causes include POI, hypothalamic dysfunction, and hyperprolactinemia. Menopause Menopause What are the most common causes of primary ovarian insufficiency (POI)? - Correct Ans-Common causes of POI are genetic, autoimmune, and iatrogenic (chemotherapy, radiation). How does POI affect fertility? - Correct Ans-POI leads to reduced fertility and increased risk of infertility. What is the definition of surgical menopause? - Correct Ans-Surgical menopause is menopause induced by bilateral oophorectomy. Name two cancer treatments that can induce menopause. - Correct Ans-Chemotherapy and pelvic radiation can induce menopause. List two clinical consequences of early estrogen loss. - Correct Ans-Early estrogen loss increases risk of osteoporosis and cardiovascular disease. What is the recommended role for hormone therapy in women with POI? - Correct Ans Hormone therapy is recommended for symptom relief and bone protection in POI, ideally until the average age of natural menopause. What are common factors contributing to weight gain during menopause? - Correct Ans Weight gain in menopause is associated with aging, hormonal changes, and decreased physical activity. How is body mass index (BMI) used in the evaluation of menopausal weight issues? - Correct Ans-BMI is used to assess weight status and risk stratification in menopausal women. What is the first-line lifestyle intervention for weight management in menopause? - Correct Ans-Diet and exercise are first-line for weight management. Name one FDA-approved pharmacologic therapy for weight loss in postmenopausal women. - Correct Ans-Orlistat is an FDA-approved pharmacologic therapy for weight loss in postmenopausal women. What is a surgical option for weight loss in menopausal women with obesity? - Correct Ans-Bariatric surgery is a surgical option for weight loss in women with severe obesity. How does estrogen deficiency contribute to hair changes in menopause? - Correct Ans Estrogen deficiency can cause hair thinning and loss. Name two types of hair loss seen in menopausal women. - Correct Ans-Androgenic alopecia and telogen effluvium are types of hair loss seen in menopause. Menopause Menopause What is the initial step in the evaluation of hair loss in menopause? - Correct Ans History and physical examination are initial steps in hair loss evaluation. List one non-pharmacologic management strategy for menopausal hair loss. - Correct Ans-Minimizing hair trauma is a non-pharmacologic management strategy for hair loss. Name a topical treatment option for androgenic alopecia in postmenopausal women. - Correct Ans-Topical minoxidil is a treatment option for androgenic alopecia. What is the most common sleep disturbance reported during menopause? - Correct Ans-Insomnia is the most common sleep disturbance in menopause. List two risk factors for sleep changes in menopausal women. - Correct Ans-Hot flashes and mood disorders are risk factors for sleep changes. Name one differential diagnosis for insomnia in menopause. - Correct Ans-Sleep apnea is a differential diagnosis for insomnia in menopause. What is a potential health outcome of untreated sleep disturbance in menopause? - Correct Ans-Untreated sleep disturbance increases risk of depression and cardiovascular disease. Name one behavioral therapy for sleep changes in menopause. - Correct Ans-Cognitive behavioral therapy for insomnia (CBT-I) is a behavioral therapy for sleep changes. What is the prevalence of sexual dysfunction in postmenopausal women? - Correct Ans-The prevalence of sexual dysfunction in postmenopausal women is over 50%. Name one model of sexual response relevant to menopause. - Correct Ans-The Basson model is a model of sexual response relevant to menopause. How do hormonal changes affect sexual function during menopause? - Correct Ans Estrogen and androgen decline can reduce libido, arousal, and vaginal lubrication.