NAMS MENOPAUSE CERTIFICATION EXAM
2024-2025 QUESTIONS AND ANSWERS 100%
CORRECT!
,Climacteric phase - ANSWER The period of endocrinologic, 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 levels sometimes.
Obese women and estradiol levels during menopause - ANSWER Obese women are
more likely to have anovulatory cycles with high estradiol levels.
Chinese and Japanese women - ANSWER These ethnic groups have lower estradiol
levels than white, black, and Hispanic women.
Stage +2 - ANSWER Late menopause stage: 5-8 years after FMP. Somatic aging
predominates.
Stages +1a, +1b, +1c - ANSWER Early post menopause: 2 years after FMP. FSH rises,
estradiol decreases.
Elevated FSH, LH - ANSWER Endocrine labs after menopause.
AMH, inhibin B - ANSWER These hormones work during reproductive years to not
deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - ANSWER Menstrual cycle
variable, persistent >7 day difference between difference in length of consecutive
cycles.
, Effects of estrogen on tissue - ANSWER Maintain blood flow, the collagen, and HA
within the epithelial surfaces.
Vaginal changes with menopause - ANSWER Thinning, loss of elasticity, loss or
absence of 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 reproductive years -3b and -3a - 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? - ANSWER
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.
AFC - ANSWER Antral follicle count. Number of follicles that are detectable with
ultrasound.
Late menopause transition (-1) FSH level on random draw - ANSWER 25 or higher.
Black women have higher or lower FSH levels? - ANSWER Higher.
Chinese and Japanese women have higher or lower estradiol levels compared to white,
black and Hispanic women? - ANSWER Lower.
Menopause transition-changes in SHBG and testosterone? - ANSWER SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
Testosterone/SHBG ratio is called what? - ANSWER The free androgen index.
What stage are VMS more likely? - ANSWER +1b (generally last 2 years).
What hormone is generally higher in obese women? - ANSWER Estrone-via
aromatization.
2024-2025 QUESTIONS AND ANSWERS 100%
CORRECT!
,Climacteric phase - ANSWER The period of endocrinologic, 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 levels sometimes.
Obese women and estradiol levels during menopause - ANSWER Obese women are
more likely to have anovulatory cycles with high estradiol levels.
Chinese and Japanese women - ANSWER These ethnic groups have lower estradiol
levels than white, black, and Hispanic women.
Stage +2 - ANSWER Late menopause stage: 5-8 years after FMP. Somatic aging
predominates.
Stages +1a, +1b, +1c - ANSWER Early post menopause: 2 years after FMP. FSH rises,
estradiol decreases.
Elevated FSH, LH - ANSWER Endocrine labs after menopause.
AMH, inhibin B - ANSWER These hormones work during reproductive years to not
deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms - ANSWER Menstrual cycle
variable, persistent >7 day difference between difference in length of consecutive
cycles.
, Effects of estrogen on tissue - ANSWER Maintain blood flow, the collagen, and HA
within the epithelial surfaces.
Vaginal changes with menopause - ANSWER Thinning, loss of elasticity, loss or
absence of 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 reproductive years -3b and -3a - 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? - ANSWER
Cycle day #3. Elevated estradiol can suppress FSH giving a falsely normal FSH level.
AFC - ANSWER Antral follicle count. Number of follicles that are detectable with
ultrasound.
Late menopause transition (-1) FSH level on random draw - ANSWER 25 or higher.
Black women have higher or lower FSH levels? - ANSWER Higher.
Chinese and Japanese women have higher or lower estradiol levels compared to white,
black and Hispanic women? - ANSWER Lower.
Menopause transition-changes in SHBG and testosterone? - ANSWER SHBG
decreases. Testosterone/SHBG ratio increases by 80%.
Testosterone/SHBG ratio is called what? - ANSWER The free androgen index.
What stage are VMS more likely? - ANSWER +1b (generally last 2 years).
What hormone is generally higher in obese women? - ANSWER Estrone-via
aromatization.
