NAMS MENOPAUSE CERTIFICATION
EXAM 2026 QUESTIONS AND
VERIFIED CORRECT SOLUTION
GRADE A+
What part of the pituitary gland secretes adrenocorticotropic hormone?
Anterior pituitary. The posterior only secretes vasopressin and oxytosin.
Cortisol and HRT
Most serum cortisol circulates bound to cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which increases total cortisol
concentration.
Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on serum cortisol concentration.
Do cortisol levels associate with VMS severity?
No, cortisol levels have NOT been associated with more severe VMS.
Local DHEA has been proven to help with what?
vaginal pain and dyspareunia
,How to DX POI?
Menstrual disturbance-oligomenorrhea or amenorrhea for at least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart.
Anyone <40years old who misses 3+ consecutive cycles gets these labs
prolactin
FSH
estradiol
TSH
pregnancy test
treatment of POI
100 microgram estradiol patch
1.25 mg CEE
2mg oral estradiol
If intact uterus-progesterone for 12 days of the month.
Physiologic is better than continuous hormonal contractption, but if menorrhagia-IUD plus
estrogen patch, or if really not wanting to risk pregnancy, continuous HRT can be used.
Hair loss. Difference between FPHL and telogen effluvium?
, FPHL is gradual, telogen effluvium is sudden and usually precipitated by a life stressor, chronic
illness, beta blockers or anticoagulants-usually more patchy hair loss.
FPHL pattern
thinning at the crown of the head and widening of the hair part
Treating FPHL
MINOXIDIL
spironolactone
finasteride
What ethnicity has the least likely chance of having bad hot flashes?
Japanese
What ethnicity is the most likely to have bad hot flashes?
black
more frequent, longer duration.
Median length of hot flashes
10 years, early menopause transition women have them the longest.
Theories about etiology of hot flashes (6)
lower ovarian estradiol
EXAM 2026 QUESTIONS AND
VERIFIED CORRECT SOLUTION
GRADE A+
What part of the pituitary gland secretes adrenocorticotropic hormone?
Anterior pituitary. The posterior only secretes vasopressin and oxytosin.
Cortisol and HRT
Most serum cortisol circulates bound to cortisol binding globulin.
Oral estrogen increases the cortisol binding globulin, which increases total cortisol
concentration.
Oral tamoxifen acts similarly.
Transdermal does not increase it, so it has a minimal effect on serum cortisol concentration.
Do cortisol levels associate with VMS severity?
No, cortisol levels have NOT been associated with more severe VMS.
Local DHEA has been proven to help with what?
vaginal pain and dyspareunia
,How to DX POI?
Menstrual disturbance-oligomenorrhea or amenorrhea for at least 4 months.
AND
elevated FSH over 25 on two occasions at least 4 weeks apart.
Anyone <40years old who misses 3+ consecutive cycles gets these labs
prolactin
FSH
estradiol
TSH
pregnancy test
treatment of POI
100 microgram estradiol patch
1.25 mg CEE
2mg oral estradiol
If intact uterus-progesterone for 12 days of the month.
Physiologic is better than continuous hormonal contractption, but if menorrhagia-IUD plus
estrogen patch, or if really not wanting to risk pregnancy, continuous HRT can be used.
Hair loss. Difference between FPHL and telogen effluvium?
, FPHL is gradual, telogen effluvium is sudden and usually precipitated by a life stressor, chronic
illness, beta blockers or anticoagulants-usually more patchy hair loss.
FPHL pattern
thinning at the crown of the head and widening of the hair part
Treating FPHL
MINOXIDIL
spironolactone
finasteride
What ethnicity has the least likely chance of having bad hot flashes?
Japanese
What ethnicity is the most likely to have bad hot flashes?
black
more frequent, longer duration.
Median length of hot flashes
10 years, early menopause transition women have them the longest.
Theories about etiology of hot flashes (6)
lower ovarian estradiol
