NAMs Menopause Certification
Exam 2025 Version
Climacteric phase ->>> CORRECT ANSWER The period of endrocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause ->>> CORRECT ANSWER LMP before age 45
Late menopause ->>> CORRECT ANSWER LMP after age 54
Primary ovarian insufficiency ->>> CORRECT ANSWER Menopause that occurs before
age 40
Early menopause transition (stage -2) ->>> CORRECT ANSWER Persistent difference of
7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) ->>> CORRECT ANSWER 60 or more consecutive
days of amenorrhea
Luteal out of phase event (LOOP) ->>> CORRECT ANSWER 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 ->>> CORRECT ANSWER Obese
women are more likely to have an ovulatory cycles with high estradiol levels. They are
also more likely to have lower pre-menopause yet higher post-menopause estradiol
levels compared with women of normal weight. (why they are at higher risk of
endometrial cancer)
Chinese and Japanese women ->>> CORRECT ANSWER These ethnic groups have lower
estradiol levels then white, black and hispanic women.
stage +2 ->>> CORRECT ANSWER late menopause stage: 5-8 years after FMP. Somatic
aging predominates. Increased genitourinary symptoms.
, Stages +1a, +1b, +1c ->>> CORRECT ANSWER early post menopause: 2 years after
FMP. FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH ->>> CORRECT ANSWER Endocrine labs after menopause
AMH, inhibin B ->>> CORRECT ANSWER These hormones work during reproductive
years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms ->>> CORRECT ANSWER
Menstrual cycle shortens, 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? ->>> CORRECT ANSWER 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. ->>> CORRECT ANSWER AMH
DHEA (dehydroepiandrosterone) ->>> CORRECT ANSWER 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 ->>> CORRECT ANSWER Vagina, vulva, urethra, trigone
of the bladder
Effects of estrogen on tissue ->>> CORRECT ANSWER maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome and protects tissue
from pathogens.
Vaginal changes with menopause ->>> CORRECT ANSWER Thinning, loss of elasticity,
loss or absence or rugae.
Vagina and urethra in menopause ->>> CORRECT ANSWER vagina narrows, urethra
moves closer to the introitus.
Stress urinary incontinence ->>> CORRECT ANSWER Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL ->>> CORRECT ANSWER Minoxidil, spironolactone, finasteride,
estrogen therapy
Exam 2025 Version
Climacteric phase ->>> CORRECT ANSWER The period of endrocrinologic, somatic, and
transitory psychologic changes that occur around the time of menopause.
Early menopause ->>> CORRECT ANSWER LMP before age 45
Late menopause ->>> CORRECT ANSWER LMP after age 54
Primary ovarian insufficiency ->>> CORRECT ANSWER Menopause that occurs before
age 40
Early menopause transition (stage -2) ->>> CORRECT ANSWER Persistent difference of
7 days or more in the length of consecutive cycles.
Late menopause transition (stage -1) ->>> CORRECT ANSWER 60 or more consecutive
days of amenorrhea
Luteal out of phase event (LOOP) ->>> CORRECT ANSWER 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 ->>> CORRECT ANSWER Obese
women are more likely to have an ovulatory cycles with high estradiol levels. They are
also more likely to have lower pre-menopause yet higher post-menopause estradiol
levels compared with women of normal weight. (why they are at higher risk of
endometrial cancer)
Chinese and Japanese women ->>> CORRECT ANSWER These ethnic groups have lower
estradiol levels then white, black and hispanic women.
stage +2 ->>> CORRECT ANSWER late menopause stage: 5-8 years after FMP. Somatic
aging predominates. Increased genitourinary symptoms.
, Stages +1a, +1b, +1c ->>> CORRECT ANSWER early post menopause: 2 years after
FMP. FSH rises, estradiol decreases. VMS predominate.
Elevated FSH, LH ->>> CORRECT ANSWER Endocrine labs after menopause
AMH, inhibin B ->>> CORRECT ANSWER These hormones work during reproductive
years to not deplete follicle pool too quickly.
Phases during menopause transition and PMS symptoms ->>> CORRECT ANSWER
Menstrual cycle shortens, 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? ->>> CORRECT ANSWER 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. ->>> CORRECT ANSWER AMH
DHEA (dehydroepiandrosterone) ->>> CORRECT ANSWER 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 ->>> CORRECT ANSWER Vagina, vulva, urethra, trigone
of the bladder
Effects of estrogen on tissue ->>> CORRECT ANSWER maintain blood flow, the
collagen, and HA within the epithelial surfaces. Supports microbiome and protects tissue
from pathogens.
Vaginal changes with menopause ->>> CORRECT ANSWER Thinning, loss of elasticity,
loss or absence or rugae.
Vagina and urethra in menopause ->>> CORRECT ANSWER vagina narrows, urethra
moves closer to the introitus.
Stress urinary incontinence ->>> CORRECT ANSWER Vaginal estrogen and urinary
incontinence: what type does it help with?
Treatment for FPHL ->>> CORRECT ANSWER Minoxidil, spironolactone, finasteride,
estrogen therapy
