NAMs Menopause Certification Exam
Questions and Guide Answers
100% Verified Graded A+
1. Climacteric phase
Answer: The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the
time of menopause.
2. Early menopause
Answer: LMP before age 45
3. Late menopause
Answer: LMP after age 54
4. Primary ovarian insufficiency
Answer: Menopause that occurs before age 40
5. Early menopause transition (stage -2)
Answer: Persistent ditterence of 7 days or more in the length of consecutive cycles.
6. Late menopause transition (stage -1)
, Answer: 60 or more consecutive days of amenorrhea
7. Luteal out of phase event (LOOP)
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.
8. Obese women and estradiol levels during menopause
Answer: 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)
9. Chinese and Japanese women
Answer: These ethnic groups have lower estradiol levels then white, black and hispanic women.
10. stage +2
: late menopause stage
Answer: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary symptoms.
11. Stages +1a, +1b, +1c: early post menopause
Answer: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate.
12. Elevated FSH, LH
Answer: Endocrine labs after menopause
13. AMH, inhibin B
, Answer: These hormones work during reproductive years to not deplete follicle pool too quickly.
14. Phases during menopause transition and PMS symptoms
Answer: Menstrual cycle short-enes, follicular phase compresses, women spend more time in luteal
phase.. meaning more premenstrual symptoms and more frequent menstrual periods.
15. How to respond if a patient requests FSH lab?
Answer: many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH
is not helpful.
16. The potentially superior marker of menopause, a lab.
Answer: AMH
17. DHEA (dehydroepiandrosterone): Adrenal androgens
Answer: precursor hromones produced by the adrenal gland that are enzymatically converted to active
androgens or estrogens in peripheral tissues.
18. Location of estrogen receptors
Answer: Vagina, vulva, urethra, trigone of the bladder
19. Effects of estrogen on tissue
Answer: maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports
microbiome and protects tissue from pathogens.
20. Vaginal changes with menopause
Answer: Thinning, loss of elasticity, loss or absence or rugae.
Questions and Guide Answers
100% Verified Graded A+
1. Climacteric phase
Answer: The period of endrocrinologic, somatic, and transitory psychologic changes that occur around the
time of menopause.
2. Early menopause
Answer: LMP before age 45
3. Late menopause
Answer: LMP after age 54
4. Primary ovarian insufficiency
Answer: Menopause that occurs before age 40
5. Early menopause transition (stage -2)
Answer: Persistent ditterence of 7 days or more in the length of consecutive cycles.
6. Late menopause transition (stage -1)
, Answer: 60 or more consecutive days of amenorrhea
7. Luteal out of phase event (LOOP)
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.
8. Obese women and estradiol levels during menopause
Answer: 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)
9. Chinese and Japanese women
Answer: These ethnic groups have lower estradiol levels then white, black and hispanic women.
10. stage +2
: late menopause stage
Answer: 5-8 years after FMP. Somatic aging predominates. Increased genitourinary symptoms.
11. Stages +1a, +1b, +1c: early post menopause
Answer: 2 years after FMP. FSH rises, estradiol decreases. VMS predominate.
12. Elevated FSH, LH
Answer: Endocrine labs after menopause
13. AMH, inhibin B
, Answer: These hormones work during reproductive years to not deplete follicle pool too quickly.
14. Phases during menopause transition and PMS symptoms
Answer: Menstrual cycle short-enes, follicular phase compresses, women spend more time in luteal
phase.. meaning more premenstrual symptoms and more frequent menstrual periods.
15. How to respond if a patient requests FSH lab?
Answer: many pitfalls, variable depending on the day of the cycle you draw the lab, normal or low FSH
is not helpful.
16. The potentially superior marker of menopause, a lab.
Answer: AMH
17. DHEA (dehydroepiandrosterone): Adrenal androgens
Answer: precursor hromones produced by the adrenal gland that are enzymatically converted to active
androgens or estrogens in peripheral tissues.
18. Location of estrogen receptors
Answer: Vagina, vulva, urethra, trigone of the bladder
19. Effects of estrogen on tissue
Answer: maintain blood flow, the collagen, and HA within the epithelial surfaces. Supports
microbiome and protects tissue from pathogens.
20. Vaginal changes with menopause
Answer: Thinning, loss of elasticity, loss or absence or rugae.
