MSCP Menopause Exam Q-Bank NAMS Certified Practitioner Study Guide

NAMS Menopause Exam Q-Bank – Complete Certified Menopause
Practitioner Practice Questions 2026 | Practice Questions &
Answers | Complete Study Guide


Prepare for the NAMS Certified Menopause Practitioner examination with this comprehensive
study guide featuring original practice questions, detailed answer explanations, and exam-
focused review material. Topics include menopause physiology, hormone therapy, nonhormonal
treatment options, vasomotor symptoms, genitourinary syndrome of menopause (GSM),
osteoporosis prevention, cardiovascular health, sexual health, patient counseling, and evidence-
based menopause management. Designed to strengthen clinical knowledge and improve
certification readiness, this guide is ideal for healthcare professionals preparing for the Certified
Menopause Practitioner examination



Climacteric phase - CORRECT ANSWER The period of endrocrinologic, somatic,
and transitory psychologic changes that occur around the time of menopause.

QUESTION :Early menopause - CORRECT ANSWER LMP before age 45

QUESTION :Late menopause - CORRECT ANSWER LMP after age 54

QUESTION :Primary ovarian insufficiency - CORRECT ANSWER Menopause that
occurs before age 40

QUESTION :Early menopause transition (stage -2) - CORRECT ANSWER
Persistent difference of 7 days or more in the length of consecutive cycles.

QUESTION :Late menopause transition (stage -1) - CORRECT ANSWER 60 or
more consecutive days of amenorrhea

QUESTION :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.

QUESTION :Obese women and estradiol levels during menopause - CORRECT
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)

, QUESTION :Chinese and Japanese women - CORRECT ANSWER These ethnic
groups have lower estradiol levels then white, black and hispanic women.

QUESTION :stage +2 - CORRECT ANSWER late menopause stage: 5-8 years after
FMP. Somatic aging predominates. Increased genitourinary symptoms.

QUESTION :Stages +1a, +1b, +1c - CORRECT ANSWER early post menopause: 2
years after FMP. FSH rises, estradiol decreases. VMS predominate.

QUESTION :Elevated FSH, LH - CORRECT ANSWER Endocrine labs after
menopause

QUESTION :AMH, inhibin B - CORRECT ANSWER These hormones work during
reproductive years to not deplete follicle pool too quickly.

QUESTION :Phases during menopause transition and PMS symptoms - CORRECT
ANSWER Menstrual cycle shortenes, follicular phase compresses, women spend
more time in luteal phase.. meaning more premenstrual symptoms and more frequent
menstrual periods.

QUESTION :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.

QUESTION :The potentially superior marker of menopause, a lab. - CORRECT
ANSWER AMH

QUESTION :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.

QUESTION :Location of estrogen receptors - CORRECT ANSWER Vagina, vulva,
urethra, trigone of the bladder

QUESTION :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.

QUESTION :Vaginal changes with menopause - CORRECT ANSWER Thinning,
loss of elasticity, loss or absence or rugae.

QUESTION :Vagina and urethra in menopause - CORRECT ANSWER vagina
narrows, urethra moves closer to the introitus.

QUESTION :Stress urinary incontinence - CORRECT ANSWER Vaginal estrogen
and urinary incontinence: what type does it help with?

, QUESTION :Treatment for FPHL - CORRECT ANSWER Minoxidil, spironolactone,
finasteride, estrogen therapy

QUESTION :Late reporoductive years -3b and -3a. What happens with menstrual
cycles, FSH, AMH, AFC, inhibin? - CORRECT 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.

QUESTION :When it is appropriate to check an FSH during the cycle if you check it?
and why? - CORRECT ANSWER Cycle day #3. Elevated estradiol can suppress FSH
giving a falsely normal FSH level.

QUESTION :AMH
produced by...
used to test...
Is it a screening tool for fertility?
When does it peak? - CORRECT ANSWER produced by granulosa cells

used to test damage to ovarian follicle reserve. If AMH is low, the woman has a low
ovarian reserve.

not recommended as a screening tool to predict fertility.

Peaks at around 25 years old. So before age 25, this test is not helpful.

It is influenced by exogenous hormones. Lower in hormonal contraception users, but
increases after d/cing.

QUESTION :AFC - CORRECT ANSWER Antral follicle count
Number of follicles that are detectable with ultrasound.
They are sensitive to FSH and considered to represent the availability poo of follicles.

QUESTION :Late menopause transition (-1) FSH level on random draw - CORRECT
ANSWER 25 or higher

QUESTION :Black women have higher or lower FSH levels? - CORRECT ANSWER
Higher

QUESTION :Chinese and Japanese women have higher or lower estradiol levels
compared to white, black and hispanic women? - CORRECT ANSWER lower

QUESTION :Menopause transition-changes in SHBG and testosterone? ratio? -
CORRECT ANSWER SHBG decreases
Testosterone/SHBG ratio increases by 80%.

, QUESTION :Testosterone/SHGB ratio is called what? - CORRECT ANSWER The
free androgen index

QUESTION :What stage are VMS more likely? - CORRECT ANSWER +1b
(generally last 2 years)

QUESTION :What hormone is generally higher in obese women? - CORRECT
ANSWER Estrone-via aromatization.

QUESTION :The postmenopausal ovary continues to produce what two hormones? -
CORRECT ANSWER testosterone and androstenedione

QUESTION :Surgical menopause causes women to have lower levels of what
hormone? - CORRECT ANSWER testosterone. 40-50% lower than in women w/
intact ovaries.

QUESTION :Driving piece of menopause is ovarian follicles depleting. What does this
do to the inhibin B and AMH? - CORRECT ANSWER inhibin and AMH decrease

therefore, follicle growth is not restrained, this allows for the growth of the remaining,
diminished follicle pool.

QUESTION :In the menopause transition, women spend more time in what phase? -
CORRECT ANSWER Luteal-more PMS symptoms, more frequent menstrual periods.

QUESTION :HPO axis theory and the menopause transition - CORRECT ANSWER
It is felt that the HPO axis may become less sensitive to estrogen, so even with good
follicle growth and estradiol secretion, LH surges can fail which can lead to more cycle
irregularity.

QUESTION :In the first year after the FMP, there is no production of what hormone? -
CORRECT ANSWER progesterone

QUESTION :What region of the adrenal gland secretes the androgens? - CORRECT
ANSWER zona reticularis

QUESTION :what are considered the 'adrenal androgens'? - CORRECT ANSWER
DHEA, DHEAS, Androstenedione.

QUESTION :Aldosterone secretion from the zona reticularis in the adrenal gland is
regulated by 3 main factors. - CORRECT ANSWER Angiotensin II, potassium
concentration, adrenocorticotropic hormone secreted by the anterior pituitary.