NAMS MENOPAUSE REVIEW TIPS ANSWERS AND
QUESTIONS SET A+
✔✔Aldosterone secretion from the zona reticularis in the adrenal gland is regulated by 3
main factors. - ✔✔Angiotensin II, potassium concentration, adrenocorticotropic hormone
secreted by the anterior pituitary.
✔✔What part of the pituitary gland secretes adrenocorticotropic hormone? - ✔✔Anterior
pituitary.
✔✔Cortisol and HRT - ✔✔Most serum cortisol circulates bound to cortisol binding
globulin.
✔✔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 <40 years 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.
✔✔Physiologic - ✔✔Better than continuous hormonal contraception.
✔✔Menorrhagia treatment - ✔✔IUD plus estrogen patch or continuous HRT.
,✔✔FPHL vs Telogen Effluvium - ✔✔FPHL is gradual, telogen effluvium is sudden and
usually precipitated by a life stressor.
✔✔FPHL pattern - ✔✔Thinning at the crown of the head and widening of the hair part.
✔✔Treating FPHL - ✔✔Minoxidil, spironolactone, finasteride.
✔✔Ethnicity least likely to have bad hot flashes - ✔✔Japanese.
✔✔Ethnicity most likely to have bad hot flashes - ✔✔Black, more frequent, longer
duration.
✔✔Median length of hot flashes - ✔✔10 years.
✔✔Theories about etiology of hot flashes - ✔✔Lower ovarian estradiol thermoregulation
zone is narrowed, neurokinins regulate GnRH secretion.
✔✔VIN low grade - ✔✔Not precancerous.
✔✔VIN high grade - ✔✔Precancerous; requires GYN ONC intervention.
✔✔Most common type of vulvar cancer - ✔✔Squamous cell carcinoma.
✔✔Vulvar disorder misdiagnosed as eczema - ✔✔Paget's disease.
✔✔Normal PVR - ✔✔<100mL.
✔✔Estrogen and urinary incontinence - ✔✔Will NOT help with stress incontinence.
✔✔Topical vaginal estrogen with highest dose - ✔✔Vaginal rings; FEMRING is the
highest.
✔✔Most common cause of vulvovaginitis - ✔✔Bacterial vaginosis (BV).
✔✔Post-menopause burning and discharge - ✔✔Desquamative inflammatory vaginitis;
treat with clindamycin or hydrocortisone + ET.
✔✔Hormones associated with sexual desire in women - ✔✔Circulating androgens.
✔✔BSO and hormone decline - ✔✔Abrupt and persistent decline in circulating
androgen levels.
✔✔HSDD and FSAD - ✔✔Combined into female sexual interest/arousal disorder.
, ✔✔HSDD treatments - ✔✔Flibanserin and bremelanotide.
✔✔FGAD treatments - ✔✔L-arginine, topical alprostadil, wellbutrin, oxytocin.
✔✔FOD treatments - ✔✔Directed masturbation is the most researched behavioral
treatment.
✔✔Systemic ET and fibroids - ✔✔Rarely causes fibroids to resume growth.
✔✔Cognition and menopause - ✔✔Difficulty concentrating and remembering are
common.
✔✔Cognition and surgical menopause - ✔✔Memory for verbal information can be
compromised immediately after surgical menopause.
✔✔Mediterranean diet and cognition - ✔✔Small benefit for global cognition and
memory.
✔✔Effect of HRT on cognition - ✔✔Small or no overall effect.
✔✔HRT and dementia risk - ✔✔EPT replacement was shown to double the risk of
developing dementia.
✔✔Reasons HRT may decrease Alzheimer's risk - ✔✔Observational studies imply it;
clinical trial data supports it.
✔✔Migraine headache and pregnancy - ✔✔Typically migraines improve as estrogen
levels stabilize.
✔✔Menstrual migraine treatment - ✔✔NSAID or triptan 2 days before expected period.
✔✔Most common form of arthritis - ✔✔Osteoarthritis.
✔✔Common thyroid disorder in women - ✔✔Hashimoto thyroiditis.
✔✔Cold thyroid nodules - ✔✔Typically most likely to be malignant.
✔✔HRT impact on gallbladder disease - ✔✔Increases risk of gallstones with oral HRT.
✔✔Screening for Hep C start year - ✔✔1992.
✔✔High-risk HPV types - ✔✔16 and 18.
QUESTIONS SET A+
✔✔Aldosterone secretion from the zona reticularis in the adrenal gland is regulated by 3
main factors. - ✔✔Angiotensin II, potassium concentration, adrenocorticotropic hormone
secreted by the anterior pituitary.
✔✔What part of the pituitary gland secretes adrenocorticotropic hormone? - ✔✔Anterior
pituitary.
✔✔Cortisol and HRT - ✔✔Most serum cortisol circulates bound to cortisol binding
globulin.
✔✔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 <40 years 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.
✔✔Physiologic - ✔✔Better than continuous hormonal contraception.
✔✔Menorrhagia treatment - ✔✔IUD plus estrogen patch or continuous HRT.
,✔✔FPHL vs Telogen Effluvium - ✔✔FPHL is gradual, telogen effluvium is sudden and
usually precipitated by a life stressor.
✔✔FPHL pattern - ✔✔Thinning at the crown of the head and widening of the hair part.
✔✔Treating FPHL - ✔✔Minoxidil, spironolactone, finasteride.
✔✔Ethnicity least likely to have bad hot flashes - ✔✔Japanese.
✔✔Ethnicity most likely to have bad hot flashes - ✔✔Black, more frequent, longer
duration.
✔✔Median length of hot flashes - ✔✔10 years.
✔✔Theories about etiology of hot flashes - ✔✔Lower ovarian estradiol thermoregulation
zone is narrowed, neurokinins regulate GnRH secretion.
✔✔VIN low grade - ✔✔Not precancerous.
✔✔VIN high grade - ✔✔Precancerous; requires GYN ONC intervention.
✔✔Most common type of vulvar cancer - ✔✔Squamous cell carcinoma.
✔✔Vulvar disorder misdiagnosed as eczema - ✔✔Paget's disease.
✔✔Normal PVR - ✔✔<100mL.
✔✔Estrogen and urinary incontinence - ✔✔Will NOT help with stress incontinence.
✔✔Topical vaginal estrogen with highest dose - ✔✔Vaginal rings; FEMRING is the
highest.
✔✔Most common cause of vulvovaginitis - ✔✔Bacterial vaginosis (BV).
✔✔Post-menopause burning and discharge - ✔✔Desquamative inflammatory vaginitis;
treat with clindamycin or hydrocortisone + ET.
✔✔Hormones associated with sexual desire in women - ✔✔Circulating androgens.
✔✔BSO and hormone decline - ✔✔Abrupt and persistent decline in circulating
androgen levels.
✔✔HSDD and FSAD - ✔✔Combined into female sexual interest/arousal disorder.
, ✔✔HSDD treatments - ✔✔Flibanserin and bremelanotide.
✔✔FGAD treatments - ✔✔L-arginine, topical alprostadil, wellbutrin, oxytocin.
✔✔FOD treatments - ✔✔Directed masturbation is the most researched behavioral
treatment.
✔✔Systemic ET and fibroids - ✔✔Rarely causes fibroids to resume growth.
✔✔Cognition and menopause - ✔✔Difficulty concentrating and remembering are
common.
✔✔Cognition and surgical menopause - ✔✔Memory for verbal information can be
compromised immediately after surgical menopause.
✔✔Mediterranean diet and cognition - ✔✔Small benefit for global cognition and
memory.
✔✔Effect of HRT on cognition - ✔✔Small or no overall effect.
✔✔HRT and dementia risk - ✔✔EPT replacement was shown to double the risk of
developing dementia.
✔✔Reasons HRT may decrease Alzheimer's risk - ✔✔Observational studies imply it;
clinical trial data supports it.
✔✔Migraine headache and pregnancy - ✔✔Typically migraines improve as estrogen
levels stabilize.
✔✔Menstrual migraine treatment - ✔✔NSAID or triptan 2 days before expected period.
✔✔Most common form of arthritis - ✔✔Osteoarthritis.
✔✔Common thyroid disorder in women - ✔✔Hashimoto thyroiditis.
✔✔Cold thyroid nodules - ✔✔Typically most likely to be malignant.
✔✔HRT impact on gallbladder disease - ✔✔Increases risk of gallstones with oral HRT.
✔✔Screening for Hep C start year - ✔✔1992.
✔✔High-risk HPV types - ✔✔16 and 18.
